{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:58:48Z","timestamp":1793447928555,"version":"4.5.0"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Stereotactic techniques play an important role in neurosurgery. The development of a miniaturized cranial robot with an efficient workflow and accurate surgical execution is an important step in a broader application of these techniques. Herein, the authors describe their experience with the Medtronic Stealth Autoguide miniaturized cranial robot.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A retrospective review of 75 cases from 2020 to 2022 was performed. The patients who had undergone surgery utilizing the Stealth Autoguide robot were analyzed for surgical indication and accuracy, operative time, and clinical outcome. The outcomes were defined as follows: for stereoelectroencephalography (SEEG), the electrode placement pattern that identified the seizure focus and did not require any revision or additional leads; for biopsy, the percentage of cases in which diagnostic tissue was obtained; and for laser interstitial thermal therapy (LITT), the percentage of cases in which laser fiber placement was adequate for ablation. Surgical complications were defined as any asymptomatic or symptomatic intracerebral hemorrhage, new neurological deficit, or need for electrode, laser fiber, or biopsy needle repositioning or revision.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The Stealth Autoguide robot was utilized in 75 on-label cases, including 40 SEEG cases for seizure focus localization, 19 LITT cases, and 16 stereotactic biopsy cases. The mean real target error (RTE) at the entry was 1.48 \u00b1 0.84 mm for biopsy, 1.36 \u00b1 0.89 mm for Visualase laser fiber placement, and 1.24 \u00b1 0.72 mm for SEEG. The mean RTE at the target was 1.56 \u00b1 0.95 mm for biopsy needle placement, 1.42 \u00b1 0.93 mm for Visualase laser fiber placement, and 1.31 \u00b1 0.87 mm for SEEG electrode placement. The surgical time for unilateral SEEG cases took an average 52 minutes (average 6.5 mins\/lead, average 8 electrodes). Bilateral SEEG cases took an average 105 minutes (average 7.5 mins\/lead, average 14 electrodes). In the SEEG population, there were no revised or unsuccessful seizure localizations. For biopsy, diagnostic tissue was obtained in 100% of cases. For LITT, fiber placement was adequate for ablation in 100% of cases. There were no cases of symptomatic or asymptomatic intracerebral hemorrhage, and no cases required repositioning or replacement of the laser fiber, electrode, or biopsy needle. One patient experienced transient cranial nerve III palsy following laser ablation that resolved in 10 weeks. A failure of communication between the robotic platform and the Stealth Autoguide as a station required the cancellation of 1 procedure.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The Medtronic Stealth Autoguide robot system is versatile across biopsy, SEEG, and laser ablation indications. Setup and surgical execution are efficient with a high degree of accuracy and consistency.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.4.jns232701","type":"journal-article","created":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T03:09:05Z","timestamp":1720235345000},"page":"1520-1526","source":"Crossref","is-referenced-by-count":12,"title":["Initial United States experience with Medtronic Stealth Autoguide cranial robotic guidance platform"],"prefix":"10.3171","volume":"141","author":[{"given":"Nadia A.","family":"Atai","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Hoag Memorial Hospital, Newport Beach, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek A.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hoag Memorial Hospital, Newport Beach, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Stereotact Funct Neurosurg","first-page":"343","article-title":"Preclinical evaluation of the Stealth Autoguide robotic guidance device for stereotactic cranial surgery: a human cadaveric study","volume":"99","author":"Brandman D","year":"2021","unstructured":"Brandman D, Hong M, Clarke DB. Preclinical evaluation of the Stealth Autoguide robotic guidance device for stereotactic cranial surgery: a human cadaveric study. Stereotact Funct Neurosurg. 2021;99(4):343\u2013350."