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Related Experiment Video

Updated: Mar 29, 2026

Probe-based Confocal Laser Endomicroscopy of the Urinary Tract: The Technique
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Intraoperative Optical Biopsy during Robotic Assisted Radical Prostatectomy Using Confocal Endomicroscopy.

Aristeo Lopez1,2, Dimitar V Zlatev1,2, Kathleen E Mach1,2

  • 1Department of Urology, Stanford University School of Medicine, Stanford, CA 94305-5118.

The Journal of Urology
|December 3, 2015
PubMed
Summary

Confocal laser endomicroscopy shows feasibility for optical biopsy during robotic prostatectomy. This technology may improve surgical outcomes by identifying key structures and guiding nerve-sparing dissection.

Keywords:
erectile dysfunctionmicroscopy, confocalprostatectomyprostatic neoplasmssurgery, computer-assisted

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Area of Science:

  • Urology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Robotic assisted radical prostatectomy (RARP) can be enhanced by intraoperative optical biopsy technologies.
  • Accurate identification of anatomical landmarks is crucial for improving surgical outcomes in RARP.

Purpose of the Study:

  • To evaluate the feasibility of using confocal laser endomicroscopy (CLE) during RARP.
  • To assess CLE's potential for intraoperative optical biopsy of prostate and periprostatic tissues.

Main Methods:

  • CLE was performed in vivo on 15 patients undergoing RARP after fluorescein administration.
  • Ex vivo CLE imaging was conducted on prostate specimens from 20 patients.
  • Standard robotic instruments were used for probe manipulation; images were analyzed with mosaicing algorithms and compared to H&E staining.

Main Results:

  • CLE was successfully integrated into RARP, with co-registration of video sequences and robotic probe handling.
  • Intraoperative CLE visualized the neurovascular bundle, showing dynamic vascular flow and intact axon fibers.
  • Ex vivo CLE distinguished normal prostate glands, stroma, and prostate carcinoma.

Conclusions:

  • This study reports the initial feasibility of optical biopsy using CLE during RARP.
  • CLE offers a novel intraoperative imaging method for image guidance and tissue interrogation.
  • This technology has the potential to enhance functional and oncologic outcomes in prostate cancer surgery.