TP Pivot Pro™
A needle guide for the minimally invasive transperineal prostate biopsy approach
Interview: Dr. Hashim U. Ahmed
Hashim U. Ahmed, Professor in Urology & Consultant Urological Surgeon, performed the first ever European TP Pivot Pro™ cases at Nuffield Health Parkside Hospital in London in January, 2025.
Hear Hashim's insights on case histology, the learning experience, the transperineal approach, and the key stand-out features of TP Pivot Pro™ below.
Interview
First European Cases Outcomes
The first cases went well and the results were exactly as Hashim wanted them: they all came back showing cancer, confirming that no cases were missed. So far, the experience using TP Pivot Pro™ has been great, providing the flexibility needed for precise targeting and systematic biopsies
Three Key Features
1) Adjustable Depth Control
The ability to vary the level provides significant precision and flexibility during procedures.
2) Angulation Capability
The ability to adjust the angle is crucial, allowing access to any area of the prostate for targeted biopsies.
3) Seamless Integration
The ability to integrate with the ultrasound or image fusion systems you already have ensures a smooth workflow without the need for additional equipment or modifications.
"I think those three features, as well as some of the cost benefits against competitors, make this something that UK urologists should strongly consider trying."
Learning Curve & Probe Attachment
Like with any device, the TP Pivot Pro™ does have a learning curve, though not a very steep one, as it is quite straightforward to use. However, Hashim recommends practicing on a phantom and becoming familiar with attaching and removing it from the ultrasound probe. The TP Pivot Pro™ is designed to fit most ultrasound probes without the need for adhesive materials like tape.
"You should, outside of the patient, practice changing the levels so that you can move the needle up and down and it requires some finesse to [do] that. You need to practise moving the angulation as well. And what I found is rather than fully tightening up the needle, keeping it loose - so allowing you to vary the angle - makes a big difference", says Hashim.
Transperineal vs. Transrectal
The debate between transperineal and transrectal prostate biopsies should be over, says Hashim. The evidence is clear - transperineal biopsies have lower infection and sepsis rates, making them the safer option.
Patient safety is key. Avoiding infections means avoiding life-threatening complications like sepsis and reducing the need for strong antibiotics, which is crucial for antibiotic stewardship. While prophylactic antibiotics may still be necessary in large cities like London, smaller towns may manage without them.
Beyond safety, transperineal biopsies also provide better access to apical and anterior lesions, further reinforcing their clinical advantage.
TP Pivot Pro™ Procedure
"If there are issues, or if there are things in terms of efficiency or costs that you think could be dealt with, then it's definitely worth giving this a try"
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