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Promise and Progress - Robots and Other Mechanical Devices

Engineering Cures: Physicians and Engineers Working Together to Fight Cancer
Issue No. 2012

Robots and Other Mechanical Devices

By: Valerie Matthews Mehl
Date: December 20, 2011

Technology Improves Prostate Cancer Treatment

Dan Stoianovici
Dan Stoianovici

The first things one notices upon entering the laboratory of Dan Stoianovici is the specialized machinery and tools.  Is it a workshop or a laboratory? The large factory-style machinery, red Craftsman toolboxes, wrenches and other tools hanging on the wall belie the room’s true purpose.   The anatomical models seen near robotic arms and other futuristic devices offer clues.

In fact, it is both workshop and medical laboratory. Stoianovici, Director of the Johns Hopkins Urology Robotics Program and Laboratory tucked away on the Bayview campus, develops and builds, piece by piece, surgical and image-guided robotics systems used to treat urological cancers. 

The plastic dummies stand in for humans as he and his team test their inventions, surgical systems that they build from scratch (thus the machinery and tools), specifically to meet the unique challenges of prostate and kidney cancer treatment delivery.   

It is a laboratory like none other where manufacturing meets medical research.  Three industry- grade manufacturing machines, almost never seen in research laboratories, allow the researchers to design, build, and test these highly advanced devices.  Among their projects is an MRI-guided robot powered by pneumatics that is completely metal-free to be compatible with the strong magnetic field generated by the MRI.  It will soon be used by urologist Mohamad Allaf and radiologist Kasia Macura to target prostate biopsies under MRI guidance.   It will also be used by radiation oncologist Danny Song to perform brachytherapy, a procedure in which radioactive seeds are injected into prostate tumors to kill cancer cells. MRI provides a much more detailed image of the prostate than other scans and possibly allows clinicians to directly target cancers for biopsy and treatment delivery.  “I can see the prostate on the MRI screen, point to a place where I want a seed, and a robotic-driven needle puts the seed in the exact spot,” says Song.

Other technology developed in the lab focuses on needle handlings. Needle interventions are common across most medical specialties, and they include needles that are guided by medical imagers, such as X-ray or ultrasound. The force as the needle is pushed into its target can move tissue, decreasing its targeting precision, To solve this problem, Stoianovici and team have developed a revolving needle driver that works like a drill, rotating as it enters, creating less force against the tissue, keeping it straighter, and therefore, providing more precise placement.

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