Dr. Jeng-Hung GuoTaiwan
Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan
| 2016/12 to present | Attending Physician of Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan |
| 2023/6 to present | Deputy Secretary-General, Taiwan Society for Neurovascular and Interventional Surgery |
| 2016 - | Attending Physician of Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan |
| 2017 - 2018 | Attending Physician of Neurosurgery, China Medical University Beigang Hospital |
| 2009/09 - 2015/06 | Residency, Department of Neurosurgery, China Medical University, Taichung, Taiwan |
| 2015/07 - 2016/06 | Fellowship, Department of Neurosurgery, China Medical University, Taichung, Taiwan |
| 2018/03 - 2020/03 | IAT certification |
| 2020/04 - 2022/09 | INR certification |
Mechanical thrombectomy for acute ischemic stroke (TSNIS IAT)
Interventional Neuroradiology (TSNIS INR)
Robot-Assisted Surgery in Brain and Spine
Minimal invasive spinal surgery
The preliminary result of Robotic-assisted putaminal ICH aspiration with NaoTrac System and the associated diffusion tensor imaging finding
1109 10:20-10:30
AI & New Technology/304B
Introduction: The intracranial hemorrhage (ICH) accounts for 15~20% of all strokes. The goal of the treatment is to coagulate the bleeder, eliminate the mass effect of the hematoma, reduce the perihematomal edema, and facilitate neurologic recovery. The ICH score is a useful scoring system to estimate the 30-d mortality rate, and also to set up clinical treatment protocols. The minimal invasive ICH aspiration not only reduces the mass effect of the hematoma, but also reduces the secondary injury to the brain. We also use the diffuse tensor imaging (DTI) to predict the outcome of motor function after ICH aspiration.
Objective: For ICH score 0-1, the 30-day mortality rate is very low. So, the neurologic outcome is quite important, influencing the quality of life. We try to remove the hematoma with the least damage method, to reduce the mass effect and the perihematomal edema, and correlate the functional outcome with DTI imaging.
Methods: Records of the patients with acute putaminal ICH presenting to China Medical University Hospital. We use the Robotic navigation machine, NaoTrac, the machine-vision registration system, to help aspirate the hematoma 3 days later.
Results: Enroll all 10 patients presenting putaminal ICH with muscle strength ≤ 3 in a clinical trial in China Medical University Hospital since 2022/10. The average registration time was 56.5 seconds. The average surface registration accuracy was 0.22 mm. The average surgical time was 59.5 minutes. In our cases, the average rate of hematoma aspiration was 83.6%. From the diffuse tensor imaging (DTI) 1 day preoperatively and 7 days postoperatively, we found that the corticospinal tract, compressed by the hematoma, returned to normal position. With NaoTrac, the surgical instruments could be precisely guided to the targeted lesion, making it easier to remove the hematoma and accelerate the functional recovery.
Conclusions: Using the NaoTrac robotic navigation system, we can register the patient/instrument quickly, aspirate the hematoma easily, quickly, and safely with high accuracy, and eliminate the influence on the surrounding neural fibers, which can be visualized on diffuse tensor imaging postoperatively.