Freehand biopsy with PrecisionPoint system

The video above, as well as videos from Amir H. Lebastchi, MD, Luke O’Connor, PhD, and Peter A. Pinto, MD; and Andre L. Abreu, MD, illustrate techniques for performing transperineal prostate biopsy. Commentary on the videos is provided by Lebastchi, clinical fellow in urologic oncology, Urologic Oncology Branch, National Cancer Institute, Bethesda, MD.

Lebatschi: George and colleagues demonstrate the use of the Michigan Urological Surgery Improvement Collaborative (MUSIC) template to perform a freehand transperineal prostate biopsy using the PrecisionPoint Transperineal Access System. The University of Michigan group utilizes the innovative PrecisionPoint device, which clamps onto the ultrasound probe. This keeps the biopsy needle in line with the sagittal imaging array and facilitates guidance of the needle toward the biopsy targets. This group uses the MUSIC template, which is a modified 12-core transperineal template biopsy that employs only two access points (one on each side of the prostate). Throughout the procedure, the height of the needle can be adjusted in the carriage to ensure the appropriate level of entry into the prostate. Following the procedure, pressure is applied to the two entry points to achieve hemostasis. The puncture sites are dressed with antibiotic ointment and gauze.

George is assistant professor of urology, University of Michigan, Ann Arbor.

'Y'tube Section Editor James M. Hotaling, MD, MS, is assistant professor of surgery (urology) at the Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City.