In theatre
In theatre
The robotic HIFU system, in use
Photographs from the operating theatre. Some images have been edited with AI tools.
Dr Sachin Arakere Nataraj · Focal therapist · Uro-oncologist · Robotic surgeon
Focused ultrasound destroys the tumour and leaves the healthy gland, nerves and sphincter untouched. No incision. Home the same day. Delhi NCR & Bangalore.
Two minutes, plain words, no jargon.
Read →Four questions, then a plain answer.
Begin →What 1,379 men over seven years tell us.
See →When focal isn't enough. roboticurologyindia.com
Visit →Remove the whole prostate, or radiate the whole prostate. Both treat a tumour the size of a grape by treating an organ the size of a walnut, and everything wrapped around it. That is why the conversation turns, very quickly, to pads and erectile dysfunction. There is a third option. It has been in use for over a decade.
Live with a cancer you know is there. Yearly MRI and PSA, biopsy when something changes. Right for very low-risk disease. Hard on the nerves.
Treat the tumour inside the gland and leave the rest. One session, no incision, home the same day. 98 in 100 pad-free; most men keep erections.
Remove or radiate the whole prostate. Right when disease is in more than one region or higher grade. Higher risk to continence and erections.
A probe placed under anaesthesia delivers focused ultrasound, like a magnifying glass concentrating sunlight, to a point inside the prostate. Each pulse heats a grain-of-rice-sized spot to around 80°C and destroys it. Guided by your MRI, the tumour is treated spot by spot with a safety margin.
Nothing is removed, nothing is sewn. The nerve bundles and urinary sphincter are deliberately left alone.
About two hours under anaesthesia. Most men go home the same day.
Back to normal life in days. Mild burning on urination for a few days is usual.
If cancer ever returns, repeat focal treatment, surgery and radiation remain fully available.
The grey points are the prostate. The red zone is the tumour with its safety margin: the only part treated. Everything else, including the nerve bundles at the back corners, is left exactly as it was.
Five scenes, each showing one step. Tap a scene to jump to it.
Illustrative animation, not surgical footage.
This practice delivers focal HIFU with a robotic HIFU system. It rests on three things: finding the target, treating it precisely, and published evidence. The four steps below are what happens during the session.
Multiparametric MRI locates the suspicious area and guides the biopsy. Both the MRI and the biopsy map are then carried into the treatment.
Focused ultrasound is delivered through the rectum with no incision. Treatment is built from small unit lesions, so the treated area follows the shape of the plan.
HIFU for prostate cancer has long-term published follow-up, including a multicentre study of treating one half of the gland.
The MRI and the biopsy map are fused with live ultrasound, so the tumour seen on your scan is shown on the treatment screen.
The fusion is elastic: it reshapes the MRI to match the prostate as it lies on the day, rather than simply overlaying one picture on another.
The tumour is outlined and a safety margin added. Everything outside that line is planned to be left alone.
The plan is made on your own images before any energy is delivered, and can be adjusted during the session.
The probe is moved by the machine, and the focal point is steered electronically, so each small lesion lands where it was planned.
The same probe images the prostate and delivers the treatment, so the surgeon watches each shot on live ultrasound as it happens.
The distance between the treatment zone and the rectal wall is measured and controlled in real time.
This is the main safety check of the procedure and the reason serious injury to the rectum is rare.
The manufacturer points to more than 80 peer-reviewed publications on prostate HIFU. Three they name are listed here so you can read them yourself. Published results describe groups of patients; they do not predict an individual result.
Device facts on this page are taken from the manufacturer's published product information and reworded. Specifications can change; this site is independent of the manufacturer.
Photographs from the operating theatre. Some images have been edited with AI tools.
Focal therapy is a family of treatments defined by how much of the gland is treated. Red is the treated zone; the white dots are the nerve bundles.
Only the tumour seen on MRI, plus a safety margin of a few millimetres. The smallest treatment; preserves the most.
It depends on accurate imaging and a biopsy that maps the whole gland properly.
One quarter of the prostate. A slightly wider field when the tumour sits clearly within one quadrant.
One whole side is treated; the other is left alone.
Used when cancer is confined to one side but involves more than one spot, or when its exact edge is uncertain.
One full side plus the front of the other, sparing one nerve bundle.
Used when a tumour crosses the midline at the front of the gland.
The entire prostate is treated without being removed. Strictly, not focal therapy.
Side effects are closer to those of radical treatment. It has a place in selected situations, including cancer that returns after radiotherapy.
A smaller field protects continence and erections. A wider field lowers the chance of leaving cancer behind.
The right answer is the smallest field that safely covers everything the MRI and biopsy have found.
Several technologies can destroy a defined zone of prostate tissue. This practice uses HIFU, delivered with a robotic HIFU system. The others are shown so you can understand what you may be offered elsewhere.
Ultrasound waves focused to a rice-grain point at 80–90°C. No needles, no incision.
The tumour is treated point by point under live ultrasound. It reaches the back and middle of the gland best; far-anterior tumours in a large gland, or heavy calcification, are harder. HIFU has the longest published follow-up of the focal treatments.
Thin needles freeze the tumour to about −40°C in two freeze–thaw cycles.
The ice ball is watched on ultrasound and a warming catheter protects the urethra. Cryotherapy reaches tumours at the front of the gland well and is useful in larger prostates.
