Removing Prostate Cancer … Via the Urethra

Our robotic system for suturing deep in the body through a very thin endoscope

Dr. Webster invented Concentric Tube Robots and then spent several years working with his graduate students to model them, control them, and build clinically useful systems using them.

When they were mature enough, he founded Virtuoso Surgical, Inc. to bring them to real-world operating rooms. The company has since raised over $20 million and is on the cusp of first-in-human. Virtuoso’s first product is amazing at reaching into small spaces in the body to remove tumors and other tissues.

But these devices will become even more powerful when one can not only cut, but reconstruct tissues via suturing.

For example, one could remove the entire prostate through the urethra. Our surgeon collaborators believe that if we could pull this off, we would dramatically complications like impotence and incontinence which occur because traditional surgery disrupts a great deal of healthy tissue, just to get to the prostate.

We are in the process of creating a system that will deliver two concentric tube manipulators through an endoscope and use them to pass sutures through tissue. We have performed feasibility studies in ex vivo biological tissues successfully suturing the urethra to the bladder neck after the prostate is removed.

We are currently working to make suturing quicker and easier for the surgeon. If we are successful, Virtuoso Surgical could one day release a second generation product that will not only remove tissue, but be capable of reconstruction afterward, which will be useful not only in prostate surgery, but all over the body.

Suturing results attaching a “urethra” to a “bladder neck,” both made from squid tissue.

Selected Related Publications:

  1. R. J. Hendrick, C.R. Mitchell, S. D. Herrell, and R. J. Webster III. Hand-Held Transendoscopic Robotic Manipulators: A Transurethral Laser Prostate Surgery Case Study. International Journal of Robotics Research, 34(15):1559-1572, 2015.

  2. E. Amanov, D. S. Ropella, N. Nimmagadda, T. E. Ertop, J. E. Mitchell, N. L. Kavoussi, R. J. Hendrick, N. Dillon, E. Blum, S. D. Herrell III, and R. J. Webster III. Transurethral Anastomosis after Transurethral Radical Prostatectomy: A Phantom Study on Intraluminal Suturing With Concentric Tube Robots. IEEE Transactions on Medical Robotics and Bionics, 2(4):578-581, 2020.

  3. T. E. Ertop, J. F. d’Almeida, E. Amanov, J. Shrand, N. Nimmagadda, S. Setia, N. L. Kavoussi, S.D. Herrell III, and R. J. Webster III, “Towards Suturing From Within the Urethra Using Concentric Tube Robots: First Experiences in Biological Tissues,” International Symposium on Medical Robotics (ISMR), 2022.

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