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In this paper, a prototype of a robotic system for accurate and consistent insertion of a percutaneous biopsy needle into the prostate is presented. A transrectal ultrasound (TRUS) probe is used to collect a series of two-dimensional (2D) images of the prostate. These images are used to create a 3D computer model of the organ which is used by the urologist to define the biopsy points within the prostate. The robotic system then calculates the required trajectory of the needle, which can be simulated on the computer. Following this, the robot is configured accordingly and the actual biopsy is performed. Cadaveric and human trials have validated the robot's needle placement error to be less than 2.5 mm. Our future work includes the integration of a cancer predictive modality into the system to increase the cancer detection rate. The robotic system could also be modified to accurately place foreign bodies into the prostate, which could improve therapeutic procedures such as Brachytherapy.

Background: The aim of this randomised prospective study is to compare the outcomes of traditional open trigger digit release versus ultrasound-guided modified small needle-knife (SNK) percutaneous release in the treatment of trigger digits.

Methods: Patients with grade 2 and above trigger digits were enrolled into the study and randomly assigned to traditional open surgery (OS) or ultrasound-guided modified SNK percutaneous release group. The patients were followed up for 7, 30 and 180 days after treatment and data with regard to visual analogue scale (VAS) score and Quinnell grading (QG) was collected and compared between the two groups.

Results: A total of 72 patients were enrolled in the study with 30 in the OS group and 42 in the SNK group. VAS scores and QG of the two groups significantly decreased at 7 days and 30 days after treatment compared to before treatment, but there was no significant difference between the two groups. There was also no differences between the two groups at 180 days and between the values at 30 days and 180 days.

Conclusions: The outcomes of ultrasound-guided SNK percutaneous release is similar to traditional OS.

Level of Evidence: Level II (Therapeutic)

Performing a surgical task on a beating heart requires superhuman skill as the surgeon must manually track the heart’s motion while performing a surgical task. However, the ability to operate on a beating heart would eliminate the need to use a mechanical stabilizer or arrest the heart and connect the patient to a heart-lung machine and would consequently eliminate their side effects. This work develops the image processing and control structure for an ultrasound-guided robot-assisted beating heart surgical system that will move the surgical tool tip in synchrony with the heart. This would allow the surgeon to operate through teleoperation on a virtually stabilized point on the heart. In developing this system, the position data acquired from ultrasound images is upsampled and predicted ahead to compensate for the image acquisition and processing delay. We present the results of a user task based on mitral valve annuloplasty performed under ultrasound guidance.