Digital Lightbox replaces the conventional light box used to observe analog x-ray images. Connected to the hospital PACS, the new digital platform can be installed both in meeting rooms and in operating rooms, where clinicians can then access, manipulate, and utilize data for surgery planning. By displaying the human body in 3D, Digital Lightbox helps clinicians to more clearly demonstrate to patients what effects a disease can have and which procedures may be necessary.

Digital Lightbox enables clinicians to select the most valuable images from large amounts of existing medical data. Ergonomic touchscreen technology with zoom functionality makes working with data easy and effective.

Clinicians can intuitively navigate within pictures and between settings. Image scrolling can be performed with one finger; zooming in and out of images with two. Images from different sources can also be fused easily. A measure functionality enables clinicians to set size and other dimensions.

By integrating the communication platform iPlan® Net from BrainLAB, clinicians can perform treatment planning with Digital Lightbox or any PC connected to the hospital network. This eliminates bottlenecks, as busy planning stations are rendered obsolete. iPlan Net helps to simplify the clinical workflow and save costs, as well as strengthen and simplify interdisciplinary collaboration between neurosurgery, nuclear medicine and radiology departments.

Digital Lightbox can be installed in any hospital environment and is compatible with all established image formats, such as DICOM, jpg, bmp, tif, png, avi, wmv. Planning data can be transferred directly from Digital Lightbox to surgical navigation systems designed for precise and minimally invasive procedures.

Video demonstrating the Digital Lightbox:

Press release: World Premiere at University Hospital in Munich: Digital Lightbox...

Product page: Digital Lightbox

Here's what the company has just announced:

KLS Martin LP, a medical device company specializing in craniomaxillofacial and sternal fixation, announced today the implantation of the Sternal Talon(R) in the 500th patient.

The Sternal Talon(R) is an alternative method of closure for midline sternotomies used in many heart procedures and utilizes rigid orthopedic-style fixation. Originally developed in conjunction with surgeons at Duke University and surgeons in Tulsa, OK, as a reconstructive alternative for patients with sternal instability and non-unions, the Sternal Talon(R) has been used successfully in primary closure for patients undergoing midline sternotomy for CABG (coronary artery bypass graft) and valvular surgery. Many of these 500 patients had multiple comorbidities, which often lead to significant infections that can be fatal. These patients represent a truly difficult population for sternal closure and until recently the cardiothoracic surgeon had very few treatment options.

"The most common method of sternal closure remains sternal wire, but this is not without problems, especially in the larger patients," says Dr. Arch Miller, one of the inventors from Tulsa, OK. "The patients often exert forces on the wires that can cause the wires to break, pull through the bone or loosen which can lead to sternal instability, infection and increased pain." Using the Sternal Talon(R) on patients with higher BMI (body mass index) improves the chances for better fixation, potentially reducing the risk of sternal complications and resulting in lower patient pain scores allowing them faster recovery.

"One of the most surprising outcomes of the use of the Sternal Talon(R) was the reaction of the post-operative nursing staff who commented that you could tell which patients had the Sternal Talon(R) as they were up and moving around quicker with less pain," said Dr. Miller.

Product page: Rapid Sternal Closure...

Press release...

The video below shows off the technology and demonstrates various cuts using the PlasmaBlade compared to scalpels and bovies.

Peak Surgical homepage...

Press release: PEAK Surgical Receives 510(k) Clearance to Market PEAK® Surgery System for Use in General Surgery...

Flashback: Peak PlasmaBlade Wants to Be The New Bovie

From the press release:

As a testament to the growing demand to improve patient care while reducing healthcare costs, Toshiba America Medical Systems, Inc. has installed the Aquilion ONE™ dynamic volume CT system at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School in Boston.

