Robotized prostate biopsy

The authors describe their experience about a robotic system designed to perform prostatic biopsies, locally and tele-controlled. The system employs an industrial robotic arm with four degrees of freedom made up of a biopty gun and 18 gauge biopty needle. An ultrasound scanner with a trans-rectal probe 7.5 MHz is necessary to localize the target area into the prostate. A telemetric system allows one to plot the position of the ultrasound probe by video cameras mounted on the robot support and three infrared lights mounted on an ultrasound probe and the coordinates (roll, pitch, yaw) are converted into robot coordinates from a computer controller. A tele control is possible too through a remote control station connected with the local station by an ISDN telephone line. Experimental tests proved a precision of 2 mm from the target point when the test has been executed in the predetermined working area. After the authorization of the Ethical Committee of the University of Milan, a clinical test has been performed in a man undergoing cistoprostatectomy because of bladder cancer. Two biopsies have been done on a 5 mm target area. No complication has been observed at the following cistoprostatectomy. The robotic prostate biopsy represents a good start point to improve the application of robotics in surgery and tele-surgery.