Project leaders: Christophe MICHAUD , Quentin MANACH
For diagnosis and therapy - (19/09/2024)
Minimally invasive surgery is constantly evolving to reduce the size of incisions. However, for organ removal surgery, the size of the incision is an obstacle to the extraction of the surgical specimen. In some cases, such as the surgical treatment of benign prostatic hyperplasia (BPH), the surgical specimen is destroyed in situ.
BPH, also known as prostate adenoma, is a common condition in men over the age of 50. The initial management of symptomatic BPH is based on drug treatment. In the event of complicated BPH, or if drug treatment fails, surgical treatment is considered (70,000 operations/year in France). French and European recommendations currently position endoscopic enucleation of the prostate as the reference treatment. This minimally invasive surgical technique involves removing the adenoma via the endoscopic urethra, meaning through the natural channels. The first stage, called enucleation, involves detaching the adenoma from the peripheral part of the prostate. The adenoma is then pushed back into the bladder, cut into tissue fragments and aspirated using a morcellator. This second stage of morcellation is a delicate one, and the time taken to complete it varies considerably (particularly in the case of dense structures). In some cases, it accounts for more than two-thirds of the operating time, with consequences such as increased anesthesia time, greater post-operative morbidity and longer, unpredictable OR occupancy. In order to reduce the time taken to morcellate the adenoma, the search for innovation has focused on cutting the adenoma with the morcellator and keeping the adenoma on the morcellator.
The aim, at this stage of the project, is to be able to qualify the prostate adenoma and its intra- and inter-patient variability, and then to numerically simulate the stresses to which the morcellators designed will be subjected. The validated designs will then move on to the prototyping phase.
Contact : Christophe MICHAUD et Quentin MANACH (Hôpitaux Paris-Saint Joseph & Marie Lannelongue)