"In one of the country's leading medical teaching hospitals, we hope the Aquilion ONE's ability to image an entire organ and show function for the first time will mean faster, more accurate diagnosis, better patient outcomes and ultimately lower healthcare costs for our patients," explained Dr. Vassilios D. Raptopoulos, interim radiologist-in-chief, Department of Radiology and director, CT services, Beth Israel Deaconess Medical Center. "We are grateful to be one of the first teaching hospitals in the United States using this advanced technology."

Toshiba's Aquilion ONE dynamic volume CT system utilizes 320 ultra-high resolution detector rows (0.5 mm in width) to image an entire organ in a single gantry rotation. The result is unparalleled in diagnostic imaging today and produces a 4D clinical video showing up to 16 cm of anatomical coverage, enough to capture the entire brain or heart, and show its movement such as blood flow.

"The Aquilion ONE has the potential to provide a single, comprehensive exam that can replace a variety of duplicative and invasive procedures," added Dr. Raptopoulos. "Its versatility and ability to diagnose disease fast will be used within our radiology department to detect and treat life-threatening conditions, including cancer, heart disease, stroke and other neurovascular conditions."

To get impressed, head on to the Aquilion ONE Clinical Movie Theatre at Toshiba, and check out some of the studies presented there...

Product page: Aquilion ONE...

Here's what Philips says about its Brilliance iCT with Essence technology:

... customers tout the system’s ability to provide greater dimension and depth across a range of clinical areas such as whole brain perfusion, cardiac CT with Step & Shoot technology that images the heart in two beats while reducing dose, head and neck angiography, full field of view lung studies, virtual colonoscopy and abdominal and pelvic imaging. Brilliance iCT with Essence technology offers an impressive combination of speed, power and coverage to improve image quality while incorporating the latest dose reduction technology. Overall patient experience is improved through shorter scan times.

In addition to the 256 slice intelligent Brilliance iCT, the Brilliance 64-channel configuration is also designed with Essence technology. Unique and proprietary to Philips, Essence technology brings advances to the X-ray tube, detector system, and reconstruction engine while offering a scalable platform to enhance image quality and dose efficiencies.

“With Brilliance iCT, the superb image quality aids our clinicians in the diagnosis of complicated health conditions,” said Dr. Nathan Peled, head department of radiology of Carmel Medical Center in Haifa, Israel. “The system has delivered increased rotation speeds and improved image quality and clinical performance for diagnostic confidence in routine and advanced radiological imaging.”

Below you can find the technical backgrounder paper distributed by the company:

Product page: Brilliance iCT...

Press release: Philips accelerates plans to install Brilliance iCT around the world...

From a press release obtained by Medgadget:

The company's platform ECM Technology, an extracellular matrix biomaterial, provides a natural bioscaffold that enables a patient's own host cells to repopulate and repair damaged tissues. The CorMatrix ECM is currently FDA cleared for the reconstruction and repair of the pericardium. The additional indication expands the use of the implant to include suture-line reinforcing, buttressing for soft tissue reaproximation, repair of cannulation sites and bleeding sites, and as an intracardiac patch or pledget for tissue repair of structural problems such as septal defects.

"We have used the CorMatrix ECM to close the pericardium for the past two years. An intact pericardium plays an important role short and long term for the patient, both anatomically and functionally. Surgeons typically prefer to restore structures to their normal anatomy whenever possible, which we have been able to do in a safe and effective manner using the CorMatrix ECM. Post-operative CT scans on patients in which we have closed the pericardium have demonstrated the re-established pericardial anatomy complete with normal pericardial space," said Douglas Boyd, M.D., Chief of Cardiothoracic Surgery at the Cleveland Clinic in Weston, Florida.

"The ease of use and post-operative results make it an excellent option for pericardial closure and now for other cardiac tissue repair applications," continued Dr. Boyd. "As with pericardial closure, intracardiac repair using the CorMatrix ECM restores the natural anatomy of the heart. We are pleased that this additional approval will allow us to use the material beyond the pericardium."