Very short high-voltage pulses punch permanent holes in cancer-cell membranes. No heat.
Because it is non-thermal, nearby nerves, vessels and the urethra tolerate it better. It needs general anaesthesia with full muscle relaxation, and is often considered near the apex or a nerve bundle. Follow-up data are shorter than for HIFU and cryotherapy.
An applicator in the urethra heats outwards while an MRI shows a live temperature map.
The urethra and rectum are cooled throughout. It can treat part or all of the gland. It needs an MRI suite and a longer procedure.
A fine laser fibre, guided by MRI, heats a small and very precise zone.
Suited to small, well-defined tumours. Available in few centres.
A light-sensitive drug is activated by laser fibres and shuts off the blood supply to the treated zone.
Studied mainly in low-risk disease, and available in few centres.
Radioactive seeds, or a temporary source, deliver radiation to part of the gland only.
A radiation-based form of focal treatment that is still being studied.
Where the tumour sits, the size of the gland, the grade of cancer, and the team’s experience.
Front, back or apex; gland size and calcification; the grade and volume of cancer; previous treatment; and the experience of the team with each technology. No single energy is right for every tumour.
Availability of each technology varies between centres in India. Which approach suits you is decided only after your MRI and biopsy have been reviewed.
Focal therapy is a programme, not a single morning. Most of the work happens before the treatment, in confirming exactly where the cancer is, and after it, in checking that it has gone.
A multiparametric MRI, then a biopsy that samples both the MRI target and the rest of the gland. A PSMA PET scan is added when the risk warrants it. The aim is to prove the cancer is confined and to know exactly where it is.
Your MRI and biopsy are combined into a treatment map: the zone to treat and the margin around it. You have an anaesthetic check and are told plainly what is being treated and what is being left.
Under anaesthesia, usually one to two hours. A catheter is placed at the end. Most men go home the same day or the next morning.
The catheter stays for a few days, sometimes a little longer. Urgency, mild burning, and a little blood or debris in the urine are common and settle. Normal activity resumes within days.
PSA every three months in the first year, then six-monthly. An MRI at six to twelve months. A biopsy of the treated area at around twelve months, or sooner if the PSA or MRI raise a question.
Nothing has been closed off. A second focal treatment, robotic surgery and radiotherapy all remain possible, and the choice is made with you.
Figures from the largest published UK multicentre series. Audited outcomes from this practice are added as they mature.
Does your MRI show a tumour in one region of the prostate?
What does your biopsy report say?
What is your most recent PSA?
What matters most to you?
What it is, how it works, who it may suit and who it does not.
Why we image twice before we treat once.
Catheter out, back at work, what to expect.
The honest version of the eligibility talk.
Operative films show Dr Sachin's own operations. Any AI avatar or narration is disclosed in the caption. More at roboticurologyindia.com.
"The right operation. Not the biggest one."
He treats prostate cancer across its full range: focal HIFU when the disease allows it, robotic radical prostatectomy when it doesn't. He has no reason to steer you toward one. He will tell you plainly which you need.
From radical robotic surgery to focal therapy, so the recommendation isn't shaped by what he happens to offer.
Over 2,000 robotic cancer operations. Volume is the strongest predictor of outcome in this field.
You'll hear what he'd choose for his own family, including when the answer is "wait" or "not me."
Consultations in Delhi NCR and Bangalore. Video review of scans for everyone else.
Short, direct answers to the questions people type into search engines and AI assistants.
Yes. Dr Sachin Arakere Nataraj offers focal HIFU for localised prostate cancer in Delhi NCR and Bangalore, with video review of scans for patients elsewhere.
Men with a tumour visible on MRI and confined to one region of the prostate, Gleason 3+4 or 4+3 (Grade Group 2–3), and PSA under about 20. Roughly one in three newly diagnosed men fit this.
In the largest published series, 98 in 100 men were pad-free and most men potent before treatment stayed potent, because the sphincter and nerve bundles are not treated.
At seven years, about 7 in 10 men needed no further radical treatment and metastasis-free survival was 100% in the largest series. About 3 in 10 need some further treatment, and every option remains open.
One session of about two hours under anaesthesia, home the same day for most men, and back to normal life in days rather than weeks.
Radical prostatectomy removes the whole prostate. Focal HIFU treats only the tumour and its margin with focused ultrasound, leaving the rest of the gland, the nerves and the sphincter untouched.
Published series tell you what focal therapy does in expert hands. These are this practice's audited figures, updated every quarter. Dashes mean the first audit is not yet complete.
No. HIFU has been used for prostate cancer for over twenty years and focal therapy is included in European urology guidelines for selected men. The largest published series follows more than 1,300 men for up to seven years.
It's done under anaesthesia. Most men describe mild burning on urination for a few days.
About three in ten men need some further treatment within seven years. Repeat focal treatment, surgery and radiation all remain possible. Nothing is burned behind you.
Suitability depends on the tumour, not your age.
Most men fly home within 48 hours.
Varies by insurer and policy; the team checks yours before you commit. You receive a written estimate before anything is booked.
Send your MRI and biopsy report. Within one working day you'll have a plain answer: suitable, not suitable, or need one more test, and why. If you're suitable, you'll be offered a treatment date; nothing is booked until you say so.
+91 76762 73920Delhi NCR · Bangalore · Video consultation for MRI review
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