| Less Invasive Surgery
Minimally invasive surgery has tended to be limited to static organs and
tissue. Startup Veran Medical Technologies’ Dynamic Track image-guided
technology is claimed to facilitate (when it is built) minimally invasive
surgery on moving organs such as the heart, lungs, and abdomen. A business
analyst foresees tremendous growth in the market for such technologies on the
basis that “hospitals will need to increase their ‘throughput’, increase their
accuracy (of the operation), reduce patient risk, reduce the amount of time that
the patient spends in the hospital, reduce the patient’s recovery time, and
reduce hospital costs.”
But the U.S. National Institutes of Health have pointed out drawbacks to the
technology, such as adding unnecessary costs to a procedure when an image is not
needed, over-interpreting images, and the failure by some systems to update
their images during a procedure, resulting in outdated images.
Veran’s product, though patented, is still conceptual and may not reach the
market until late 2007, assuming it is funded at all.
Reference: Moore, Roy (2003). “Breaking
new ground, Veran Technologies seeks funding.” Nashville Business Journal,
October 10.
See also an article about a stereotactic hair
transplant robot in the October issue.
Shape-memory Alloy Clot Remover
The MERCI Retriever is a tiny experimental corkscrew that has already
enabled brain surgeons to successfully extract blood clots from stroke victims
and, in about half of patients who underwent early tests of the procedure and
for whom this was a last chance, it restored blood flow.
Most of the more than 700,000 annual strokes in the United States are caused
when arteries to the brain are blocked by a clot. The drug TPA can
“dissolve” the clot and, if given within three hours of the first symptoms,
prevent permanent brain injury. But less than five percent of victims get
TPA, either because it is too late, or the clot is too big.
The MERCI Retriever appears to be effective as late as eight hours
after a stroke, and can remove big clots. It is made of a shape-remembering
alloy wire that automatically coils into a corkscrew shape as it exits the
catheter at the point of the stroke, where it is pushed through the spongy clot
then pulled back to dislodge the clot, which is then sucked inside the catheter.
Results of a study of 125 patients ineligible for TPA, conducted at
some of the country’s largest stroke centers, are due in February.
Reference: Neergaard, Lauran (2003). “New
Device May Aid in Stroke Recovery.” Associated Press/Yahoo, October 20.
Infrared Therapy
The therapeutic effects of LEDs (light-emitting diodes) have been known for a
decade, but little understood. A glimmer came in 2002, when infrared LEDs
restored vision in rats blinded by toxic doses of methanol. Flashes of infrared
light repaired up to 95 percent of the damage to their retinas. A handheld LED
cut wound-healing time in half on a U.S. submarine, and “improved healing of
Navy SEALs’ training injuries by more than 40 percent,” reports Wired‘s
Noah Shachtman, somewhat unclearly. DNA synthesis in muscle cells quintupled
after a single application of LEDs, so NASA plans to use LEDs to build
astronauts’ muscles during weightlessness.
The therapeutic effects appear to result from changes in genetic activity in
cells exposed to LED pulses of certain wavelengths. One researcher suspects they
give the damaged cells extra energy, stimulating the natural healing process.
Mitochondria in the cell convert sugars into energy with the help of an enzyme
that carries electrons during the energy-transfer process. His hypothesis is
that photons from the LED substitute for the electrons, but an LED device maker
disagrees and would rather see the research money spent instead on buying its
already Medicare-approved product, which is being marketed as an antidote to
diabetic neuropathy, a deadening in the small nerve endings at the body’s
extremities and the leading cause of diabetic amputations.
A California endocrinologist claims to have successfully treated 95 percent
of more than 200 diabetic neuropathy patients with LED treatments, but says he
has no idea why it works. A pediatrics professor at the Medical College of
Wisconsin “expressed similar sentiments,” writes Shachtman.
Following an earlier study in which mucositis (a chemotherapy side effect
that produces sores in the mouth and throat) in bone-marrow transplant
recipients fell after daily LED therapy, a seven-hospital clinical test is
underway to confirm whether LEDs do indeed reduce mucositis. Early indications
are that patients getting LED therapy have significantly fewer sores than the
control group.
Reference: Shachtman, Noah (2003). “Light at the End
of the Tunnel.” Wired News, October 29.
Drug Delivery via Ultrasound
An Israeli company has developed a handheld device that administers a burst
of radio frequency energy to scrape away the top layer of skin cells, producing
pores big enough for large-molecule drugs such as insulin and human growth
hormone to transfer from a patch (such as used to deliver nicotine to would-be
non-smokers) into the bloodstream. In early studies, pores remained open for a
whole day. The device is said to cause minimum discomfort, sterilize the skin
under the patch, and adjust for different skin types.
Clinical trials of a patch for people suffering from human-growth-hormone
deficiencies may begin in “a few months,” the company says, adding that it is
conducting studies with four pharmaceutical companies to determine the
feasibility of the approach with insulin and other drugs. Competitive approaches
to opening skin pores do exist, including heating, mild electric current, and
ultrasound.
Reference: Hershman, Tania (2003). “Drug Patches
Advance.” Innovation News, November. |
