The Probot—an active robot for prostate resection

Harris, Simon; Cosı́o, Fernando Arámbula; Mei, Quelin; Hibberd, R.D.; Davies, Brian; Wickham, J. E. A.; Nathan, Malavika; Kundu, Biswanath

doi:10.1243/0954411971534449

Cited by 196 publications

(74 citation statements)

References 6 publications

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“…They eliminated the translational motion of the needle in front of the perineum and used angulation only by 2-DOF remote center of motion kinematics implemented by goniometric arcs. Their concept resembled one of the earliest medical robots by Harris et al (1997) used in transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. (It is of particular historical note that this device was the first medical robot ever to remove tissue from a live human patient.)…”

Section: Introductionmentioning

confidence: 99%

Robotic assistance for ultrasound-guided prostate brachytherapy

Fichtinger

Fiene

Kennedy

et al. 2008

Medical Image Analysis

108

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We present a robotically assisted prostate brachytherapy system and test results in training phantoms and Phase-I clinical trials. The system consists of a transrectal ultrasound (TRUS) and a spatially co-registered robot, fully integrated with an FDA-approved commercial treatment planning system. The salient feature of the system is a small parallel robot affixed to the mounting posts of the template. The robot replaces the template interchangeably, using the same coordinate system. Established clinical hardware, workflow and calibration remain intact. In all phantom experiments, we recorded the first insertion attempt without adjustment. All clinically relevant locations in the prostate were reached. Non-parallel needle trajectories were achieved. The preinsertion transverse and rotational errors (measured with a Polaris optical tracker relative to the template's coordinate frame) were 0.25mm (STD=0.17mm) and 0.75° (STD=0.37°). In phantoms, needle tip placement errors measured in TRUS were 1.04mm (STD=0.50mm). A Phase-I clinical feasibility and safety trial has been successfully completed with the system. We encountered needle tip positioning errors of a magnitude greater than 4mm in only 2 out of 179 robotically guided needles, in contrast to manual template guidance where errors of this magnitude are much more common. Further clinical trials are necessary to determine whether the apparent benefits of the robotic assistant will lead to improvements in clinical efficacy and outcomes.

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Section: Introductionmentioning

confidence: 99%

Robotic assistance for ultrasound-guided prostate brachytherapy

Fichtinger

Fiene

Kennedy

et al. 2008

Medical Image Analysis

108

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“…Por su parte el robot PROBOT, del Imperial College of London, fue usado en el bienio 1997-98 para realizar operaciones endoscópicas de próstata en Inglaterra 46 , estableciendo un hito en la robótica quirúrgica ya que se trata de un robot autónomo que trabaja después de la preprogramación sobre el caso clínico, una vez obtenidas coordenadas ecográficas.…”

Section: Robots Quirúrgicosunclassified

Historia de la robótica: de Arquitas de Tarento al Robot da Vinci. (Parte II)

Martín

Rodríguez

Bayarri

et al. 2007

Actas Urológicas Españolas

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La cirugía robótica es ya una realidad. Revisar la historia de la robótica antigua (ver parte I) y moderna es importante para conocer cómo funcionan los nuevos robots. La fabricación de máquinas que imitan al ser humano se ha mantenido desde hace más de 4000 años. En la robótica clásica destacaron inventores como Arquitas de Tarento (hacia 400 a.C.), Heron de Alejandría, Hsieh-Fec, AlJazari, Bacon, Turriano, Leonardo da Vinci, Vaucanson o von Kempelen (ver parte I). En 1942 Asimov publica las tres leyes de la robótica. Con el desarrollo de la mecánica, la electrónica y la informática en el siglo XX se han desarrollado robots capaces de realizar de forma autónoma tareas de gran complejidad. En 1985 el robot PUMA 560 fue utilizado para introducir una aguja en el cerebro. A partir de ahí se desarrollan robots cirujanos como World First, Robodoc, Gaspar o Acrobot, Zeus, AESOP, Probot o PAKI-RCP. En el año 2000 la FDA aprueba el da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale, CA, USA) un sofisticado robot asistente del cirujano. Procedimientos urológicos como la prostatectomía, cistectomía o la nefrectomía son realizadas con el robot da Vinci, situando a la urología como una de las especialidades más idóneas para la cirugía robótica.Palabras clave: Robótica. Urología Robótica. Historia de la Robótica. Historia de la Medicina. Arquitas. ABSTRACT HISTORY OF ROBOTICS: FROM ARCHYTAS OF TARENTUM UNTIL DA VINCI ROBOT. (PART II)Robotic surgery is a reality. In order to to understand how new robots work is interesting to know the history of ancient (see part i) and modern robotics. The desire to design automatic machines imitating humans continued for more than 4000 years. Archytas of Tarentum (at around 400 a.C.), Heron of Alexandria, Hsieh-Fec, Al-Jazari, Bacon, Turriano, Leonardo da Vinci, Vaucanson o von Kempelen were robot inventors. At 1942 Asimov published the three robotics laws. Mechanics, electronics and informatics advances at XX th century developed robots to be able to do very complex self governing works. At 1985 the robot PUMA 560 was employed to introduce a needle inside the brain. Later on, they were designed surgical robots like World First, Robodoc, Gaspar o Acrobot, Zeus, AESOP, Probot o PAKI-RCP. At 2000 the FDA approved the da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale, CA, USA), a very sophisticated robot to assist surgeons. Currently urological procedures like prostatectomy, cystectomy and nephrectomy are performed with the da Vinci, so urology has become a very suitable speciality to robotic surgery.

