Urology Archive

Wednesday, June 24, 2009

Improve Your Ultrasound Skills With New SonoSite iPhone App

SonoSite has released an iPhone application, called SonoAccess™, to help clinicians improve their analytical and performance skills when using ultrasound. With the help of instructional videos and an accompanying image gallery, you can improve on your echo knowledge while on your train ride to work.

Features:

Scanning Technique Videos are designed to provide expert techniques and tips for point-of-care ultrasound applications.
Video Case Studies provide an in-depth look into specific cases that you may encounter in your practice.

Clinical Image Gallery is designed to give you a look at expert ultrasound images for anatomy recognition and as a quick comparative reference for you to compare your results to.

Quick-Start Guides are abbreviated user manuals designed to give new SonoSite users a digital roadmap of their system's controls and features to help navigate the user interface.

The Reimbursement Guides are designed to provide general coverage and payment information for diagnostic ultrasound and ultrasound-guided procedures so you have accurate coding and billing information.

The SonoAccess News Feed keeps you up-to-date on the latest SonoSite news.

Watch video here demonstrating the app...

Product page: SonoAccess™ Ultrasound iPhone App

Download link @ AppStore...

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Friday, June 19, 2009

Voice Activated SonoSite Ultrasound System Keeps Hands Free to Perform Procedures

SonoSite just released their SonoRemote for controlling the company's M-Turbo and S Series ultrasounds during interventional procedures like joint injections or central line placements. In addition to traditional style buttons, the remote control features voice recognition and can be programmed to understand commands in any language. So now you can hold the probe in one hand and the syringe in the other, and not have to fiddle with reaching over to the unit to take snapshots or change parameters.

Voice or touch activated

Programmable to your voice and language

Adjust system controls from a radius of 10 meters

No need to break the sterile field

Drop-tested to 3 feet

Works with M-Turbo® and S Series™

Press release: SonoSite Begins Customer Shipments Of Ultrasound Remote Control

Product page: SonoRemote

Flashbacks: M-Turbo™: New Portable Ultrasound from SonoSite ; SonoSite S-ICU™ Ultrasound Tool; S-Nerve™ from SonoSite; The SonoSite® MicroMaxx™; Titan

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Thursday, May 28, 2009

PMI Gets Approval for Powered Minimally Invasive Surgical Tools

The FDA has given 510(k) clearance to Power Medical Interventions (Langhorne, Pennsylvania) for the firm's iDrive Intelligent Power Unit, detachable Intelligent Surgical Instruments and iConsole device. The company believes that its powered tools, that sport a high level of articulation, can make a lot of difficult laparoscopies much easier to perform.

More about the components from PMI:

A first-of-its-kind breakthrough in operating room instrumentation, the iDrive is designed to support a variety of minimally invasive procedures by offering surgeons a broad range of cutting and stapling configurations combined with increased flexibility, access and precision. The iDrive is a novel hand-held, computer-controlled power unit to which any of the company's Intelligent Surgical Instruments can be attached. This innovation allows all of PMI's Intelligent Surgical Instruments to be driven by a single power unit. As a result, hospitals will be able to acquire PMI's advanced technology platform at less than half of the current cost, which may lead to significant savings for hospitals. The potential now exists for a comprehensive surgical solution that may be significantly less expensive than manual surgical stapling devices. In addition, the iDrive is reusable, easy to use, cost effective, and less wasteful, potentially leading to savings for hospitals and health networks.
The iConsole is a proprietary wireless device that communicates directly with the iDrive during surgical procedures to output specific auditory and visual reference information via its speaker and liquid crystal display. Outputs provide surgeons with important information regarding calibration, firing, and instrument and reload type, allowing surgeons to make real-time, critical decisions that may ultimately lead to an improved patient outcome.

The iDrive and iConsole combination represents a dynamic technology solution which is designed to enable the incorporation of important functional enhancements. PMI intends to aggressively pursue and implement a variety of key enhancements, which ultimately could lead to offering surgeons the world's first wireless computer mediated platform with unprecedented capabilities such as wireless video processing, Internet access, a patient record interface and controlled tissue compression software.

Press release: Power Medical Interventions(r) Receives 510(k) Clearance to Market iDrive Intelligent Power Unit(tm) With iConsole(tm)

Link: PMI Intelligent Surgical Instrument page

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ViRob, a Cavities Crawler

At the upcoming ILSI-Biomed Israel 2009 conference (June 15-17 in Tel Aviv), researchers from the Medical Robotics Laboratory at the Israel Institute of Technology (Technion) will be showing off a microrobot called ViRob, that has only a 1millimeter diameter and can crawl through vessels and cavities, when controlled by an external magnetic field. The big idea behind the ViRob device is that it can be used to deliver pharmaceutical payloads to precise locations or pull a microcatheter through tortuous terrain.

