Robot-assisted versus frame-based stereoelectroencephalography (sEEG) electrode implantation in drug-resistant epilepsy: a meta-analysis of accuracy, efficiency, and safety

Category	Detail
Condition	Drug-resistant epilepsy requiring precise localization of epileptogenic zone
Key Mechanisms	Stereoelectroencephalography (sEEG) electrode implantation for intracranial EEG recording to localize epileptogenic zone
Target Population	Patients with focal drug-resistant epilepsy undergoing presurgical evaluation
Care Setting	Epilepsy centers performing invasive intracranial monitoring and epilepsy surgery

Robot-assisted sEEG offers greater planning flexibility allowing complex, nonlinear electrode trajectories compared to frame-based stereotaxy.
Robot-assisted systems demonstrate comparable or superior submillimetric accuracy and reduced operative times relative to frame-based methods.
Safety profiles of robot-assisted sEEG are favorable with complication rates comparable to or lower than frame-based approaches.

Use sEEG for precise localization of epileptogenic zone when non-invasive modalities fail to localize seizure focus.

Consider robot-assisted sEEG implantation for improved trajectory planning and operative efficiency.
Frame-based stereotaxy remains a reliable standard for electrode placement accuracy.

Monitor for intracranial hemorrhage and other complications post electrode implantation.
Use postoperative imaging to verify electrode placement accuracy.

Potential complications include intracranial hemorrhage; complication rates are similar or lower with robot-assisted techniques.

Patients with drug-resistant focal epilepsy undergoing sEEG electrode implantation

Robot-assisted sEEG may enhance surgical planning and reduce operative time without increasing complication risk.

Employ robot-assisted systems to enable flexible, nonlinear electrode trajectories inaccessible by frame-based methods.
Ensure multidisciplinary team involvement for accurate planning and verification of electrode placement.
Adhere to standardized protocols for preoperative imaging, intraoperative navigation, and postoperative assessment.
Select implantation technique based on center expertise, available technology, and patient-specific anatomical considerations.

Clinical Scorecard: Comparative Analysis of Robot-Assisted and Frame-Based Stereoelectroencephalography (sEEG) Electrode Placement in Patients with Drug-Resistant Epilepsy: Assessing Accuracy, Efficiency, and Safety Through Meta-Analysis