Luh, Hui-TzungHui-TzungLuhZhu, ChunranChunranZhuLU-TING KUOLo, Wei-LunWei-LunLoLiu, Heng-WeiHeng-WeiLiuSu, Yu-KaiYu-KaiSuSu, I-ChangI-ChangSuLin, Chien-MinChien-MinLinDAR-MING LAISUNG-TSANG HSIEHLin, Ming-ChinMing-ChinLinABEL PO-HAO HUANG2024-11-152024-11-152024-06-1109296646https://scholars.lib.ntu.edu.tw/handle/123456789/723083Background: Spontaneous intracerebral hemorrhage (ICH) accounts for up to 20% of all strokes and results in 40% mortality at 30 days. Although conservative medical management is still the standard treatment for ICH patients with small hematoma, patients with residual hematoma ≤15 mL after surgery are associated with better functional outcomes and survival rates. This study reported our clinical experience with using Robotic Stereotactic Assistance (ROSA) as a safe and effective approach for stereotactic ICH aspiration and intra-clot catheter placement. Methods: A retrospective analysis was conducted of patients with spontaneous ICH who underwent ROSA-guided ICH aspiration surgery. ROSA-guided ICH surgical techniques, an aspiration and intra-clot catheter placement protocol, and a specific operative workflow (pre-operative protocol, intraoperative procedure and postoperative management) were employed to aspirate ICH using the ROSA One Brain, and appropriate follow-up care was provided. Results: From September 14, 2021 to May 4, 2022, a total of 7 patients were included in the study. Based on our workflow design, ROSA-guided stereotactic ICH aspiration effectively aspirated more than 50% of hematoma volume (or more than 30 mL for massive hematomas), thereby reducing the residual hematoma to less than 15 mL. The mean operative time of entire surgical procedure was 1.3 ± 0.3 h, with very little perioperative blood loss and no perioperative complications. No patients required catheter replacement and all patients' functional status improved. Conclusions: Within our clinical practice ROSA-guided ICH aspiration, using our established protocol and workflow, was safe and effective for reducing hematoma volume, with positive functional outcomes.entrueICH aspirationIntra-clot thrombolysisROSARobotic stereotactic assistanceSpontaneous intracerebral hemorrhage[SDGs]SDG2[SDGs]SDG3journal article10.1016/j.jfma.2024.05.018388666942-s2.0-85195643654