Ground-breaking surgery for those with epilepsy
The causes of different epilepsies can be complex and sometimes hard to identify. But a remarkable procedure using a surgical robot could be the answer to curing people of the condition once and for all
Awoman who was experiencing up to six epileptic fits a day for years has become the first person in Wales to be cured of the condition using a robot.
The stereoelectroencephalography (SEEG) procedure, conducted at the University Hospital of Wales, in Cardiff, was carried out with the help of the neuromate stereotactic robot, made by Renishaw.
The aim of the groundbreaking surgery is to identify which region of the brain is acting as a source for the epileptic seizures and remove it.
The robot’s job is to position probes accurately and steadily deep into the brain during surgery using MRI scanning images.
Surgeons were then able to use electrodes to measure signals from the brain during a fit, allowing them to pinpoint the area of the brain responsible for the epilepsy.
During the UHW operation, Professor William Gray used the neuromate’s robotic arm and spent 55 minutes identifying and operating on the “epileptogenic zone” in a procedure that would normally take four hours.
It is understood that the patient, from Port Talbot, has not suffered any fits since the pioneering operation in March this year.
According to latest figures, 90% of patients who have undergone the procedure using the neuromate have been cured of their epilepsy.
Andrea Richards, directorate manager for neurosciences at Cardiff and Vale University Health Board, said: “This is the first neurosurgical procedure to be carried out with robotic assistance in Wales.
“Neurosurgical patients will now spend less time in the operating theatre, have a reduced risk of infection and benefit from improved surgical outcomes.”
Now used in hospitals around the world, including seven in the UK, neuromate is claimed to be both faster and more accurate than conventional manual techniques which typically require a patient’s head to be fixed to a frame and depend on continuous use of manual measurement devices.
Prof Gray, professor of functional neurosurgery at Cardiff University’s School of Medicine, is also a director of the university’s Brain Repair and Intracranial Neurotherapeutics (BRAIN) Unit.
The unit brings together experts from Cardiff University, Swansea University, Bangor University and the NHS and is funded by Health and Care Research Wales.
Overseen by the Welsh Government, the organisation supports the development and delivery of worldclass health and social care research.
“The Renishaw robot is a significant step forward for epilepsy surgery in Wales, enabling us to investigate and treat even the most complex cases, to achieve seizure freedom for our patients,” said Prof Gray. “In collaboration with the BRAIN Unit, it will also enable us to perform leading research for measuring brain signals and delivering therapies directly into the brain, across many neurological diseases.” In the past, implantation of electrodes for deep brain stimulation (DBS) has typically required the patient to be awake so surgeons can be sure they’re not damaging any critical structures. But according to Anna Ritchie, from Renishaw’s Neurological Products Division, the accuracy of neuromate allows this procedure to be performed under general anaesthetic. Dr Abed Hammoud, CEO of Renishaw Mayfield SA (Switzerland) commented: “We are delighted to hear that our expertise in technology and engineering contributed to a positive result at the University Hospital of Wales, and look forward to working closely with the neuroscience department to deliver best possible outcomes for patients in Wales.”
The Renishaw Healthcare Centre of Excellence, based in Miskin, Rhondda Cynon Taff, was built in 2011 and opened by First Minister Carwyn Jones after it was acquired from Bosch.
The 461,000-sq-ft site houses a full production engineering facility and the UK’s only dedicated production line for making additive manufacturing machines.
The new centre was established as a manufacturing base for the company’s medical products, as well as an education and training centre for the life sciences community.
It houses a mock operating theatre for the training and professional development of surgeons and a facility for the manufacture of customised medical implants produced using Renishaw’s metal 3D printing systems.
In the state-of-the-art theatre suite, which enables X-ray use, surgeons can be trained to perform highly complex stereotactic neurosurgery procedures using the Renishaw range of neurological products.
The company’s success has been recognised with numerous international awards, including 18 Queen’s Awards recognising achievements in technology, export and innovation.