Prostate exams aren't exactly an enjoyable experience, but if you ever need one, you'll want the doctor to know what they're doing. Unfortunately, the procedure is difficult for med students to learn, thanks to the internal nature of the examination and a lack of willing test subjects. Scientists at Imperial College London wanted to solve that problem by developing a robotic rectum that recreates the feel of the real thing and even provides haptic feedback.
The cheek-clench-inducing procedure involves a doctor snapping on a glove and probing a man's back passage, which is the most direct path to the prostate gland. A hardened or enlarged prostate is often a warning sign for prostate cancer, and the procedure is commonly used to determine if a patient needs to undergo further tests.
"Internal examinations are really challenging to learn – and to teach," says Dr Fernando Bello of Imperial College London. "Because the examinations occur in the body, the trainer cannot see what the trainee is doing, and vice versa. In addition to this, medics rarely get the chance to practice the examination, as few patients would volunteer as practice subjects. In fact there is only one person registered in the country as a test subject, called a Rectal Teaching Assistant (RTA) in the UK."
Rather than rely on that one person with a pain-in-the-butt job, the scientists' robobottom is designed to feel far more authentic than existing plastic models. The user slips their finger inside a silicone thimble, and small robotic arms apply pressure to recreate the sensation of living tissue. Using a screen to display a 3D image of the anatomy allows both trainer and trainee to see what's happening in there.
The robotic rectum is customizable too, allowing trainers to program in a variety of scenarios and teach students the difference between a healthy and a potentially cancerous prostate gland.
"We have already asked a number of doctors and nurses - including prostate specialists and cancer surgeons - to trial the technology," says Dr Alejandro Granados, the researcher leading development of the project. "They commented on the great advantage of being able to alter the anatomy. The size and shape of the rectum and prostate can vary greatly from person to person, and this technology enables medics to practice their skills in many different virtual patients. They also observed that because these examinations are performed solely by feel, experiencing a realistic sensation is crucial."
"Previous models have had a few pressure sensors placed inside a model rectum, but none have provided the type of 3D modeling and detailed touch feedback available with this technology," adds Dr Bello.
This realism was achieved by conducting MRI scans of patients, and the team continues to collect data to improve the device. For example, they're asking doctors to put small pressure sensors inside their gloves, at the fingertip, to register the exact pressure needed for an exam, as part of ongoing research into the best practice for the procedure. These sensors could also be used in conjunction with the imaging software and standard plastic models as a more affordable alternative to the robo-rectum, which could cost over £10,000 (US$13,250).
The team is currently working on developing these prototypes for use in medical schools, as well as adapting the technology for use in gynaecological exams. The device is being presented at the Eurohaptics conference in London this week.
Source: Imperial College London
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