104HO - Introduction to Office-Based Transperineal Prostate Interventions: Systematic Biopsy, Rectal Hydrogel Spacer, and MR/US Fusion

Transrectal prostate biopsy has a cemented role in the diagnosis of prostate cancer, however there is mounting concern regarding biopsy-related infectious complications. Transperineal access to the prostate offers an opportunity to completely avoid fecal contamination during biopsy and
significantly reduce complications inherent to transrectal sampling.

Novel devices and updated sampling techniques have recently been introduced to allow for in-office transperineal biopsy performed under local anesthesia. Such advances permit urologists to perform a transperineal biopsy, historically performed under general anesthesia, in the same amount of time and with significantly less side effects.

Participants will have the opportunity to ask questions and obtain tips and tricks from some of the leaders in the field who have helped develop these new technologies and techniques.

SCIENTIFIC PROGRAM

8:00 am Welcome and Introduction

8:05 am Indications/Rationale for In-Office Transperineal Interventions

8:20 am MRI/Ultrasound Transperineal Fusion Biopsy

8:30 am Transperineal Rectal Hydrogel/Hyaluronic Acid Spacer

8:50 am Hands-on Lab Session - Orientation

8:55 - 11 am Hands-on Lab Session

SURGICAL SKILLS STATIONS: 25 minutes/rotation, 5 Rotations

Hands-on Topic Descriptions

1. Device Assisted Transperineal Systematic Biopsy (PrecisionPoint)
• Skills Assessed:
o Transperineal prostate block
o Transperineal access to all regions of the prostate gland
o Angiocath placement
o Anterior, Posterior, Right/Left Extreme lateral sampling on phantoms
o Transperineal fiducial marker placement in 3 sites on phantom

2. Device Assisted Transperineal Systematic Biopsy (SureFire)
• Skills Assessed:

o Transperineal prostate block
o Probe Set-up
o Device assembly
o Condom and gel placement on probe
o Transperineal access to all regions of the prostate gland
o Perineal skin puncture
o Anterior, Posterior, Right/Left Extreme lateral sampling on phantoms

3. Transperineal Hyaluronic Acid Spacer Placement
• Skills Assessed:

o Administration of hyaluronic acid spacer (via Phantom)
o Dissolution of Hyaluronic acid

4. Transperineal Hydrogel Spacer Placement
• Skills Assessed:
o Transperineal prostate block (via simulator)
o Hydrogel resuspension and preparation (with dummy kits)
o Administration of hydrogel spacer (via simulator)

5. Transperineal MR/US Fusion Biopsy Stations (Randomly assigned)

5a. Transperineal MR/US fusion biopsy (Mechanical Arm)

Skills Assessed:

o US sweep
o US Segmentation
o Co-registration
o Targeted biopsy

5b. Transperineal MR/US Fusion Biopsy (Electromagnetic Tracking)

Skills Assessed:

o US sweep
o US Segmentation
o Co-registration
o Targeted biopsy

5c. Transperineal MR/US Fusion Biopsy (3D - Ultrasound)

Skills Assessed:

o US sweep
o US Segmentation
o Co-registration
o Targeted Biopsy


5d. Transperineal MR/US Fusion Biopsy (Predictive Fusion)

Skills Assessed:

o US Segmentation
o Re-slicing
o Co-registration
o Targeted Biopsy

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Accreditation: The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The American Urological Association designates this live activity for a maximum of 3.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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