2026/11/15 08:30-10:10 Room 301
- ICH Diagnosis & Treatment
- Time
- Topic
- Speaker
- Moderator
- 08:30-09:00
- Case Selection and Experience of Robotic ICH Aspiration
- SPEAKER:
Chun-Chung Chen
陳春忠
Taiwan (台灣)
- MODERATOR:
Chao-Liang Chou
周兆亮
Taiwan (台灣)
Po-Hao Huang
黃博浩
Taiwan (台灣)
- Chun-Chung Chen
- MD PhD
-
Director of Neurosurgery department of CMUH, Director
E-mail：cck36701@gmail.com
Lecture Abstract：
Endoscopic Surgery Versus Robot-assist Surgery for Basal Ganglion Intracerebral Hemorrhage: A Single Center Experienc
Abstract
Background: Spontaneous basal ganglia intracerebral hemorrhage (ICH) is associated with high morbidity and mortality. Minimally invasive surgical (MIS) approaches, including endoscopic surgery (ES) and stereotactic robotic-assisted surgery (RAS), are increasingly replacing open craniotomy. This study compares the clinical efficacy, perioperative metrics, and radiological outcomes between ES and RAS for basal ganglia ICH.
Methods: A retrospective comparative analysis evaluated 110 consecutive patients with basal ganglia ICH (20–50 mL) treated between April 2020 and January 2026: Group 1 (ES, n=42) and Group 2 (RAS, n=68). Perioperative parameters, radiological outcomes, and clinical recovery were statistically analyzed.
Results: Baseline demographics, initial GCS score (9.74±3.64 vs. 10.06±4.66, p=0.705), and pre-procedure hematoma volume (32.80±8.81 vs. 31.50±9.66" mL" , p=0.483) were comparable. ES achieved a significantly higher immediate hematoma clearance rate (92.0±8.6% vs. 73.3±33.1%, p<0.001), lower residual volume (2.50±2.56 vs. 9.13±15.27" mL" , p=0.006), and greater midline shift reduction (2.69±2.05 vs. 1.63±2.56" mm" , p=0.025). Conversely, RAS demonstrated significantly shorter operative time (85.12±32.80 vs. 149.26±43.82" min" , p<0.001) and lower blood loss (17.13±26.00 vs. 107.26±118.67" mL" , p<0.001), though requiring longer preparation time (107.60±32.87 vs. 72.19±20.89" min" , p<0.001) and more follow-up CT scans (3.82±1.12 vs. 2.81±0.83, p<0.001) due to post-operative thrombolysis. Ninety-day functional recovery (mRS 3.36±1.48 vs. 3.18±1.39, p=0.520; favorable outcome rate 52% vs. 57%, p=0.614) was comparable.
Conclusion: Both ES and RAS are effective and safe minimally invasive options for basal ganglia ICH. Endoscopic surgery provides superior immediate mass effect relief and immediate hematoma evacuation. Robotic-assisted surgery offers minimal intraoperative tissue trauma, shorter operative duration, and negligible blood loss, though it requires longer preoperative setup and frequent post-operative thrombolysis to achieve optimal hematoma resolution.
Endoscopic Surgery Versus Robot-assist Surgery for Basal Ganglion Intracerebral Hemorrhage: A Single Center Experienc
Abstract
Background: Spontaneous basal ganglia intracerebral hemorrhage (ICH) is associated with high morbidity and mortality. Minimally invasive surgical (MIS) approaches, including endoscopic surgery (ES) and stereotactic robotic-assisted surgery (RAS), are increasingly replacing open craniotomy. This study compares the clinical efficacy, perioperative metrics, and radiological outcomes between ES and RAS for basal ganglia ICH.
Methods: A retrospective comparative analysis evaluated 110 consecutive patients with basal ganglia ICH (20–50 mL) treated between April 2020 and January 2026: Group 1 (ES, n=42) and Group 2 (RAS, n=68). Perioperative parameters, radiological outcomes, and clinical recovery were statistically analyzed.
Results: Baseline demographics, initial GCS score (9.74±3.64 vs. 10.06±4.66, p=0.705), and pre-procedure hematoma volume (32.80±8.81 vs. 31.50±9.66" mL" , p=0.483) were comparable. ES achieved a significantly higher immediate hematoma clearance rate (92.0±8.6% vs. 73.3±33.1%, p<0.001), lower residual volume (2.50±2.56 vs. 9.13±15.27" mL" , p=0.006), and greater midline shift reduction (2.69±2.05 vs. 1.63±2.56" mm" , p=0.025). Conversely, RAS demonstrated significantly shorter operative time (85.12±32.80 vs. 149.26±43.82" min" , p<0.001) and lower blood loss (17.13±26.00 vs. 107.26±118.67" mL" , p<0.001), though requiring longer preparation time (107.60±32.87 vs. 72.19±20.89" min" , p<0.001) and more follow-up CT scans (3.82±1.12 vs. 2.81±0.83, p<0.001) due to post-operative thrombolysis. Ninety-day functional recovery (mRS 3.36±1.48 vs. 3.18±1.39, p=0.520; favorable outcome rate 52% vs. 57%, p=0.614) was comparable.
Conclusion: Both ES and RAS are effective and safe minimally invasive options for basal ganglia ICH. Endoscopic surgery provides superior immediate mass effect relief and immediate hematoma evacuation. Robotic-assisted surgery offers minimal intraoperative tissue trauma, shorter operative duration, and negligible blood loss, though it requires longer preoperative setup and frequent post-operative thrombolysis to achieve optimal hematoma resolution.
