Abstract decorative graphic with orange circular shape and thin black lines going through and around it.

A New Era in Prostate Care

The landscape of prostate biopsies is undergoing transformative changes. In Europe, the European Association of Urology now strongly recommends transperineal over transrectal biopsies. 1

In the US, leading Centers of Excellence including the Mayo Clinic are also recommending transperineal biopsies. 2

Robotics will be essential to delivering this new gold standard for patients.

The Challenge
with the Status Quo

Traditional transrectal prostate biopsies carry significant drawbacks:

High infection risk

  • 3–5% infections 3,4
  • 6.9% 30-day re-admission rate 5
  • 4-fold increase in hospital admissions over a 10-year period 6

Underdiagnosis

  • Traditional ultrasound biopsies only detect 23% of clinically significant cancers 7
Two thin black arrows pointing up and down. Orange and blue rectangles behind them. "Maximal prostate coverage" next to the first arrow, "Minimal infection rate" next to the second one.

The New Standard of Care:
Transperineal Biopsies

To address these issues, the standard of care is shifting to transperineal biopsies, and utilizing MRI+ultrasound fusion guidance to provide better visualization and maximal prostate coverage.

However, these manual transperineal biopsies pose a steep learning curve 8 for urologists, potentially hindering widespread adoption.

The Robotic Advantage

Robotic-controlled needle positioning offers urologists the precision needed for transperineal procedures, ensuring:

A 3/4 frontal view photo of Mona Lisa 2.0 [TX] robot.

01

Higher accuracy in cancer detection 9

02

Virtually zero infection risk 10

03

Less invasive tissue sampling

Mona Lisa

A catalyst for change →

  1. Diagnostic evaluation guidelines, EAU: https://uroweb.org/guidelines/prostate-cancer/chapter/diagnostic-evaluation.
    BaturaD, Rao GG. The national burden of infections after prostate biopsy in England and Wales: a wake-up call for better prevention. J AntimicrobChemother2013;68:247–9.
  2. https://www.mayoclinic.org/medical-professionals/urology/news/ultrasound-guided-transperineal-prostate-biopsy/mac-20473283
  3. Pradere B, Veeratterapillay R, Dimitropoulos K, et al. Nonantibiotic Strategies for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol. 2021;205(3):653-663. https://pubmed.ncbi.nlm.nih.gov/33026903/.
  4. Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Complications after prostate biopsy: data from SEER-Medicare. J Urol2011; 186: 1830–1834.
    Nam RK, SaskinR, Lee Y etal. Increasing hospital admission rates for urological complications after transrectalultrasound guided prostate biopsy. J Urol 2010; 183: 963–968.
  5. Valerio, M., Donaldson, I., Emberton, M., Ehdaie, B., Hadaschik, B. A., Marks, L. S., Mozer, P., Rastinehad, A. R., & Ahmed, H. U. (2015). Detection of Clinically Significant Prostate Cancer Using Magnetic Resonance Imaging-Ultrasound Fusion Targeted Biopsy: A Systematic Review. European urology, 68(1), 8–19.
  6. Halstuch D, Baniel J, Lifshitz D, Sela S, Ber Y, Margel D. Characterizing the learning curve of MRI-US fusion prostate biopsies. Prostate Cancer Prostatic Dis. 2019;22(4):546-551. DOI: 10.1038/s41391-019-0137-2.
  7. Patel MI, Muter S, Vladica P, Gillatt D. Robotic-assisted magnetic resonance imaging ultrasound fusion results in higher significant cancer detection compared to cognitive prostate targeting in biopsy naive men. Transl Androl Urol. 2020;9(2):601-608.
  8. Patel, A. & Servian, P. & Winkler, Mathias & Tiong, L.C. & Yuen, John & Ho, Hey & Chen, Kenneth & Kruck, S. & Grummet, Jeremy. (2017). Robotic MRI/US fusion transperineal biopsy using the iSR’obot Mona Lisa: Technique, safety and accuracy. European Urology Supplements. 16. e2092-e2093.
  9. Patel MI, Muter S, Vladica P, Gillatt D. Robotic-assisted magnetic resonance imaging ultrasound fusion results in higher significant cancer detection compared to cognitive prostate targeting in biopsy naive men. Transl Androl Urol. 2020;9(2):601-608.
  10. Patel, A. & Servian, P. & Winkler, Mathias & Tiong, L.C. & Yuen, John & Ho, Hey & Chen, Kenneth & Kruck, S. & Grummet, Jeremy. (2017). Robotic MRI/US fusion transperineal biopsy using the iSR’obot Mona Lisa: Technique, safety and accuracy. European Urology Supplements. 16. e2092-e2093.