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Neuromate Robot Helps Deliver Deep Brain Stimulation to World’s Youngest Patient

Stereotactic robot helps identify target and deliver electrodes to target with submillimetric accuracy

Published: Monday, August 26, 2019 - 11:00

(Renishaw: Wotton-under-Edge, Gloucestershire) -- The youngest patient in the world to receive deep brain stimulation has undergone surgery at Evelina London Children’s Hospital in London. The aim of the procedure was to help the patient, Viktoria Kaftanikaite, who was just two years old, to manage her symptoms of dystonia. The procedure was carried out in partnership with King’s College Hospital, also in London, and with assistance from Renishaw’s neuromate stereotactic robot.

During the procedure, two stimulation electrodes were implanted into a part of the brain known as the globus pallidus internus, an area concealed deep within the brain that is responsible for the control of movement. A device called a neurostimulator then sends electrical impulses, via the electrodes, to change brain activity in a controlled manner.

For the procedure to be successful, the contact points at the tip of the electrode must be precisely aligned with the target anatomy. Carrying out the procedure on a patient as young as 2 years is particularly challenging for a number of reasons, one of which is that the space within the skull is small and difficult to navigate. Renishaw’s range of products for stereotactic neurosurgery is designed to aid neurosurgeons in identifying the position of the target and deliver implantable electrodes to the chosen target with accuracy and safety.

Renishaw neuromate robot with neurolocate module. Click here for larger image.

The procedure began with the team creating a customized surgical plan using Renishaw’s neuroinspire neurosurgical planning software. Crucially the chosen trajectory must avoid key anatomy and blood vessels. Magnetic resonance imaging and computerized tomography scan data were uploaded into the software, allowing neurosurgeons to visualize the anatomy of the patient and identify the safest route to target. Once a route has been chosen, the neuromate robot is then able to move into position to align the surgical instruments along the pre-planned trajectory.

An additional challenge with performing this kind of surgery on a patient so young is that as the child grows, the brain anatomy will move in relation to the electrode. In preparation for this, the neurosurgeons chose to implant the electrodes with Renishaw’s neuroguide electrode delivery system. The neuroguide delivery system includes a long-term implantable guide tube which stays in place as the patient grows. The aim of implanting the guide tube is to allow for easy revisional surgery in the future.

Neurosurgeons Richard Selway and Haru Hasegawa, who performed the surgery, comment on the performance of Renishaw’s technology. “The Renishaw neuromate robot, with the 3D neurolocate technology, enabled reliable and accurate placement of the electrodes into the target deep inside the patient’s brain,” they say. “The implantable guide tubes that we used in this case allow electrode revisions without the need for stereotactic equipment, which is a significant advantage in this group of patients.”

“We are delighted to hear of the success of this highly complex procedure, and we send our best wishes to Viktoria and her family as she continues to recover,” says Paul Skinner, general manager for Renishaw’s neurological products division. “We’re excited about the implications of this procedure for other young patients who might benefit from surgery, and we look forward to continuing our support to Evelina London Children’s Hospital in the future.”

Evelina London is celebrating its 150th anniversary this year. The hospital was founded in 1869 as Evelina Hospital for Sick Children by Baron Ferdinand de Rothschild, whose wife, Evelina, died along with their baby in childbirth.

Further information on neurosurgical products and systems at www.renishaw.com.


About The Author

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Renishaw is a global company with core skills in precision measurement, motion control, healthcare, spectroscopy, and manufacturing. The company supplies products and services used in applications as diverse as jet engine and wind turbine manufacturing to dentistry and brain surgery. Also a world leader in additive manufacturing, Renishaw designs and makes industrial 3D printers. Between 13 and 18-percent of annual sales are invested in R&D and engineering. The Renishaw Group has more than 80 offices in 36 countries, with 5,000+ employees.