Use of a Telerobotic Arm to Perform Ultrasound Guidance During Renal Biopsy in Transplant Recipients: A Preliminary Study

BACKGROUND: Renal biopsies are usually performed by a nephrologist and require ultrasound guidance from an expert. This procedure can be time-consuming and expensive. PATIENTS AND METHODS: We propose using a robotic arm, controlled from a remote location, to perform ultrasound guidance during renal biopsies in postrenal transplant patients. The procedure would be performed under ultrasound guidance from a radiologist, controlling a robotic arm from one institution, while the nephrologist would perform the biopsy at another. This would allow biopsies to be performed under the guidance of an expert in ultrasonography, without requiring him to leave his institution. RESULTS: Four patients underwent teleoperated renal biopsy. None of the patients had any postbiopsy complication. Total time used to perform the renal biopsies was significantly increased when compared with conventional biopsy technique. Compared with conventional ultrasound guidance, the nephrologists performing the biopsies reported discomfort with the robotic arm carrying out the ultrasonography. CONCLUSIONS: We demonstrated the feasibility of teleoperated ultrasound-guided renal biopsies. This technique can be used to compensate for the absence of an ultrasonography expert and save time. Additional invasive urologic procedures using the ESTELE robot arm, including renal punctures before percutaneous nephrolithotomy and prostate biopsies, are planned.