Here's what organizers of ILSI-Biomed Israel 2009 conference tell Medgadget:

Researchers are currently examining the possibility of using ViRob as a treatment for lung cancer—the world’s deadliest cancer. ViRob could assist in targeted drug delivery to lung tumors as well as take samples from different areas within the body. In addition, a number of these micro robots could simultaneously treat a variety of metastases. Researchers also plan to install additional equipment on the robot, including cameras, miniature tongs and other miniature equipment.
ViRob measures 1 millimeter in diameter and 14 mm in its entirety was developed in the lab of Prof. Shoham in the Medical Robotics Laboratory at the Israel Institute of Technology. The robot moves using an external electromagnetic ignition system, stimulated by an electromagnetic field with frequency and volume that do not agitate the body, enabling it to maneuver in different spaces and surfaces within diverse viscous fluids. The vibration created by the magnetic field propels the robot forward, as the tiny arms protruding from a central body grip the vessel wall. A basic prototype of the ViRob, which can move as fast as 9 mm per second, has been developed thusfar.

Link: ILSI-Biomed Israel 2009...

White paper from Technion...

A few videos below the fold demonstrating the ViRob:

Wednesday, May 13, 2009

BrainLab's Digital Lightbox Getting an Upgrade

BrainLab AG is planning on releasing an updated version of its Digital Lightbox multitouch clinical display. Still reminding us of a giant iPhone, the unit interfaces with EMRs to display and manipulate clinical images easily and intuitively, essentially making the keyboard or any other interface device unnecessary.

Here's what the company tells Medgadget about the new features in the latest release of the Digital Lightbox scheduled for this summer:

The new Video-input feature allows the integration of data on the Digital Lightbox, when it is located in the OR, from sources like micro-, endo- and arthroscopes; and video signals can be streamed from the OR and displayed on the Digital Lightbox when it is positioned in surgeons' offices or meeting rooms. This feature extends the range of application into new medical subspecialties, strengthening the value of Digital Lightbox as a core multi-disciplinary platform for hospital information networks.
When version 1.0 came to the market, a number of customers wanted the Digital Lightbox in rooms dedicated for teaching, patient education, tumor boards and internal meetings. The new External Display-out feature makes it possible to connect the Digital Lightbox to one or more additional displays or projectors, in or outside the room. This makes it more versatile for use in situations when large groups of medical experts come together and the even the 30" display of the Digital Lightbox isn't big enough.

Digital Lightbox also serves as the viewing display and remote control for VectorVision flex, combining an image-guided surgery platform with large-scale viewing, and fast data access and manipulation.

Here's a company video demonstrating the system:

Product page: Digital Lightbox

Flashback: Digital Lightbox Brings Minority Report to The OR (No Precognition Capabilities)

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Monday, May 4, 2009

Magnus Operating Table from Maquet

MAQUET has just unveiled improvements to its Magnus operating table, a system that can position the patient into virtually any surgical position, and at the same time accommodate patients weighing up to 250 kilograms.

From the press release:

An optimum exposure area is achieved in combination with gravitational force and the operating table's extreme tilting and tipping functionality. The tilt angle of up to 80º and canting angle of up to 45º combined with the system's fully compatible modules open up virtually unlimited positioning possibilities. "This way a patient weighing up to 250 kilograms can be brought into any possible position. MAGNUS is thus fast approaching its vision of the "floating" patient," so Dr. Engel.
This is of particular significance when it comes to minimally invasive surgery, as it is the table's extreme tilting and tipping function that makes surgical interventions even possible on an obese patient.

With its unique height adjustment range varying between 535 mm (21 Inch) and 1235 mm (49 Inch), the MAGNUS ensures ergonomic and thus relaxed working conditions even during longer operations. The benefits of individual settings are particularly evident during laparoscopic interventions: As the MAGNUS can be lowered further than any other table the surgeon can keep his elbows positioned comfortably at his side and is not forced to revert to a tiring position. The table's unique lowering functionality makes the commonly used step stool to decrease the distance to the surgical field a thing of the past. The larger abdomens of obese patients can be operated on the MAGNUS while maintaining a relaxed and comfortable posture. In contrast to laparoscopic operations, a high table position is required for hip replacement in the dorsal position. This way, the operation which may take up to 90 minutes can be performed in an upright position. If the table cannot be adjusted to the height required, the surgeon is forced to assume a bent over posture which generally results in tension and fatigue.

