This is the pioneering moment a teenage boy became one of the first children in the UK to have his epilepsy cured by a robot which created a ‘sat-nav’ of his brain.
Billy Whitaker, 15, had suffered daily seizures for seven years and conventional surgery to remove part of his brain had failed.
But neurosurgeons used a brand-new £350,000 robot – almost exactly like those used in car factories – to drill electrodes deep into his brain.
They pinpointed the epicentre of his debilitating attacks with minute accuracy for the first time.
That enabled surgeons to access and remove the tiny piece of seizure-causing tissue.
Since the ground-breaking operation two weeks ago Billy has not had a fit and medics are confident he has been cured for good.
Consultant neurosurgeon Michael Carter said: “There were little part of his brain we suspected were the candidates for causing these residual seizures.
“We used the robot to implant a series of electrodes using ultra-high, sub-millimetre precision, into these small areas of the brain, in order to see if his seizures were coming from them.
“In fact we located the area absolutely beautifully using one of the electrodes and on the strength of that we took him back to theatre a week later and we removed the area of brain tissue that was defined by the examination.
“We can use the robot to define extremely safe and high precision trajectories through the brain tissue, so that we can implant a number of electrodes through tiny little holes in the skull, with little stab incisions, directly into the areas we want.
“It is incredibly well tolerated, and got a very high safety profile, and gives us very high quality recordings.”
Mr. Carter, of Bristol Royal Hospital for Children, added: “He has been incredibly well since and hasn’t had any seizures.
“We’re hoping that he’s going to be seizure free for the future.
“This event represents a revolutionary transition into the 21st century for epilepsy surgery and absolutely cements our credentials as a premier paediatric epilepsy surgery facility not only for this city, but comparable with anything worldwide.”
Billy, a keen sportsman, had suffered with epilepsy since the age of eight with daily seizures or ‘auras’ – pre-attack episodes which left him feeling dazed.
In 2014 surgeons removed a section of his right temporal lobe removed, the area where it was thought the abnormal electrical signals were being produce.
The seizures stopped for around a year but Billy was devastated when they returned – and they became harder to control with medication in recent months.
When Bristol Royal Hospital for Children got their new Neuromates Robot, thanks to fundraising by local people, they decided he would be their ideal first child patient.
The procedure under general anaesthetic saw surgeons do a number of scans to create a 3D map of Billy’s brain to identify the areas for “interrogation”, on January 14.
They then screwed a frame into his head using four pencil-lead thick screws to guide the robot to position the drill.
The robot then provided a 3D trajectory of the place it was going to place the electrode, and positioned the 1mm thick drill bit ready for the surgeon.
The high-tech machine drilled through the skin and skull, and then 3cm into the brain tissue in four difference locations, before then guiding in a silicon electrode.
When Billy came round following the five-hour operation his epilepsy medication was reduced to bring-on seizures – and he had nine attacks over three days.
The electrodes – which were screwed onto his scalp – picked up the signals via the sensors along their length, pinpointing the exact location in his brain causing the attacks.
A week later, Billy went back under the knife where surgeons cut a ‘trap door’ in his skull and cut out the finger-tip sized bit of brain which was causing his fits.
Only four units in the UK have the machine – and Billy is the first child at the Bristol hospital to have the operation – called robotic stereotactic EEG.
It is understood it has been previously carried out at Great Ormond Street two or three times.
Before this procedure, electrodes were placed on the outside of the skull over a long period of time, or couldn’t be inserted in difficult to reach areas, or with exact accuracy.
The machine maps and moves to the chosen place where the electrode will be placed, and guides the surgeon who makes the incision.
In the future the operation could be performed completely by the robot – with a surgeon guiding it from 1,000 miles away.
Billy, from Trequite, Cornwall, is still recovering in hospital but is looking forward to getting back to school and playing sports soon.
Speaking after the op on January 21 he said: “Being seizure free means I will be able to take part in sports like football and rugby again.
“I love playing sport and continue to play golf but since my epilepsy diagnosis I can no longer play for teams as this often increases the number of seizures I have.
“It is exciting to be the first patient to have been treated at the hospital with this technique, especially as I and my family have travelled all the way from Cornwall.
“Although it is sometimes boring being monitored, the care I have received and the nurses who have treated me, have inspired me to look at the potential of working for the NHS and in a hospital.”
