Prostate Biopsy

An image-guided robot system has been developed and employed for transperineal prostate biopsies.

The surgeon selects the biopsy site using transrectal ultrasound images and the robot obtains the sample from that location with a precision of 1 to 2 mm in needle position. This procedure was found to be quicker, more precise than the conventional

Two alternative robotic projects enabling automated harvesting of prostate biopsy samples have been recently developed.

Certain urologic procedures are very challenging for conventional laparoscopic surgeons due to either complex anatomy or the need for extensive intracorporeal suturing. Examples include radical prostatectomy, radical cystectomy, and pyeloplasty.

Surgeon-driven robots augment the manipulation capabilities of the physician above and beyond the surgeon's manual and visual capacity.

Computer Motion's National Aeronautics and Space Administration-funded research demonstrated that voice-controlled commands are preferable to alternatives such as eye tracking and head tracking, which control motion in response to movements of the surgeon's head.

techniques, and very reliable as the robot maintains its own position (17). An SR 8438 Sankyo Scara robot is used to perform this operation. It is remote controlled, i.e., via tele-robotics, and requires accurate positioning in known points of three-dimensional space with a high degree of precision (18).

Two alternative robotic projects enabling automated harvesting of prostate biopsy samples have been recently developed.

In the projects proposed by the group at Johns Hopkins University, prostate biopsies are taken using a modified Percutaneous Access of the Kidney robot. In fact, current Percutaneous Access of the Kidney drive system is not strong enough to drive the needle into prostatic tissue, and also requires instrumentation to provide feedback regarding the needle position. In the modified Percutaneous Access of the Kidney system, a computerized tomography-image set is used to target the prostate and register the robot, and the biopsy needle is inserted through the skin rather than through the rectum. A second approach has been pursued by a group at Politecnico di Milano, Italy, where an industrial robot is being used directly to insert biopsy needles through the skin using a telerobotic approach. Biopsy site may be localized by computerized tomography, stereotactic fluoroscopy, or ultrasound. However, the two systems described above are relatively expensive because they require additional computerized tomography-based imaging of the prostate.

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