The laparoscopic surgical approach to prostate cancer (one of the 1st cause of death in men) is undergoing radical transformation, with the introduction in the operating room of the da Vinci® robot or the ViKY® robot. These robotically-assisted interventions both have advantages and drawbacks. However, neither exploits ultrasound or fluorescence Imaging intra-operatively. Because of their appeal, these new intra-operative Imaging modalities are awaited eagerly by surgeons, in order to provide a more pertinent therapeutic answer to prostate cancer, a major public health problem doomed to grow in the next few years. DEPORRA aims at demonstrating that, with the robotic environment ViKY, one can give to the surgeon the possibility of studying the prostatic tissue intra-operatively and more pertinently, by enhancing endoscopic images with (trans-urethral) ultrasound images and fluorescence images.
Three challenges must be taken up: first, the state of the art in the miniaturization of ultrasound probes and their driving systems, and in the miniaturization of fluorescence probes able to characterize the nature of dissected tissue (prostatic/not prostatic) and their quality (cancerous/not cancerous) must be integrated into a single common environment. Then, the multimodal information must be registered in an enriched robotic environment that provides the surgeon with a global, exhaustive view of his work environment, thus enhancing his capacity to take strategic intra-operative decisions. Finally, the optimal exploitation of this intra-operative environment requires the development of « navigation » procedures that will guide the surgeon in carrying out his gesture (especially the avoidance of regions that must be spared to prevent a degradation of the patient's quality of life).
We have constituted a consortium of experts to take up those challenges: EndoControl brings an expertise in the form of a surgical environment enriched by ViKY and an original method to track surgical instruments; Vermon brings a capacity to build and miniaturize ultrasound probes for the study and the navigation of prostatic tissue; FEMTO-ST brings its technical expertise in miniaturized optical systems for the detection of fluorescence, complemented by the expertise of TIMC-IMAG-RFMQ in the field of fluorescent markers tagging the nature of tissue. ; SQI brings its know-how in the registration between endo-rectal ultrasound and endoscopic images. TIMC-IMAG-GMCAO has a long experience in the conception and integration of multimodal systems for computer-assisted surgery. The Centre d'Investigation Clinique – Innovation Technologique of Grenoble's CHU brings, with its clinical partners, an environment serving as the support for (pre-)clinical evaluations and the validation of prototypes.
At the end of this project in industrial research, we will have all the scientific, technical and clinical elements to create a product having a huge impact. DEPORRA will strengthen the position of three complementary and very specialized industrial actors, EndoControl, SQI, Vermon, SurgiQual Institute, by creating, thanks to a very innovative approach, a new segment in the wide urologic surgery market. We think that the TIMC-IMAG laboratory and its partners will generate at least 3 major publications. A study of prior work showed that the patents that are considered by the consortium will guarantee a significant competitive advantage. Finally the participation of CIC-IT will prepare the demonstration to the Haute Autorité de Santé of the Delivered Medical Service provided by this innovative approach.
The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.
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