Robotic breast cancer surgery

机器人乳腺癌手术

• 批准号: 549590-2020
• 负责人: Fichtinger, Gabor
• 金额: $ 8.32万
• 依托单位: Queen's University
• 依托单位国家: 加拿大
• 项目类别: Collaborative Health Research Projects
• 财政年份: 2021
• 资助国家: 加拿大
• 起止时间: 2021-01-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=722580
• 关键词: Robotic; breast; cancer; surgery

Breast cancer affects 1 in 8 women during their lives and is the second-leading cause offemale cancer related deaths. The ideal treatment is breast-conservation surgery during itsearly stage to remove the cancer while conserving healthy parts of the breast. Wirth currentresection methods, on average, one out of every three women undergoing breastconservationsurgery needs at least one additional surgery due incomplete tumor resection.Repeat surgery leads to increased risk of postoperative complications, impaired cosmetics,delayed radiation therapy, increased psychological distress, and increased costs and risks ofundergoing a second general anesthesia. Repeat surgery often leads to full mastectomy,which is a traumatic experience for a patient who expected a curative treatment with breastconservation.As early stage breast cancer is not palpable or visible, surgeons tend to applygenerous safety margins around the target tumor and remove a great deal of healthy breasttissue. In current practice, up to 40% of patients who undergo breast-conservation surgeryexperience severe breast deformity that requires surgical reconstruction, but over half ofthese women do not get treated due to lack reconstructive surgical capacity.In this research, we aim to develop NaviKnife, a next-generation breast conserving surgerynavigation system to achieve complete tumor resection with minimal tissue loss. NaviKnifebuilds on novel multiparametric ultrasound imaging to accurately target the cancer prior toresection and novel real-time metabolomic tissue typing to identify and trace the tumorboundary during resection while guided by a simple robotic arm. NaviKnife assists thesurgeon in precise tumor resection and allows for systematic probing of the resection cavityfor residual cancer and, if necessary, guides the surgeon in targeted shaving of the cavity wallwith minimal loss of healthy tissue, thus guaranteeing complete tumor removal before thewound is closed.

乳腺癌影响八分之一的女性一生，是女性癌症相关死亡的第二大原因。理想的治疗方法是在早期阶段进行保乳手术，以切除癌症，同时保留乳房的健康部分。根据目前的切除方法，平均每三个接受保乳手术的女性中就有一个由于肿瘤切除不完全而需要至少进行一次额外手术。重复手术会导致术后并发症风险增加、美容效果受损、放射治疗延迟、心理困扰增加以及费用增加以及进行第二次全身麻醉的风险。重复手术通常会导致全乳房切除术，这对于希望通过保乳进行治愈性治疗的患者来说是一种创伤性经历。由于早期乳腺癌不易触及或可见，外科医生倾向于在目标肿瘤周围应用宽松的安全裕度并切除大量乳腺癌。健康的乳腺组织。在目前的实践中，高达40%的接受保乳手术的患者会出现严重的乳房畸形，需要进行手术重建，但其中一半以上的女性由于缺乏重建手术能力而没有得到治疗。在这项研究中，我们的目标是开发NaviKnife，下一代保乳手术导航系统，以最小的组织损失实现肿瘤的完全切除。 NaviKnife 以新颖的多参数超声成像为基础，可在切除前准确定位癌症，并以新颖的实时代谢组学组织分型为基础，在简单的机械臂引导下，在切除过程中识别和追踪肿瘤边界。 NaviKnife 协助外科医生进行精确的肿瘤切除，并允许系统地探查切除腔内是否有残留的癌症，并在必要时指导外科医生有针对性地剃除腔壁，同时将健康组织的损失降至最低，从而保证在伤口闭合之前完全切除肿瘤。