Events & News

Image

Northeast Regional Epilepsy Group and Atlantic Health System bring the Rosa System to persons living with epilepsy in the tri-state area.

Today, we sat down with epileptologist, Dr. Jeffrey Politsky, Associate Director and Co-Director of Research of the Northeast Regional Epilepsy Group, Medical Director, MEG & Functional Brain Mapping Center, and Atlantic Neuroscience Institute Epilepsy Center.  We asked him about a new and groundbreaking robotic device (ROSA®) that will soon be available to persons with epilepsy at Atlantic Health System hospitals.  

What is ROSA®?  

It is a robotic device approved by the U.S. Food and Drug Administration that can be used to perform minimally invasive neurosurgical procedures, most specifically the placement of depth electrodes in the brain of an epilepsy patient to assist with pinpointing exactly where epileptic seizures originate. It's the only robotic assistant approved for neurosurgical procedures in the United States. 

What can it be used for?

It can be used for all types of cranial interventions that require precise location of the patient's anatomy, pre-operative data to better plan out neurosurgery, and accurate positioning and handling of instruments. The ROSA® can assist the neurosurgeon with biopsies, electrode implantation, and open skull surgical procedures requiring a navigation device.  

Comparative studies have found ROSA® significantly reduces operating room time and has low complication rates of < 1% hemorrhage rate per electrode. Certainly, using ROSA® Brain guidance increases accuracy as well. 

How does it work:

The device uses facial recognition technology to create a map of the patient's brain. The surgeon uses ROSA Brain and its planning software to create a 3D map of the patient's brain. Using that information, the surgeon creates trajectories or courses for the procedures and the robotic arm assists with the rest of the procedure.

Why is it considered "minimally invasive?"

Well, that is because it is significantly less invasive than a craniotomy, where a bone flap is removed from the skull to gain access the brain. Using the robotic device, the surgeon can make several pinhole-size openings in the scalp and enter through these incisions instead.

Are there any risks associated to this system?

As with any surgery there are some risks. The most common risks include vascular injury, inflammation, and/or infection. However, these risks are less likely to occur compared to an open craniotomy, which involves a larger incision for greater exposure to the surface of the brain. Regardless of which neurosurgical procedure is thought to be optimal for a patient, he or she will have the opportunity to discuss the process in depth with the epilepsy specialist and the neurosurgeon.

How long is the recovery?

With the ROSA robotic device, symptoms after implant and removal are minimal, which makes recovery significantly shorter and more tolerable than traditional epilepsy surgery. With the ROSA robotic device, most patients feel back to normal within a day or two, compared to several weeks after a craniotomy. The risk for infection is much lower too with ROSA compared to a traditional craniotomy.

Are there specific reasons why a patient might be a better candidate for ROSA® than for traditional neurosurgery?

Almost any epilepsy surgery case could be planned using ROSA. Perhaps the most ideal epilepsy surgery cases are those where there is more than one potential epileptic focus or where the epileptic focus is presumed to be located well beneath the cortical surface. Additional tests such as a MEG, MRI, and continuous video-EEG are very important in the surgical planning process. The process leading to epilepsy surgery is detailed and complex, but worth it because of the possibility of having a much better quality of life.

This all sounds amazing! How would a patient inquire about the ROSA® and determine if he/she is a good candidate for this?  

Patients can call any of our office numbers for more information and to make an appointment with an epilepsy specialist. 

908-522-4990 (Summit);

973-695-8033 (Morristown);

732-828-1373 (Hopewell; New Brunswick);

201-343-6676 (Hackensack);

Before being referred to an epilepsy surgeon, patients will undergo a variety of tests including inpatient continuous video EEG to confirm the diagnosis and capture and record typical events or seizures. Other tests include MEG, PET, MRI and cognitive testing. Once all of that is done, the patient's case is discussed in a conference format with the entire epilepsy team including the neurosurgeon to ensure the patient is an appropriate surgical candidate. Then the patient is referred for a consultation with the neurosurgeon, to review everything, ask any questions directly to the surgeon, and potentially to select a date for the procedure.

Based on the results of the intra-cranial evaluation, subsequent recommendations will be made to the patient regarding the next best steps to treat his/her epilepsy.

Does health insurance cover this?  

Yes, Insurance covers the use of the ROSA. Patients should always check with their carrier, as policies may have certain restrictions and variations.

 

Twitter Facebook