},{"issue":"5","key":"b2","series-title":"J Neurosurg","first-page":"1622","article-title":"A novel miniature robotic device for frameless implantation of depth electrodes in refractory epilepsy","volume":"126","author":"Dorfer C","year":"2017","unstructured":"Dorfer C, Minchev G, Czech T,  A novel miniature robotic device for frameless implantation of depth electrodes in refractory epilepsy. J Neurosurg. 2017;126(5):1622\u20131628."},{"issue":"3","key":"b3","series-title":"J Neurosurg","first-page":"985","article-title":"A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot","volume":"126","author":"Minchev G","year":"2017","unstructured":"Minchev G, Kronreif G, Mart\u00ednez-Moreno M,  A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot. J Neurosurg. 2017;126(3):985\u2013996."},{"issue":"2","key":"b4","series-title":"J Neurosurg","first-page":"479","article-title":"Development of a miniaturized robotic guidance device for stereotactic neurosurgery","volume":"137","author":"Minchev G","year":"2021","unstructured":"Minchev G, Wurzer A, Ptacek W,  Development of a miniaturized robotic guidance device for stereotactic neurosurgery. J Neurosurg. 2021;137(2):479\u2013488."},{"issue":"4","key":"b5","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e150","article-title":"Placement of stereotactic electroencephalography depth electrodes using the Stealth Autoguide robotic system: technical methods and initial results","volume":"22","author":"Tay ASS","year":"2022","unstructured":"Tay ASS, Menaker SA, Chan JL, Mamelak AN. Placement of stereotactic electroencephalography depth electrodes using the Stealth Autoguide robotic system: technical methods and initial results. Oper Neurosurg (Hagerstown). 2022;22(4):e150\u2013e157."},{"issue":"2","key":"b6","series-title":"Neurosurgery","first-page":"222","article-title":"Robot-assisted stereotaxy reduces target error: a meta-analysis and meta-regression of 6056 trajectories","volume":"88","author":"Philipp LR","year":"2021","unstructured":"Philipp LR, Matias CM, Thalheimer S, Mehta SH, Sharan A, Wu C. Robot-assisted stereotaxy reduces target error: a meta-analysis and meta-regression of 6056 trajectories. Neurosurgery. 2021;88(2):222\u2013233."},{"issue":"3","key":"b7","series-title":"J Neurosurg Pediatr","first-page":"297","article-title":"Accuracy of robot-assisted versus optical frameless navigated stereoelectroencephalography electrode placement in children","volume":"23","author":"Sharma JD","year":"2019","unstructured":"Sharma JD, Seunarine KK, Tahir MZ, Tisdall MM. Accuracy of robot-assisted versus optical frameless navigated stereoelectroencephalography electrode placement in children. J Neurosurg Pediatr. 2019;23(3):297\u2013302."},{"issue":"5","key":"b8","series-title":"Epilepsia","first-page":"841","article-title":"How technology is driving the landscape of epilepsy surgery","volume":"61","author":"Dorfer C","year":"2020","unstructured":"Dorfer C, Rydenhag B, Baltuch G,  How technology is driving the landscape of epilepsy surgery. Epilepsia. 2020;61(5):841\u2013855."},{"issue":"1","key":"b9","series-title":"Neurosurg Rev","first-page":"5","article-title":"Advances, technological innovations, and future prospects in stereotactic brain biopsies","volume":"46","author":"Bex A","year":"2022","unstructured":"Bex A, Mathon B. Advances, technological innovations, and future prospects in stereotactic brain biopsies. Neurosurg Rev. 2022;46(1):5."},{"issue":"6","key":"b10","series-title":"J Neurosurg Case Lessons","first-page":"CASE21556","article-title":"Stealth Autoguide for robotic-assisted laser ablation for lesional epilepsy: illustrative case","volume":"3","author":"Mazur-Hart DJ","year":"2022","unstructured":"Mazur-Hart DJ, Yaghi NK, Shahin MN, Raslan AM. Stealth Autoguide for robotic-assisted laser ablation for lesional epilepsy: illustrative case. J Neurosurg Case Lessons. 2022;3(6):CASE21556."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/6\/article-p1520.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/6\/article-p1520.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/6\/article-p1520.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T15:45:01Z","timestamp":1734018301000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/6\/article-p1520.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":10,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2024.4.jns232701","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,1]]}}}