Robotic Guided Bilateral Anterior Cingulate Radiofrequency Ablation for Obsessive-Compulsive Disorder
- 1 January 2020
- journal article
- research article
- Published by Medknow in Neurology India
- Vol. 68 (8), 333-336
- https://doi.org/10.4103/0028-3886.302467
Abstract
Background: Bilateral anterior cingulotomy (BAC) constitutes the most commonly performed procedure for treatment of refractory OCD. Evolution of stereotactic procedures has rekindled the interest in the effective management of refractory psychiatric disorders, especially OCD with utmost safety and excellent outcomes. Objective: The aim of this study was to demonstrate the technique of performing BAC under robotic guidance using radiofrequency ablation with an operative video. Procedure: A 23-year-old gentleman diagnosed with symptoms of OCD for a duration of 8 years and was refractory to conventional therapy. The trajectories for BAC were planned on the robotic platform (ROSA, Zimmer-Biomet, Warsaw, Indiana, USA). The target point was selected on the anterior cingulate, approximately 2 cms posterior to the anterior most point of the frontal horn, 2-3 mm above the corpus callosum and 7 mm lateral to the midline. Pre coronal (1 cm anterior and 3 cms lateral to midline) holes of 2.5 mm diameter were made using pneumatic handheld drill. Radiofrequency (RF) thermocoagulation of the anterior cingulum was performed using an RF probe of 2.2 mm diameter and 4 mm uninsulated tip under robotic guidance after confirming the position with intraoperative O-arm imaging bilaterally. Results: The surgery was uneventful and the patient had a significant improvement following surgery, with the Yale Brown Obsessive Compulsive Scale of 18 at 1 year follow-up compared to the preoperative score of 36. Conclusion: Robotic-guided BAC is a safe and effective technique for the treatment of drug-refractory OCD. Intraoperative O arm CT augments the precision of the lesions created.Keywords
This publication has 10 references indexed in Scilit:
- Hypothalamic Hamartoma and Endocrinopathy: A Neurosurgeon's PerspectiveNeurology India, 2020
- Current and future directions of deep brain stimulation for neurological and psychiatric disordersJournal of Neurosurgery, 2019
- Indian guidelines on neurosurgical interventions in psychiatric disordersPublished by Galenos Yayinevi ,2019
- Ablative neurosurgery and deep brain stimulation for obsessive-compulsive disorderIndian Journal of Psychiatry, 2019
- Clinical practice guidelines for Obsessive-Compulsive DisorderIndian Journal of Psychiatry, 2017
- Dorsal anterior cingulotomy and anterior capsulotomy for severe, refractory obsessive-compulsive disorder: a systematic review of observational studiesJournal of Neurosurgery, 2016
- An overview of Indian research in obsessive compulsive disorderIndian Journal of Psychiatry, 2010
- Bilateral Anterior Cingulotomy for Refractory Obsessive-Compulsive Disorder: Long-Term Follow-Up ResultsStereotactic and Functional Neurosurgery, 2006
- Cingulotomy for Psychiatric Disease: Microelectrode Guidance, a Callosal Reference System for Documenting Lesion Location, and Clinical ResultsNeurosurgery, 2004
- Stereotactic cingulotomyNeurosurgery Clinics of North America, 2003