Following implantation by a surgeon, CorMatrix ECM Technology products act as a scaffold into which the patient's own cells migrate and integrate, stimulating the body's innate wound-healing mechanisms to repair tissue at the site of implantation. As the patient's cells populate the matrix they lay down their own collagen, which matures over time to form a functional tissue repair. The implanted ECM material is gradually replaced and resorbed by the body as the patient's tissue is remodeled.

CorMatrix technology page...

Long story short, PEAK Surgical wants its Peak PlasmaBlade, a cold cutter and coagulator, to be the bovie of the 21st century. The company is quite hopeful: a new study presented in a poster session at the ongoing American College of Obstetricians and Gynecologists' (ACOG) 56th Annual Clinical Meeting in New Orleans showed that PEAK PlasmaBlade™ "cut freshly excised human abdominal tissue with little thermal tissue injury compared with traditional electrosurgery."

More about the technology:

Electrosurgery was invented in the beginning of the 20th century and became one of the most-often used surgical tools after William Bovie introduced his electrosurgery (radiofrequency) generator in 1926. Since then, electrosurgical cutting has been performed using continuous radiofrequency waveforms, which thermally vaporizes soft tissue via an electrical arc through air and Joule heating. This results in a cutting and coagulation action that leaves a wide zone of collateral thermal damage.

By contrast, PEAK Surgical’s PULSAR Generator supplies pulsed waveforms that produce short plasma-mediated, highly controlled electrical discharges through extensively insulated electrodes on a handheld device -- the PEAK PlasmaBlade. Because the radiofrequency is provided in short pulses with low duty cycle (fraction of time the voltage is ON), and the PEAK PlasmaBlade is so highly insulated, heat diffusion and associated thermal damage to surrounding tissues is limited, resulting in greatly reduced collateral damage and extreme cutting precision.

PEAK Surgical’s technology including the pulsed plasma-mediated discharges and electrode insulation techniques were originally developed by Professor Daniel Palanker’s group at the Hansen Experimental Physics Laboratory and Department of Ophthalmology at Stanford University. They have been evaluated in ophthalmic applications, including human studies in retinal and cataract surgery – one of the most delicate, precise and difficult types of surgery, and in preclinical studies.

Check out the following product brochure distributed by PEAK Surgical:

Product page: Peak PlasmaBlade...

Press release: PEAK Surgical Announces Positive Results from Preclinical Study of PEAK PlasmaBlade™ for Obstetric and Gynecologic Surgery

Video demonstrating the device...

Bronchial thermoplasty is an investigational procedure in which precisely controlled thermal energy is delivered with a tiny catheter to targeted airway walls of patients with asthma. This procedure is intended to reduce muscle in the walls of airways, and thereby decrease the ability of airways to narrow in patients with symptomatic asthma.

The RISA Trial was a randomized trial conducted at a total of eight centers in three countries, and evaluated the safety and efficacy of bronchial thermoplasty in a total of 32 adult subjects, randomized 1:1 between the BT group and Control group with severe persistent asthma who were symptomatic despite taking regular asthma medications.

In this group of patients with severe asthma, an increase in respiratory-related symptoms was expected and observed during the period immediately following the procedure. Most occurred within one day of the procedure and resolved on average within a week. Following the treatment period, respiratory-related symptoms were similar between treatment groups.

Almost 6 months after the procedure, compared to the control group, patients who received bronchial thermoplasty showed clinically and statistically significant improvements in pulmonary function, quality of life and asthma control. In addition, patients in the treatment group used an average of 25 fewer puffs per week of rescue medication than those in the untreated Control group.

All patients then attempted to reduce their inhaled and/or oral corticosteroids (OCS) during a 14-week period. Fifty percent (50%) of bronchial thermoplasty treated patients were able to wean completely off their oral corticosteroids (OCS), compared to 14% of patients who did not receive the treatment. This improvement did not reach statistical significance; however the study was not powered to show statistical significance in medication changes.

One year following treatment, and after the period of medication reduction, patients who received the bronchial thermoplasty procedure continued to show clinically and statistically significant improvements in quality of life and asthma control, and used less rescue medication.

