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Robots assisting in the treatment of breast cancer
―For more accurate and safe no-incision surgery―

Yo Kobayashi
Associate Professor (Senior Researcher), Faculty of Science and Engineering, Waseda University

Introduction

I am a researcher and engineer who develops new medical devices using robotics. As I am not a physician, this article is not intended to provide you with information about whether and why a particular treatment method is good or not. Please understand this before reading the article.

Our group is aiming at improving treatment through the utilization of the accurate and precise movements of robots. To achieve this goal, we consider that it is very important to express medical practice in numerical terms using our knowledge in physics (dynamics). In this article, I will introduce the approaches that we are working on, especially focusing on the treatment of breast cancer.

Radiofrequency ablation for the treatment of breast cancer

Fig. 1 Illustration of radiofrequency ablation

We focus on a treatment method for breast cancer called radiofrequency ablation in the development of new treatment devices. Radiofrequency ablation kills cancer cells by heat or coagulation by inserting a special needle of about 1.5 millimeters in diameter and generating radio waves from the tip of the needle (the principle of radiofrequency ablation is the same as that of microwaves, which use radio waves to heat up objects). This is a popular method for the treatment of hepatic cancer (if liver function permits, surgical therapy is the first choice; it has already been authorized for health insurance coverage) and currently under medical review for its application to breast cancer. Radiofrequency ablation is often introduced as a no-incision treatment method for breast cancer, because it only requires the insertion of a needle to treat cancer and leaves only a small needle mark on the patient body after treatment. Current treatment policies, not only for breast cancer but also in general, require less post-surgical damage to the body and shorter length of hospital stay or time until patients return to society. In the treatment of breast cancer, the top priority is the proper removal of cancer cells, but it is also important to take into account beauty (cosmetic) aspects (for example, whether or not breasts can return to their original shape after treatment and how fast they can return to the woundless pretreatment condition). We saw a promising future in radiofrequency ablation, which has more cosmetic benefits than conventional resection surgery (incision with a surgical knife or other instrument, which often leaves an incision scar), and we decided to start the development of devices assisting in the ablation procedure.

Physical perspective of medical treatment

Fig. 2 Robotic system that assists in the insertion of a needle into breast cancer

We discussed the current problems of ablation from the perspectives of engineering and physics before starting development. The procedure of ablation is roughly divided into the following two processes: (1) inserting a needle accurately into cancer cells (positional relationship between cancer and the tip of the needle) and (2) ablating the region of cancer cells accurately (spread of heat around cancer cells). As the first step to determine the benefits of a particular therapy, it is important to quantify these indices in numerical terms and control them accurately. At the current level of medical device technology, there is no technique that can quantify these indices in numerical terms accurately and control them. For this reason, physicians are forced to depend on their own know-how and experience to provide treatment for patients.

In order to resolve these issues, we are making efforts to develop next-generation treatment systems that can interpret treatment practice physically to quantify it in numerical terms and enable robots to perform accurate movements for treatment according to the obtained numerical values. If this concept is applied to the above-mentioned indices of (1) positional relationship between cancer and the tip of the needle and (2) spread of heat around cancer cells, a treatment device must:

Fig. 3 Visualization of the spread of heat in the organ by simulation

(1) detect the location of cancer cells to enable robots to insert a needle into an accurate position, and
(2) track the spread of heat to enable robots to control the amount of heat to be generated accurately.
For these purposes, we apply robots that can consistently reproduce quantitative and accurate movements to medical devices. We are also trying to understand the physical mechanism for the positional change of cancer cells and spread of heat around cancer.

If such systems become available, the current treatment that depends heavily on the physician’s experience and know-how will be transformed into that based on surgical devices that can quantify treatment practice in numerical terms and control it accurately. This will further result in the reduction of medical errors and improvement of the reproducibility of treatment.

Physician- or patient-friendly medical devices

The development of robot-based treatment devices does not necessarily mean the automation of medical treatment or health care. Even if more robots are introduced to clinical settings, the physician’s knowledge, experience, and skills will remain fundamental for medical care. We are trying to quantify treatment practice in numerical terms as much as possible, hoping to help physicians make judgments or perform medical activities, to reduce the variability of treatment and increase the reproducibility of treatment efficacy. Our goal is to improve the safety of treatment by popularizing the use of robot-based treatment devices. I hope that the improvement of safety will alleviate the concern about becoming ill and contribute to a secure society where people can live a healthy, bright, and active life.

Yo Kobayashi
Associate Professor (Senior Researcher), Faculty of Science and Engineering, Waseda University

October 2005 to March 2007: Visiting Research Associate, Graduate School of Science and Engineering, Waseda University
April 2007 to March 2008: Japan Society for the Promotion of Science, Research Fellowship for Young Scientists
March 2008: Ph.D. in Engineering, Department of Integrative Bioscience and Biomedical Engineering, Graduate School of Science and Engineering, Waseda University
April 2008 to March 2009: Research Associate, Institute for Biomedical Engineering, Waseda University
April 2009 to March 2010: Research Associate, Faculty of Science and Engineering, Waseda University
October 2010 to January 2011 (part-time): Visiting Researcher, LIRMM, Montpellier, France
April 2010 to March 2012: Lecturer (Junior Researcher), Faculty of Science and Engineering, Waseda University
April 2012 to Present: Associate Professor (Senior Researcher), Faculty of Science and Engineering, Waseda University