A methodology for breast biopsy for ambulatory applications.
Robotic surgical systems, which now are almost 500 in the world, present
some main positive characters. Robotic application may offer a large
reduction of risks of infection, because of the standardization of the
procedure. It also decreases the possibilities of contamination in the
hospital, because all the parts of the robot may be sterilized and cleaned
completely, avoiding the deposit of unhealthy material, and washing it
away completely after every surgical act.
The infection due to
contacts with the environment covers a percentage of 10% in regular
hospital activities in highly technologically developed Countries. The
presence of surgical robotics and of telerobotics may reduce the infection
The robotic and telerobotic
surgical system in Laboratory of Telerobotics, Politecnico di Milano has
been developed to perform the operations of breast biopsy in an automated
and mini-invasive way, acting under an ecographic guide. In the procedure
followed, similar for the four operations, the physician characterises the
target using the probe of the ecograph, and then a second operator starts
the system confirming the target position on the PC monitor. The computer
calculates the position of the point in the space and the ideal trajectory
to follow, and then the robotic arm proceeds automatically to move and to
insert the needle in the patient to take the desired tissue sample. The
device consists of four main components: a robot with its control system,
an ecograph, a tracking device and a supervising master PC.
The presence of surgical
robotics and of telerobotics may reduce the infection risk. The robotic
and telerobotic system increases the number of components in the surgical
room. Because the robot must work as in clean room, the European Union and
the Federal Drug Administration rules impose some restrictions, which are
very strong for cleaning, for safety, for infection risk reduction. These
rules provoke also a decrease of the elements to be carried in the
surgical room, and reduce the time of biopsy.
The precision of
surgical robotic act, which is only a part of the total surgical action,
is very high. The time of action (biopsy, surgical operation) is reduced.
Because in every case the act of the robot is not different in the results
from the surgeon action, the pain of the patient (if some pain is) is not
changed by the presence of the robot action.
The preliminary tests
- great efficiency of the
- high precision (the robot may
present 0.02 mm in precision)
- high speed in execution of the
breast biopsy (1-2 minutes in front of 3-6 minutes);
- high reduction of risks of
infection due to the environment.
The reduction of risks is very high
because the person and the robot are completely insulated; the sample may
be extracted by telerobotics and the barriers between the person and the
environment may be checked every time and maintained continuously. The
safety of the robotic system is the main aspect, which must be considered
in parallel with the reduction of the risk of infection and