Clinical benefit of robot-assisted minimally invasive stereotactic aspiration/drainage in hypertensive intracerebral hemorrhage.

OBJECTIVE

To evaluate the efficacy of robot-assisted minimally invasive stereotactic aspiration/drainage (RAMISAD) in hematoma evacuation for hypertensive intracerebral hemorrhage (HICH) and assess its associated clinical benefits.

METHODS

A retrospective analysis was conducted on 121 HICH patients admitted between October 2020 to March 2025. According to surgical procedures, patients were categorized into a control group (n=62, conventional craniotomy for hematoma evacuation) and an observation group (n=59, RAMISAD). Surgical factors, neurological recovery (National Institutes of Health Stroke Scale, NIHSS), daily living function (Barthel Index), and pre- and post-operative serum markers (neuron-specific enolase [NSE], tumor necrosis factor-α [TNF-α], and high-sensitivity C-reactive protein [hs-CRP]) were compared between groups. Complication rates were also documented postoperatively.

RESULTS

The hematoma clearance rate was significantly higher in the observation group than in the control group. RAMISAD was associated with shorter operative time, reduced blood loss, and shorter hospital stays (P<0.05). No significant differences were observed in residual hematoma volumes or transfusion rates (P>0.05), and all postoperative hematoma volumes remained below the 30 mL safety threshold. On postoperative day 7, serum NSE, TNF-α, and hs-CRP levels decreased more markedly in the observation group than in controls (P<0.05). After three-months, the observation group displayed significantly reduced NIHSS scores and elevated Barthel Index scores compared to the control group (P<0.05). Additionally, complications occurred less frequently in the observation group (P<0.05).

CONCLUSION

For HICH cases, RAMISAD offers clear advantages over traditional craniotomy, including improved hematoma evacuation efficiency, reduced neurological impairment, enhanced functional recovery, and lower postoperative inflammatory responses, thereby promoting faster rehabilitation.