Robotic rectum to boost prostate cancer diagnosis

A robotic rectum, which consists of prosthetic buttocks and a robotic interior, may help doctors and nurses boost their ability to detect prostate cancer.

The device has been created to help train doctors and nurses to perform rectal examinations by accurately recreating the feel of a rectum, as well as providing feedback on their examination technique.

The device contains small robotic arms that apply pressure to the silicone rectum, to recreate the shape and feel of the back passage.

Rectal examinations are necessary to diagnose conditions such as prostate cancer and involve a medic placing their index finger into the anus and feeling the prostate gland.

The walnut-size gland sits below a man’s bladder and can be felt just inside the anus, through the rectal wall. Around one in eight men in the UK suffer from prostate cancer at some point in their lives.

Furthermore, 75 per cent of men over 70 suffer from benign prostate enlargement, which although harmless can cause urinary problems.

A rectal examination is often the first test a doctor or nurse uses to recognise a problem prostate. This determines whether they send a patient for further tests.

Generally, cancerous prostates tend to feel hard and knobbly, but learning exactly what a potentially cancerous prostate feels like can be difficult, explains Dr Fernando Bello, from the Department of Surgery and Cancer at Imperial College London.

"Internal examinations are really challenging to learn - and to teach," he said. "Because the examinations occur in the body, the trainer cannot see what the trainee is doing and vice versa.

“In addition to this, medics rarely get the chance to practise the examination, as few patients would volunteer as practice subjects. In fact, there is only one person registered in the country as a test subject, called a Rectal Teaching Assistant (RTA), in the UK.”

“The results of these examinations can have major implications for patients. They are very important for early diagnosis of various conditions, such as prostate cancer."

Although plastic models exist to help train medical staff, these do not feel like living flesh and tissue, therefore to help doctors and nurses practice how to perform these examinations and to ensure they are as comfortable as possible for patients, Dr Bello and his team have created a robotic 'trainer rectum'.

When using the trainer, a doctor inserts his finger inside a silicone thimble attached to robotic technology able to recreate the exact sensation of the human rectum.

Furthermore, a computer screen behind the device can display a 3D model of the rectum and prostate, allowing the doctor, with the aid of 3D glasses, to see the anatomy while they perform the examination. The technology can also be programmed for different scenarios, allowing the anatomy to be changed each time.

Furthermore, the team are continuing to perfect the device, by collecting data from real prostate examinations in patients.

The team are now working towards building an affordable prototype for medical schools and the technology is also being adapted for gynaecological exams.

Although each device may cost over £10,000, the team say a more affordable option may be to use the finger pressure sensors and 3D software on traditional plastic models, to enhance existing training facilities.

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