Originally Published MDDI December
2004
R&D DIGEST
Navigation Surgery Changing Medical Device Development |
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| As a surgeon moves an instrument inside the patient’s body, a camera displays its location on a computer screen. |
A new approach to technology-assisted surgery may greatly influence the design
of medical devices.
A technique called computer-assisted navigation surgery uses a computer and
image-guided camera. It is gaining acceptance as a more precise and less-invasive
way to perform surgery. The technology allows surgeons to move an instrument
inside a patient’s body while its location is displayed on a computer screen.
Doctors can guide instruments the way a global positioning system guides drivers
to their destinations.
In early trials, navigation surgery has contributed to shorter recovery times
and reduced risk of blood clots for thousands of patients. Some in the industry
speculate that these positive signs may cause medical device designers to adapt
their products to the new practice.
Cameron Georges, director of sales for orthopedics at Brainlab (West-chester,
IL), is working with implant manufacturers to make surgical instruments navigation-ready.
Brainlab, DePuy (Warsaw, IN), Zimmer Inc. (Warsaw, IN), and
Biomet Inc. (Warsaw, IN) are developing medical devices with posts for reference
arrays. Reference arrays are small reflective spheres that make it possible
for medical instruments to be seen by image-guided surgery cameras.
“Instead of an adapter, we’re building navigation components right
into the instruments,” Georges says. “Ultimately, this will reduce
surgical time and make devices easier to use.”
Because the surgery enables doctors to make smaller incisions, they can’t
always rely on their eyes to make operating room decisions. David Morrow, director
of computer-assisted surgery at DePuy, is developing microchip-embedded implants
to improve these circumstances. Called “smart implants,” the devices
provide surgical information without the area having to be seen by the surgeon.
“If a patient gets examined every two years, [the microchip] can provide
information on whether the implant has sunk or rotated from its position,”
Morrow says. “It allows doctors to predict failures of the implant.”
Morrow’s team is also developing a detector that can pass over the body
to collect information from the implant’s microchip. The detector will
work “like a security wand at the airport,” he says. Morrow anticipates
having prototypes for the implants and the detector in about two years.
Besides surgery, computer-assisted navigation may affect the way other medical
devices are used. Navigation systems may replace x-rays and fluoroscopy in the
operating room—older technologies that, through years of use, can damage
the health of medical personnel. “Cancer is a danger to surgeons; with
navigation, the danger is less,” says Mitchell Sheinkop, MD, a professor
of orthopedics at Rush University (Chicago).
Sheinkop predicts that in five years a majority of surgeries will be performed
with navigation in some form. Sonny Bal, MD, at the University of Missouri–Columbia
Health Care, agrees. “This is relevant technology that will ultimately
be the standard of care, just like electronic ignition is standard equipment
on all cars now,” he says. “Not that long ago, electronic ignition
was an expensive optional upgrade, pretty much how computer technology in joint
replacement is right now. ”
Copyright ©2004 Medical Device & Diagnostic Industry
