"The future of surgery is not about blood and guts; the future of surgery is about bits and bytes.”
/Dr. Richard Satava/

Monday, November 28, 2011

IRCAD France // Taiwan

"It all began in 1985, when the first cases of successful implementation of minimally invasive cholecystectomy were done. Minimally Invasive Surgery means to have a smaller wound, less bleeding, reduced risk of infection and reduced postoperative pain. Most often MIS comes with faster recovery, increased utilization of hospital beds in medical institutions, therefore it was predestined to gradually replace traditional open surgery." (Yet to see...)
IRCAD stands for Institut de Recherche contre les Cancers de l'Appareil Digestif (so, the Institute for Research into Cancer of the Digestive System). It was founded by Prof. Jacques Marescaux in 1994, and has quickly emerged to be the world's No 1. MIS training center. Just to mention a few milestones, the Lindbergh operation took place here in 2001, the first documented NOTES procedure was done, and they have been running the extremely useful Websurg webite/online university. (Not to mention their most recent MIS student course, covered here.)  
IRCAD, in consortium with the University of Strasbourg, also runs a couple of engineering and research programs, such as their Image Sciences, CS and Remote Sensing Lab. They are about to start their own interdisciplinary engineering MS program. Interesting... 

    "In 2008, the Asian long-range minimally invasive surgery center (IRCAD--Taiwan, AITS) was founded in Changua with the direct support and control of the French IRCAD. "It was planned to become the world's top MIS teaching institute: organize and implement intensive classroom training, enhance Taiwan's minimally invasive surgery with the world, but also allow Taiwan to become the clinical knowledge of minimally invasive surgery and technology high ground". The goal is  "that in 2020 Taiwan advanced minimally invasive surgery became a leading national technology and equipment." Just last week, the International Symposium of MIS and Medical Robotics was orgnaized there. (This will be covered in the next post.)
Currently, they have no da Vinci, due to it's price, but there are a total of 9 robots in Taiwan. 
Also, the International Medical Center of Excellence on Medical Robotics was founded here. (This will be introduced later in more details.)
We were extremely happy to be given a personal tour by our host, Prof. Hsiao-Wen Tang (will cover the event later). We were shown the training facilities of IRCAD, and then to the Show Chwan Health Care, where the private section is really lile a 5* hotel. IRCAD-Taiwan is probably the biggest operating simulation room in the world with 22 stations to provide excellent equipment. (Also available for rent.)

Tuesday, November 22, 2011

ARTAS hair transplant robot

Hair transplantation has been a time consuming and tidious procedure, therefore very expensive. According to the classical method, skin stripes are cout out from the hairy part, grafts are collected from it and then reiserted in tha bald area. This has been partially rpelaced with the newer technique, the individual collection of folliculi. However, this requires advanced skills and great practice--therefore it calls for robotization! 
The ARTAS system was first reported in 2003, and this spring it has finally received FDA approval. It is capable of automatically identifying the individual folliculi and cut some out randomly, in a minimally invasive manner. Reportedly, it is possible to achieve 500 grafts/hour with the robot, which is practically double the speed of manual harvesting. (Still takes hours to perform a complete session of 1500-2500 grafts.) Also, the robot reduces the proportion of dead (i.e., cut, injured) folliculi to around 10%.
One robot is already at work at Brenstein Medcial Center.

The US patent was granted to Dr. Gildenberg in 2003. Interestingly, it was described on a Neuromate robot.
Back in time, a French company also tried to come up with a similar system, but apparently they never got commercial.

Friday, November 18, 2011

IRCAD MIS course #2

Yesterday, we had the second event of the IRCAD B.E.S.T. course with Prof. Errol Lobo (USA) on Airway Management and  Prof. Joel Leroy on Trocar Insertion: complications & preventions.

Friday, November 11, 2011

IRCAD MIS course #1

The first B.E.S.T. Innovation in MIS event was really great: Dr. Barry introduced the history of MIS briefly. Next session willl be Nov. 17. 5 PM (CET):
  • Basic Management of Airway (Prof. Errol Lobo, USA)
  • Trocar Insertion: complications & preventions (Prof. Joel Leroy, F)
You will be able to watch it live on this site, after registration.

Tuesday, November 8, 2011

Into Intuitive financials

Q3 results are out, stocks are at their very best (above $430), since there are over 2000 da Vincis world wide! It’s time to take a closer look at Intuitive’s financial situation (which is getting better and better). They have achieved (yet again) around 30% increase in revenues, sales and procedures:
  • 133 da Vincis sold in Q3 (up from 105 a year ago), 29 dual consoles sold along with 98 simulators.
  • 14 classic and 21 da Vinci S systems were upgraded to Si-s
  • total revenue was $447 million, up 30% over Q3 2010
  •  revenue  from instrument and accessoriec: $176 million, up 38% over Q3 2010
  • total recurring revenue (from service fees and so): $248 million, up 34%
  • net income: $122 million, up 41%
  • operating profit of $214 million, up 32% 
  • Intuitive hired 76 people bringing the total team to 1,845 employees
  • total revenue for the first 9 months of 2011 was $1.26 billion, up 23% from last year
  • procedures grew app. 30% , mostly driven by gynaecology
  • quarter ended with $1.9 billion in cash and investments
Prior studies typically underestimated Intuitive's performance (like this 2008 study from Leeds), yet bidding on it against other med tech companies:


Tuesday, November 1, 2011

Eye surgery system from Univ. Eindhoven

"Researcher Thijs Meenink et al. at TU/e has developed a smart eye-surgery robot that allows eye surgeons to operate with increased ease and greater precision on the retina and the vitreous humor of the eye." It consists of a custom developed dual-joysticked master unit (from Ron Hendrix) and a two-armed "slave" robotic module. Basic features include:
You can see a short video on the range of motions here. Or learn about the system through Thijs' publications.

Source: TU/e, Gizmag
Ed.: Since  I've know Thijs for a while, more details to come soon.