Background Stereoelectroencephalography (SEEG) electrodes are implanted using a variety of stereotactic technologies to treat refractory epilepsy. The value of the SINO robot for SEEG electrode implantation is not yet defined. The aim of the current study was to assess the value of the SINO robot in conjunction with Angio Render technology for SEEG electrode implantation and to assess its efficacy.

Methods Between June 2018 and October 2020, 58 patients underwent SEEG electrode implantation to resect or ablate their epileptogenic zone (EZ). The SINO robot and the Angio Render technology was used to guide the electrodes and visualize the individual vasculature in a three-dimensional (3D) fashion. The 3D view functionality was used to increase the safety and accuracy of the electrode implantation, and for reducing the risk of hemorrhage by avoiding blood vessels.

Results In this study, 634 SEEG electrodes were implanted in 58 patients, with a mean of 10.92 (range: 5–18) leads per patient. The mean entry point localization error (EPLE) was 0.94 ± 0.23 mm (range: 0.39–1.63 mm), and the mean target point localization error (TPLE) was 1.49 ± 0.37 mm (range: 0.80–2.78 mm). The mean operating time per lead (MOTPL) was 6. 18 ± 1.80 minutes (range: 3.02–14.61 minutes). The mean depth of electrodes was 56.96 ± 3.62 mm (range: 27.23–124.85 mm). At a follow-up of at least 1 year, in total, 81.57% (47/58) patients achieved an Engel class I seizure freedom. There were two patients with asymptomatic intracerebral hematomas following SEEG electrode placement, with no late complications or mortality in this cohort.

Conclusions The SINO robot in conjunction with Angio Render technology-in SEEG electrode implantation is safe and accurate in mitigating the risk of intracranial hemorrhage in patients suffering from drug-resistant epilepsy.

R.J. conceived and coordinated the study. S.SW. and R.J. signed, performed, and analyzed the experiments, and wrote the manuscript. Y.D. and J.Z., Z.Q. performed data collection and data analysis. S.SS. revised the manuscript. Z.C. statistical analysis. All the authors reviewed the results and approved the final version of the manuscript.

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Received: 25 July 2023

Accepted: 17 January 2024

Accepted Manuscript online:
04 April 2024

Article published online:
03 July 2024

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