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“…An on-line transrectal ultrasound imaging system monitors the procedure by constructing a 3-D prostate model and there is an appropriate surgeon ± computer interface. 12 To date, 43 patients have undergone this procedure and only three failures have been reported due to technical problems.…”

Section: New Treatment Strategies Minimally Invasive Therapiesmentioning

confidence: 99%

BPH in the next millennium:a glimpse to the future

Sancha

1999

Prostate Cancer Prostatic Dis

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Benign prostatic hyperplasia (BPH) is a highly prevalent, age-related disease. As the world population continues to grow and life expectancy increases, the population of men suffering from BPH will expand. A greater emphasis will be placed on quality of life. The BPH patient of the future will also have greater expectations regarding therapy, which will need to be effective in a shorter period of time. New technologies for the treatment of BPH are anticipated. Already, robot-operated vaporisation of the prostate is being undertaken. With regard to medical therapy, more selective and hence, more effective drugs are under development. With the identi®cation of new a 1 -adrenoceptor subtypes, a-blocker therapy should target the prostate more accurately. Gene-based therapies will have an important role in the future. It is envisaged that technology will exist whereby defective genes can be replaced and gene expression controlled to overcome the disease process. Through pharmacogenomics, drugs will be tailored to the individual, which will, in turn, result in more economical use of medical therapy. Similarly, the development of nanotechnology will allow sitespeci®c delivery of drugs. Together, these advances will make the treatment of BPH even more effective in the new millennium.Keywords: benign prostatic hyperplasia; treatment; pharmacogenomics; nanotechnology; a-blockers Prevalence of BPHBenign prostatic hyperplasia (BPH) is an age-related disease that is highly prevalent, with approximately 90% of men aged over 80 y having histological evidence of the disorder. 1 Community-based studies have evaluated the prevalence of symptomatic BPH or lower urinary tract symptoms (LUTS) by age in several European countries, 2 ± 5 the US 6 and Japan. 7 Results show that one in four men aged 50 y have LUTS, increasing to one in two men aged 65 y.The world population continues to grow by approximately 80 million each year, the equivalent to the current population of Germany, and it is expected to double by the year 2060, reaching a total of 10 billion people (Table 1). 8 This is partly explained by the fact that the world population is ageing, with people enjoying a greater life expectancy. It is currently estimated that each month the population aged b 65 y increases by 800 000. 8 In addition, a signi®cant percentage of men, particularly those living in developed countries, will reach a century. As nearly 50% of men b 65 y are at risk of LUTS suggestive of BPH, with the ageing population, LUTS is set to become even more prevalent in the future. The projected increase in the world male population aged b 65 y, leads to the assumption that, by the year 2010, 115 million men will have LUTS (Table 2). 8 This means that in just 50 years time, there will be three times as many men suffering from BPH. The changing populationWith the technological developments that are ongoing, patients will become better informed about their disease conditions. The Internet as a source of information will continue to evolve and patients will have incre...

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The Probot—an active robot for prostate resection

Cited by 196 publications

References 6 publications

Robotic assistance for ultrasound-guided prostate brachytherapy

Robotic assistance for ultrasound-guided prostate brachytherapy

Historia de la robótica: de Arquitas de Tarento al Robot da Vinci. (Parte II)

BPH in the next millennium:a glimpse to the future

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