Experimental study of transurethral robotic laser resection of the prostate using the LaserTrode lightguide

Abstract

A longer operating time and steeper learning curve in mastering the techniques for transurethral laser resection of the prostate are the main problems faced by surgeons in addition to the existing ones in standard transurethral resection of the prostate (TURP). However, these disadvantages can be alleviated with the introduction of a treatment procedure designed and developed based on an integrated system of computer, robotics and laser technology. In vitro experiments were carried out to determine variables affecting the vaporization and coagulation lesions, in order to study the effectiveness and feasibility of robotics for this procedure. Human cadaveric prostates and fresh tauted chicken breast tissues were irradiated with different parameters using the LaserTrode lightguide in contact with the tissue. The effects of irrigant flow rate, fiber/tissue angle of inclination, number of passes, direction, speed and power of lase on the volume of tissue vaporized and coagulated, were assessed. The final phase of the experiments includes executing the robotic motion plan for the laser resection procedure on the human cadaveric prostate tissue embedded in an anatomically alike prostate phantom. It was concluded from our study that power and speed of lase are the most significant parameters influencing the volume of the vaporized and coagulated lesion. Comparison of removal rate using the new treatment procedure of robotic laser resection of the prostate with TURP and HoLRP evinced equivalent results.

Robotic Systems: Past, Present, and Future

“…The URobot system was developed in Singapore by Ng et al The robot was designed to perform a transurethral and trans-perineal access to the prostate for laser resection in 2001 13 or brachytherapy, 14 respectively. At the Johns Hopkins University our team has developed several needle driving systems under various X-Ray-based guidance modalities and performed numerous clinical tests for urology applications.…”

Robotic instrumentation: Evolution and microsurgical applications

“…This device was utilized for trans-urethral HIFU (High Intesity Foucsed Ultrasound), brachytherapy, needle prostate biopsy and laser resection of the prostate. [1112] A collaboration with Dornier Asia Medical Systems led to the creation of the SPUD device (Surgeon Programmable Urological Device). However, no further publications have been presented yet on this device.…”

Robotic surgery: India is not ready yet

“…[2] Johns Hopkins University developed PAKY, a robotically controlled device for percutaneous access to the kidney. [3] However ROBODOC hip replacement milling device was the first robotic surgical device to be marketed in 1992.…”