Type of Surgery
Robotic Prostate Surgery and Biopsy
Last updated: 05/26/2009
Robotic Prostate Biopsies
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Prostate cancer is all too common in American men and early diagnosis can mean less invasive surgery and even make the difference between life and death. There are approximately one million prostate biopsies performed each year in United States and many more around the world. Prostate biopsy, a procedure in which small bits of the prostate gland are removed and tested for the presence of cancer cells, is considered the definitive diagnostic tool for prostate cancer.
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The sensitivity and specificity of a prostate biopsy (making sure those with cancer are detected and those without cancer are cleared) depends on several factors. Perhaps the most important factor for an effective prostate biopsy and accurate cancer diagnosis is the procedure by which the prostate gland is sampled. The sampling process has been made much more effective by the introduction of robotic prostate surgery and biopsy.
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Robotic prostate biopsy is different than other robotic surgery approaches. Robotic prostate surgeries use a technique known as DIGI or direct image-guided interventions. This process is completely different than the da Vinci® Surgical System that is used for most robotic surgeries. With DIGI, the patient’s prostate is continually reimaged meaning that X-ray or MRI pictures are taken throughout the biopsy or surgery in order to make sure that the entire gland is sampled. Also, because of the precision of the robotic arm, each section of the prostate can be sampled systematically.
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Imagine for a moment that you wanted to take one seed out of each wedge section of a whole lemon. You can pierce the skin, but you cannot peel the lemon or disturb it in any real way. First you would need to know where the seeds were located within each wedge, the orientation of the wedges, and to make sure that all wedges were sampled. With the DIGI approach, the device would gently hold the lemon, see inside of it with imaging techniques and advance the needle robotically so that you would disturb the lemon as little as possible. Something similar happens with robotic prostate surgery. The robotic arm, when combined with continual imaging allows for unprecedented control and accuracy of prostate biopsies.
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While the da Vinci® robotic surgery system provides the surgeon remote control over robotic arms, the DIGI robot can actually perform some autonomous actions. The robot takes CT or MRI imaging information, calculates the path of entry, determines the area to be tested and can biopsy the prostate. The surgeon is still in direct and constant control of the process from beginning to end, but by defining certain tasks and programs rather than guiding the robotic device manually. The technology has advanced to such a degree that patient outcomes are generally better with some robotic prostate surgery procedures than manual or human operations.
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Robotic prostate surgery has been one of the pioneering procedures for robotic surgical technology. The prostate is near the outside of the body, has a relatively limited blood supply (so bleeding risk is minimized) and the tissues within the prostate are easily identified and differentiated by CT or MRI. Because of these and other factors, more autonomy can be given to the robotic device in prostate surgery.
Last Updated: 05/26/2009
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