Transurethral resection of bladder tumors (TURBTs) is a common procedure that normally requires the use of a rigid resectoscope, through which tools and an endoscope are passed, that doesn’t allow for much maneuvering around the target. A team from Vanderbilt and Columbia universities have developed a telerobotic system that can combines visualization and interventional tools in one controllable snake-like device that’s only 5.5 millimeters in diameter. The probe has a bending angle of 180° for full access to just about any spot around its entry point, and includes a light source, video camera, forceps, and a laser for cauterizations.
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The engineers report that they can control the position of the snake-like arm with sub-millimeter precision: a level adequate for operating in clinical conditions. They have also demonstrated that the device can remove tissue for biopsies by gripping target tissue with the forceps and then cutting it off with the laser. The fiberscope produced a 10,000-pixel image that was directed to a digital video camera system. Because it is steerable, the instrument was able to provide closeup views of the bladder walls at favorable viewing angles. However, the testing revealed the camera system’s effectiveness was limited by poor distance resolution. According to the researchers, this can be corrected by re-designing the fiberscope or by replacing it with a miniature camera tip. In the future, the researchers intend to incorporate additional imaging methods for improving the ability to identify tumor boundaries. These include a fluorescence endoscope, optical coherence tomography that uses infrared radiation to obtain micrometer-resolution images of tissue and ultrasound to augment the surgeon’s natural vision.
Here’s the system being used to remove tumors from a pig’s bladder:
Article in IEEE Transactions on Biomedical Engineering: Design and Performance Evaluation of a Minimally Invasive Telerobotic Platform for Transurethral Surveillance and Intervention…
Press release: Telerobotic system designed to treat bladder cancer…