With Robotic Rectum, Doctors Practicing Prostate Exams Are No Longer In the Dark

By Elizabeth Preston | July 19, 2016 11:11 am

Roborectum 2.smaller

The rectal exam is a delicate art to learn. Doctors perform this procedure entirely by feel, with just one finger. Students who are learning how to do such an exam have no way of showing their work to their teachers. And volunteer subjects are—unsurprisingly—rare. In the entire United Kingdom there’s only one person registered as a test subject for rectal exams, says Fernando Bello, who works on surgical computing and simulations at Imperial College London.

Rectum models made of plastic exist to help train new doctors. But these are limited in how much they feel like the real thing. That’s why Bello and his colleagues built a robotic rectum.

On the outside, the teaching tool (shown in the photo above getting an exam from Imperial College London’s Alejandro Granados) looks approximately like a disembodied rear end. Inside, squishy robotic elements recreate the feel of a patient’s prostate gland and other anatomy.

The model’s robotic parts both track the examiner’s finger and push back on it in a realistic way, Bellos explains. “The position of the finger is sent to the simulation software,” he says, “which can then detect when the finger collides with anatomical regions and generate adequate reaction forces.”

The device can even be programmed to match different anatomical specifications. When Bello and his colleagues took MRI scans of volunteers, they found a lot of variation in the sizes and shapes of people’s rectums and prostates. Being able to program the robotic rectum means doctors could practice on a range of anatomies that represents human variation better than an unchanging plastic model does.

Meanwhile, a computer screen shows a 3D image of what’s happening inside the robotic patient. Researchers presented the technology at the Eurohaptics conference earlier this month. (“Haptic” technology is the intersection of computer science and the sense of touch.)

Bello says the next frontier in robotic anatomy is the female pelvis.

“We are already working on bimanual vaginal examinations,” he says. The haptic technology is similar, “but of course the virtual anatomy is that of a female patient rather than male.” This model is even more challenging to build than a robotic rectum, Bello says, because a doctor doing a female pelvic exam uses two hands—one inside and one outside the body—to squeeze the uterus or ovaries. So a robotic model has to simulate the interaction between the anatomy and both hands, rather than just one finger.

But the researchers think the effort will pay off. Robotic models could be an added step in training, they suggest, after simpler models but before students practice on an actual person. By the time doctors get to examine patients, maybe the robots will have helped give their technique a more human touch.


Image: Imperial College London

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  • http://www.mazepath.com/uncleal/qz4.htm Uncle Al

    Physicians as assembly line workers, awesomely billable, and all men get assaulted because “it’s routine.” Non-special risk and asymptomatic populations will suffer iatrogenic and nosocomial “misadventures” in excess of summed diagnostic advantages, ditto colonoscopy for both sexes.

    You have the fundamental right to refuse any medical procedure. Remember Joan Rivers and “It’s routine.” “ a female pelvic exam uses two hands—one inside and one outside the body—to squeeze the uterus or ovaries.” Sexual assault.

    • http://tim-barrus.4ormat.com/ Tim Barrus

      I totally agree. Rape is rape. The medical community needs to find another way. But the old paradigms are the new paradigms. It’s not even open for discussion. The patient must submit to humiliation because humiliation is routine. And then they wonder why men stay away.

      • Amaya Hiko

        Being a women and living most of my life with a gynecologist looking into my vagina and sticking her fingers inside for a routine inspection..

        I know – that what you are talking about is rape. Rape is intentional. If you go to a doctor to let him or her stick they finger into you – because you have problems and you can’t compare them to a textbook – there will be an expert opinion if your bowels are in the right place and if there is a knot or not. They even know a thing or too about smell or stiffness.

        Best words my proctologist said to me.. knead your buttocks once in a while.. that way you are able to prevent it from tearing. And i was like.. this makes sense.

        He has to look for the intensity of tears as well. Because you could be stuck with your digested food otherwise.

        And my gynacologist – she can tell me if i look inside as healthy as i should or not.

        Its not rape. Rape is – when i don’t want somebody to touch my innards and to mistread my body for his sexual pleasure.

        Even if i feel slightly elated because something was touched – its a body response. I am thinking analytical about it.

        If you refused a medical procedure.. thats another thing. But don’t compare the fact that you need to squeeze things sometimes or rub over them with assault.

        • http://tim-barrus.4ormat.com/ Tim Barrus

          As a rape survivor, my reactions around being touched — touched at all, anywhere — are not what most people would describe as being rational. Rational to them. I can understand that other people don’t see it in the same way I see it. I would never allow a doctor to touch me. At all. Ever. I would rather be dead. My choice. My right. My way. I loathe being touched by anyone. You can be as rational as you want. I cannot even imagine removing my clothes to be inspected. Being touched will never, ever, ever be forced upon my body again. It is my body. It belongs to me. It does not belong to the rapist. It is your right to see doctors as helpers. That is fine. For you. It is not fine for me. People often think one size fits all. It does not fit me in any way.

    • Bobareeno

      Yes. We need a low cost medical device to do these very “personal” examinations. Nuts to the convenience of the MD’s

  • http://ourdayart.com Sandra9

    We have found that a favorite choice is family portrait painting or painted family portraits.

  • nik

    How long before these features become incorporated into sex dolls?
    Sex sells!

  • Obsbi

    it’s what some french would call a “quenelle”

  • Obsbi

    poor Fernando Bello, he will need some other talent to stay in touch with the medical world

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Like the wily and many-armed cephalopod, Inkfish reaches into the far corners of science news and brings you back surprises (and the occasional sea creature). The ink is virtual but the research is real.

About Elizabeth Preston

Elizabeth Preston is a science writer whose articles have appeared in publications including Slate, Nautilus, and National Geographic. She's also the former editor of the children's science magazine Muse, where she still writes in the voice of a know-it-all bovine. She lives in Massachusetts. Read more and see her other writing here.

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