How I do it: Image-based robot-assisted deep brain stimulation under general anesthesia.

Robotic assistance has been introduced in deep brain stimulation (DBS) surgery to enhance stereotactic accuracy and workflow reproducibility. We describe a step-by-step technique for robot-assisted DBS implantation using the Neuromate® system, integrating frame-based head fixation, image-based planning, robotic guidance, and intraoperative 3D imaging for accuracy verification. This workflow prioritizes anatomical precision, procedural reproducibility, and intraoperative verification, providing a fully image-based alternative to conventional physiological mapping strategies.