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.

每8名妇女中就有1人罹患乳腺癌，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进行保乳手术，在保留乳房健康部分的同时切除肿瘤。使用目前的切除方法，平均每三个接受保乳手术的妇女中就有一个由于肿瘤切除不完全而需要至少一次额外的手术。重复手术会导致术后并发症、化妆品受损、放射治疗延迟、心理困扰增加以及第二次全身麻醉的费用和风险增加。重复手术往往导致全乳切除术，这是一个创伤的经验，病人谁期望治愈治疗乳房保留。由于早期乳腺癌是摸不到或看不见的，外科医生倾向于在目标肿瘤周围应用大量的安全边缘，并切除大量健康的乳腺组织。在目前的实践中，多达40%的接受保乳手术的患者经历了严重的乳房畸形，需要手术重建，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，我们的目标是开发新一代保乳手术导航系统NaviKnife，以实现最小组织损失的肿瘤完全切除。naviknife建立在新的多参数超声成像的基础上，在切除前准确地靶向癌症，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残余的癌症，如有必要，指导外科医生有针对性地剃除腔壁，最大限度地减少健康组织的损失，从而保证在伤口关闭之前完全切除肿瘤。