In order to help surgeons perform image-guided open and minimal-invasive spinal surgery, Royal Philips works on an surgical navigation technology based on augmented-reality.

According to a company statement, the technology is significant for cranial and trauma surgeries, pediatric spine surgery, and thoracic spine fusion surgery in adults. Because the thoracic spine is located in the mid- to upper part of the back, the vertebrae are smaller than that of the lower lumbar spine. This makes thoracic fusion surgery more difficult and risky for the surrounding nerves and tissue.

In a preclinical study, more accuracy in placing screws in spines of cadavers, was obtained by neurosurgeons using augmented reality. The accuracy rate of pedicle screw placement in thoracic cadavers’ spines versus freehand placement was increased from 64% to 85% according to the study result.

Less complications are implied by better accuracy according to the business leader of image-guided therapy systems at the company located in Amsterdam.

Since the release of Google Glass in 2013, surgical applications for augmented and virtual reality have gained attention. A London surgeon and the co-inventor of a VR company used the low-cost VR system Google Cardboard to livestream a procedure removing a colon tumor from a patient in April 2016.

In order to add its latest technology, for clinical trials scheduled at about 10 global testing sites, together with its existing low-dose X-ray systems, Philips will need regulatory approval. After full approval by FDA and EU, Philips can expand its use to countless hospitals around the world.

To image the surface of the patient a high-resolution optical camera is placed on a flat X-ray device. The technology constructs a 3D augmented reality vision of the internal and external anatomy, by combining the internal 3D X-ray view and the external camera view. This actual 3D image of the spine of the patient improves procedure planning, surgical tool navigation, accuracy of the implant, and reduces procedure time.

Especially in cranial surgery the technology could be useful, because of brain shape change after releasing the pressure in opening of the cranium. This makes actual images more important than pre-surgical MRI or CT scan images.

 

Because of the extensive experience in the field of designing image guiding systems Philips needs to tailor them to specific procedures. Starting with spinal surgery, fine tuning the system for trauma surgery will follow, and in the future there is the possibility of the system assisting in brain surgery.

 

 

 

  

Friday the 19. May the first patient was treated using the high-field MR-guided linear accelerator (MR-Linac) at the University Medical Center (UMC) in Utrecht/Netherlands. This latest radiotherapy device provide accurate and actual visual images enabling precise irradiation with minimal damage to surrounding tissue even in case of a moving tumor while treating.

 

This MR-Linac system, installed by Elektra and Royal Philips, is emerging as a promising appliance in the field of oncology, for locating and quantifying the tumor tissue, for planning the appropriate therapy, for treatment guidance and therapy evaluation.

 

According to The Netherlands Cancer Institute, precise and correct dose of radiation is potentially reducing side effects of radiation sessions and improves the quality of life, and ultimately regulating the radiation dose increases tumor control ability. 

 

By combining a MRI device and a radiation device, cancer patients would need less radiation because of the greater effectiveness of the radiation. A further great advantage is that less healthy surrounding tissue is affected by the radiation.

 

The new device, developed by some Utrecht professors, is currently being tested on people for the first time, after its development period of 18 years.  Groundbreaking the experts call this new device and it is expected to be used in hospitals and cancer centers and clinics on a word-wide scale in future.  Showing crystal clear images during the treatment, the device can accurately irradiate the tumor, even when moving while the patient is breathing for instance. In this way the treatment can be adjusted to the patient while being in the device. The irradiation times can be lowered so the patient does not have to spend so much time at the hospital.

 The experimental irradiation method is currently applied to five patients with bone tumors. When this radiation turns out to be successful, patients with tumors in the abdomen or pelvis are next to receive the treatment.

  

FDA approval was just granted for a new device combining a digital stethoscope and electrocardiogram for home use. This gadget that patients can use at home to automatically alert them and the physicians of aggravated cardiac functions. By developing machine-learning algorithms, in future also a suspected decline in the heart activity is detected.

The handheld device, called the Eko Duo, contains a smartphone app for wireless transmission of heart noise and electrical activity to a specialist as a warning for heart problems.

The stethoscope intensifies heart sounds up to 60 times, contains four digital audio filters and has an enclosed noise reduction. The electrocardiogram (ECG) is to be connected by two electrodes, patients can select between using the 50 Hz or 60 Hz primary filter.

Berkeley’s Eko Duo is a monitoring and warning device for possible heart failure and atrial fibrillation. It detects possible problems, but this doesn’t mean, it could not give a false alarm. According to the company, doctors can use the Eko Duo at the bed or in medical telecommunication consultations with other clinicians.

In developing machine-learning algorithms Eko expects to combine this with Duo to automatically alert care teams and patients of presumed decrease in heart function.

As studies have shown that approximately one quarter of the patients with heart failure are readmitted to hospital within 1 month and half are readmitted within 6 months it’s obvious that cardiac failure cause extremely high costs for the countries.

Cardiologists consider the device as a great way to gather electrocardiographic findings and heart sounds in a user-friendly manner. It may supply cardiologists with data and information from patients concerning the heart sounds that they couldn’t detect by ears in the past.

 It is planned to start studies focussed on valvular heart disease, to see if it’s possible to develop an algorithm to reliable recognize of patients with serious valvular disease versus those without. Specialists see a great potential for future development.