Dr. Ramesh Doddamani Podcast

This video presents the technique and surgical nuances of robotic stereoelectroencephalography (sEEG) in patients with drug-resistant epilepsy who require invasive monitoring to localize the epileptogenic zone.

sEEG is a minimally invasive neurosurgical method that places depth electrodes into the brain to record electrical activity from deep and cortical structures with high spatial resolution. When combined with robotic guidance, such as the ROSA platform, electrode placement becomes more accurate, efficient, and safer, reducing operative time and manual targeting errors.

In this video, the surgical team demonstrates:

🔹 Preoperative planning using 3D imaging for accurate electrode trajectories
🔹 Robot-assisted registration and trajectory execution
🔹 Entry point localization and skull drilling
🔹 Depth electrode insertion into target epileptogenic regions
🔹 Intraoperative verification of electrode position
🔹 Safety strategies to avoid vasculature and critical structures

Robotic sEEG allows comprehensive sampling of deep and eloquent brain regions, including the insula, mesial temporal structures, cingulate gyrus, and frontal operculum, with minimal invasiveness. This technique is essential in complex epilepsy cases where noninvasive modalities (EEG, PET, MRI) fail to precisely define the seizure onset zone.

By combining advanced imaging, robotic precision, and meticulous surgical planning, robotic sEEG enhances the diagnosis and surgical decision-making process for patients with refractory epilepsy, ultimately improving outcomes and guiding tailored resective or ablative procedures.