Services and Programs | Pediatric Neurosurgery | UC Davis Health

In robot-assisted epilepsy surgery, a robotic system is employed to enhance the surgeon's precision during the procedure. This technology allows for more accurate placement of electrodes or probes in the brain, which are used in procedures like stereoelectroencephalography (SEEG), deep brain stimulation (DBS), and responsive neurostimulation (RNS) to identify specific areas responsible for seizures (SEEG) or to target areas for neuromodulation (DBS and RNS).  Robot-assisted surgery is also used to help precisely target specific regions of the brain in laser interstitial thermal therapy  (LITT).

The use of robotics in epilepsy surgery aims to improve surgical outcomes, minimize invasiveness, and reduce the risk of complications. The surgeon controls the robotic system, that can be precisely guided to the targeted area in the brain. This technology facilitates minimally invasive approaches, shorter recovery times, and potentially better results for patients with epilepsy who undergo surgical interventions.

Neuronavigation aims to enhance the surgeon's ability to navigate through delicate and complex structures in the nervous system, providing real-time guidance during the procedure. This can contribute to minimizing damage to healthy tissue, reducing the risk of complications, and improving the overall precision and effectiveness of the surgery.

Minimally invasive endoscopic repair of craniosynostosis is a special surgery to fix a problem with the bones in a infant's skull. In some infants, these bones join together too early, and it can affect the way the head grows. In this procedure, surgeons use an endoscope, a thin tube with a light and camera at the end, to visualize and guide the surgery through small incisions. This approach is associated with benefits such as reduced scarring, shorter recovery times, and potentially less trauma to the surrounding tissues compared to traditional open surgeries for craniosynostosis.

Laser interstitial thermal therapy, or LITT, is a minimally invasive treatment that uses the power of laser light to focus on and treat specific areas inside the brain. The laser is introduced through a bolt in the skull that is placed very precisely using stereotactic or robotic guidance. Once the laser is in place, it produces heat to precisely treat the affected tissue.  This is done in the MRI suite so that the volume of tissue treated can be visualized in real time. This kind of treatment is often used for conditions like brain tumors or epilepsy.

Endoscopic treatment of hydrocephalus is a special procedure to help with a condition called hydrocephalus. Hydrocephalus happens when there is too much fluid in the brain, causing harmful pressure. The goal of these treatments is to permanently treat hydrocephalus without using catheters or any permanent implantations. There are two types of endoscopic treatments commonly used.

ETV (Endoscopic third ventriculostomy): This involves using a small camera (endoscope) to create a small hole in the floor of one of the fluid-filled cavities (the third ventricle) in the brain. This minimally invasive procedure creates a new pathway for excess fluid to drain, relieving pressure in the brain. 

CPC (Choroid plexus coagulation): This procedure involves using the endoscope to cauterize or coagulate a part of the brain called the choroid plexus, which normally contributes to fluid production. In combination with the ETV, this additional procedure improves the likelihood of controlling hydrocephalus in infants.

The Endoscopic endonasal and eyebrow approaches for skull base tumors are special surgeries to remove tumors at the bottom part of the skull. 

Endoscopic endonasal approach: This involves going through the nostrils to reach the skull base. The endoscope helps the surgeon see and remove the tumor without making external incisions on the face or scalp. The procedure is done a joint procedure with colleagues from the ear, nose, and throat (ENT) surgical team.

Eyebrow approach: This alternative approach involves making a small incision in the eyebrow region, and the endoscope is used to guide the surgery to the skull base. This method is also less invasive than traditional open surgeries.

Both approaches aim to remove the tumor while minimizing damage to surrounding healthy tissue. These techniques often result in less scarring, a faster recovery time, and a reduced risk of complications compared to traditional open surgeries.