Hospital da Luz Lisboa has introduced a new state-of-the-art robotic arm for performing prostate biopsies. This is the first system of its kind in the Iberian Peninsula and one of the first in Europe, representing another step forward in the Hospital’s commitment to technology aimed not only at treatment, but also at the early and highly accurate diagnosis of prostate cancer. The system is used to perform fusion-guided prostate biopsies, a procedure that combines images from a previously performed multiparametric MRI with real-time ultrasound images acquired during the intervention. By combining these images, a three-dimensional model of the prostate is created, allowing suspicious lesions to be identified. The robotic arm then assists the urologist in guiding the needle to the correct target and depth, enabling tissue samples to be collected precisely from the areas that require investigation and, above all, making the procedure faster, more comfortable, and safer for the patient, while minimizing the risk of infection. “Prostate cancer is the most frequently diagnosed cancer in men. In Portugal alone, more than 5,000 cases are diagnosed every year, which makes early detection essential. The earlier it is diagnosed, the easier it is to treat,” says Kris Maes , Coordinator of the Robotic Surgery Centre at Hospital da Luz Lisboa. He adds: “Today, we have highly effective treatments for prostate cancer, such as robotic surgery. However, our goal as physicians is to detect the disease as early as possible. By performing prostate biopsies with this new system, we can target even the smallest lesions directly, providing diagnostic results in which we can have great confidence.” Greater diagnostic accuracy The new technology enables suspicious lesions to be located with a level of precision that can reach two millimetres. The system also compensates for possible patient movement or changes in positioning during the procedure, reducing reliance on manual guidance and improving biopsy reproducibility. “We use MRI as a map that allows us to identify suspicious lesions. The system is calibrated to direct the needle to the exact target with a very high degree of accuracy, which gives us greater confidence in both the procedure and the outcome,” explains João Pina , urologist at Hospital da Luz Lisboa. In addition to providing more precise guidance, the system facilitates both training and execution of the procedure, contributing to more consistent results among different clinicians. Collaboration between Urology and Medical Imaging The success of this type of biopsy also depends on the quality of the MRI scan and the accurate identification of lesions. For this reason, the procedure involves close collaboration between the Urology and Medical Imaging teams at Hospital da Luz Lisboa. Radiologists identify and delineate suspicious areas on the MRI scan. In the operating theatre, urologists then perform a three-dimensional ultrasound, while dedicated software fuses the two sets of images, enabling the robotic arm to pinpoint the locations from which tissue samples should be collected. “This is a multidisciplinary process from the very beginning. The imaging preparation is carried out by the Medical Imaging team, while the biopsy itself is performed by Urology. This collaboration is essential for accurately locating lesions,” says Kris Maes. Greater safety and comfort for patients The biopsy is performed using a transperineal approach, meaning through the skin between the scrotum and the anus. This route avoids passing the needle through the rectum and helps reduce the risk of infection associated with the procedure to virtually zero. The system also allows different regions of the prostate to be reached through a limited number of entry points, helping to minimise discomfort and facilitate patient recovery. The use of high-quality MRI scans also enables clinicians to better identify which patients need a biopsy. When the procedure is indicated, robotic guidance increases confidence that tissue samples have been collected from the most relevant areas. “The more precise the biopsy, the more reliable the diagnosis. This technology helps us target small lesions more effectively and may contribute to the earlier identification of tumours that require treatment,” stresses Kris Maes. The introduction of this new robotic arm reinforces Hospital da Luz Lisboa’s strategy of integrating technological innovation into every stage of prostate cancer care, from diagnosis through to the various treatment options available. João Pina, Urologist at Hospital da Luz Lisboa “With this system, everything is calibrated to ensure that we can guide the needle to exactly the right location and collect tissue from the precise point where the lesion is located, which is not always visible even with high-quality ultrasound images. This is undoubtedly the most accurate system currently available, giving us the highest level of confidence in the results of these biopsies.” “This equipment also allows us to perform biopsies with less discomfort for patients. Overall, it makes the procedure simpler for the urologist and delivers a far more accurate result, giving us complete confidence in the final diagnosis.” Kris Maes, Urologist and Coordinator of the Robotic Surgery Centre at Hospital da Luz Lisboa “This is the first robot of its kind designed specifically for prostate biopsies. Previously, the main challenge was accurately targeting the lesion in order to collect tissue samples for analysis. Although we had made significant advances, it was still a largely manual procedure. With this robot, we automate the path to the lesion, making the procedure extremely precise.” “Hospital da Luz Lisboa has one of the largest and most advanced prostate cancer treatment centres in Portugal. We have all the necessary tools and can offer every available treatment for prostate cancer. However, our investment goes beyond treatment. We must also invest in better and more effective diagnosis. That is exactly what Hospital da Luz Lisboa has done with the acquisition of this robotic arm for prostate biopsies, providing greater confidence in diagnosis and improved accuracy in lesion identification.”