Press release: One-Year Results of Bronchial Thermoplasty in Refractory Asthma

Technology page: Bronchial Thermoplasty

Flashback: The Alair® System for Bronchial Thermoplasty™

Here's what the company says about the presentation mentioned above:

Dr. Patrick Ross stressed the clinical importance of using autofluorescence imaging to provide guidance during endoluminal and traditional surgical treatments for lung cancer. Dr. Ross reported the use of real-time autofluorescence bronchoscopy, compared to the gold standard white light bronchoscopy, provides for a more detailed assessment of the patient's anatomy before pulmonary resection, a more accurate assessment for the presence of early lung cancers and the ability to more precisely perform endoluminal therapies such as Photodynamic Therapy. Dr. Ross also reminded the cardiothoracic surgeon audience that autofluorescence bronchoscopy is now recommended in the 2008 American College of Chest Physicians Evidence Based Practice Guidelines for use in detecting cancerous lesions and for guiding surgical treatments in patients with lung cancer.

Professor Taggart reported his clinical experience using the SPY Intra-operative Imaging System to optimize the clinical outcomes of his coronary artery bypass procedures, which have been previously published in the literature and confirm the need for intra-operative graft assessment. Professor Taggart's presented clinical results of studies he has performed using SPY. Data reported by others indicating that as many as 30% of all vein grafts may be closed at 1 year post bypass were also included. Professor Taggart stressed that coronary artery disease has become more complex, making coronary artery bypass surgery more technically demanding, which further increases the need for real-time assessment of graft quality. Professor Taggart reported on studies of the clinical utility of available technologies for graft assessment, including a report by Nimesh Desai, MD., et.al, published in The Journal of Thoracic and Cardiovascular Surgery in 2006. The randomized study compared SPY and the Transit Time Flow Meter, the two most commonly used tools, to the gold standard x-ray angiography. In the study of 139 bypass grafts, SPY was found to result in 83% sensitivity and 100% specificity compared to 25% and 94% respectively for the Transit Time Flow Meter.

To learn more about the Spy and real-time autofluorescence bronchoscopy, head on to company's website...

Product page: SPY Imaging System ...

Spy system's real-time images ...

Press release: Novadaq Data Presented at 2008 Society of Thoracic Surgeons Meeting ...

Here's how Dr. Beard's Photoacoustic Imaging Group website explains the technology:

The sensor is placed in acoustic contact with the surface of the target tissue, the excitation laser pulses transmitted through it and the resulting photoacoustic signals recorded at different points over the surface of the sensor. From the time-of-arrival of the signals, and with knowledge of the speed of sound, a 3D image of the tissue structure, based upon the absorbed optical energy distribution, can then be reconstructed. This type of imaging instrument has several important advantages over conventional piezoelectric based photoacoustic detection systems. Firstly, the system operates in "backward mode". That is to say, the photoacoustic signals can be detected on the same side and over the same region of the tissue surface that is irradiated with the excitation light, a consequence of the transparent nature of the sensor. This is particularly important for imaging superficial anatomical features, such as blood vessels in the skin, where it would be problematic to deliver the excitation laser beam around an array of opaque piezoelectric receivers. Secondly, the concept provides excellent acoustic performance, with uniform broadband frequency response characteristics (to at least 30MHz) and wideband detection sensitivities (<0.1kPa noise-equivalent-pressure) comparable to piezoelectric PVDF receivers but with much smaller "element" sizes (<50μm) and "interelement" spacings -- the latter being a consequence of the optically addressable nature of the sensor which, in principle, affords near-optical diffraction limited spatial sampling of the incident acoustic field. These attributes make the instrument well suited to high resolution (10μm-100μm) tissue imaging applications - click here to see examples of some of the images that have been obtained with the system.

More from Photoacoustic Imaging Group ...

NewScientist: Laser scanner gives 3D view inside tumours ...