title: Robotic transperineal prostate biopsy: pilot clinical study.
abstract: OBJECTIVE
  To develope a robot (BioXbot) that performs mapping transperineal prostate biopsy (PB) with two perineal skin punctures under ultrasound guidance. Our pilot study's clinical endpoints were complications and its technical endpoints were the duration for each phase.
  
  
  METHODS
  This institution review board-approved prospective clinical trial included patients with indications for PB. Two urologists performed these PBs. In the lithotomy position and under general anesthesia, the transrectal biplane ultrasound probe acquired transverse images of the prostate gland. The urologist defined its boundaries and planned the biopsy. It guided the PB in 3 axes, passing through a single perineal skin puncture for each prostate side. After each biopsy, it automatically moved to the next position. The steps were repeated on the contralateral side.
  
  
  RESULTS
  Our 20 patients had a mean prostate-specific antigen of 8.4 ± 4.9 ng/mL. Two patients had 2 previous biopsies, whereas the rest had one. The mean number of biopsies taken was 28.5 ± 6.2 in a mean total procedure time of 32.5 ± 3.2 minutes. We detected 3 patients with prostate cancer with Gleason score 3 + 3. Two patients required brief bladder catheterization after their biopsy. Their prostate volumes were >50 mL and the number of biopsies taken was >30 cores. There was no mechanical failure, sepsis, bleeding per-rectal, or perineal hematoma.
  
  
  CONCLUSIONS
  This pilot study demonstrated BioXbot's safety and feasibility as a biopsy platform. It can potentially be used for image-guided PB and focal therapy.
authors.affiliation: Department of Urology, Singapore General Hospital, Singapore. ho.henry.s.s@gmail.com
authors.forename: H
authors.initials: H
authors.lastname: Ho
authors.forename: J S P
authors.initials: JS
authors.lastname: Yuen
authors.forename: P
authors.initials: P
authors.lastname: Mohan
authors.forename: E W
authors.initials: EW
authors.lastname: Lim
authors.forename: C W S
authors.initials: CW
authors.lastname: Cheng
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum; D010865:Pilot Projects; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D012371:Robotics / Q000295:instrumentation