Besides its settings designed to cater to various indications, the MAGNUS can optimally adjust to the height of the surgeon. The advantage of this comes to the fore when putting the table in an international context: Whereas the height of the average male in Sweden is 181.5 cm (71,4 Inch), the average male in the Philippines is less than 164 cm (64,5 Inch).

Press release (.pdf)...

MAGNUS : Product Features...

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Monday, April 6, 2009

da Vinci Surgical System Now in Enhanced 3D HD

Intutive Surgical, the ultimate toy maker in the surgery market (at least by price), has just announced a new da Vinci robotic endoscopic system. The da Vinci® Si™ system sports high definition 3D video and an array of other gadgets that come with fashion and ownership value similar to a family Rolls Royce sedan.

* World’s only robotic surgical system with 3D HD vision
* Two separate HD optical channels that merge for highly accurate depth perception
* Lightweight camera head features buttons for focus control, automated scope setup and illuminator control directly form the camera head
* Integrated surgeon touchpad offers comprehensive control of video, audio and system settings
* Surgeon console features multiple ergonomic adjustments, allowing surgeons to customize four different parameters for added comfort during longer procedures
* An extensive array of wristed EndoWrist® instruments, available in 5mm and 8mm diameters, provides a wide selection of surgical tools for multiple specialties
* Fingertip controls allow for precise, dexterous control of the EndoWrist instruments and fingertip controls.
* Footswitch controls allow the surgeon to perform a multitude of tasks, such as swapping between different types of energy instruments
* A variety of time-saving features, such as one-step cable connectors, enable quick and efficient setup
* A motorized patient cart facilitates quick and controlled docking of the system to the patient
* TilePro™ multi-input display allows the surgeon and OR team to view 3D video of the operative field along with two additional video sources such as ultrasound and EKG
* Widescreen touchscreen for telestration capability
* Boom compatibility allows vision system components to be installed on a ceiling-mounted boom to conserve OR floor space
* Expandable system architecture allows for upgrades and compatibility with current and future OR technology.
* Enables two surgeons to collaborate during a procedure for da Vinci-enabled surgical assistance, or facilitate teaching
* Allows surgeons to exchange control of the instrument arms and endoscope
* Features built-in intercom to facilitate communication between surgeons while both are seated at consoles

Company video introducing the system:

Press release: Intuitive Surgical Announces New da Vinci(r) Si(tm) Surgical System...

Product page: da Vinci Si Surgical System...

Flashbacks: da Vinci Robot Surgery System ; da Vinci Robot Surgery System in Action

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Thursday, March 19, 2009

Cardinal's Endura Scrubs for the Modern Clinician

Cardinal Health is releasing a new line of clinical scrubs that the company believes will make your life safer, easier, and more comfortable. The big deal about Cardinal's Endura™ apparel line is the specialty fabric used, which is supposedly stronger and more breathable.

Some features from the product page:

Excess moisture is wicked away from your skin to keep you dry and cool, no matter what you’re doing.

Scrubs shouldn't leave you feeling restricted or confined. Endura™ scrubs move with your body and help maximize your gait and pace. In addition, the Maximum-Motion™ sleeve allows your shirt to stay tucked in even when you reach and stretch.

Our advanced, synthetic material is breathable, flexible and helps control your heat index and perspiration.

Our scrubs offer a shirt pocket and two side flanking pant pockets to tuck away the important things you want to keep close. The deep side pockets in our pants are angled to keep items in, whether you're sitting or standing.

The smooth fabric of Endura™ scrubs feels natural and soft on the skin.

People aren’t rectangular. So instead of making our scrubs rectangular, we looked at the actual dimensions of thousands of healthcare workers. The cut of our scrubs follows the natural line of your body and gets rid of the bulky feel and appearance of traditional scrubs.

A unique snap system allows you to customize pants length and avoid tripping, falling or slipping. Elastic on the waistband, in addition to a drawstring, helps position pants where you want them.

Strategically placed ventilation zones across the middle of the back and behind the knee keep you dry and comfortable.

Even after 90 washes, EnduraT scrubs are still going strong. Stronger than a brand-new pair of the top-selling traditional scrubs, in fact*. You'll also notice minimal color loss and lasting moisture-wicking abilities. The competitor's scrubs, on the other hand, typically only last 50 washes.

The top-selling traditional scrubs lose 15% lint when abraded. EnduraT scrubs lose only 1.4%, making them the lowest linting scrub on the market.

Made of the strongest material on the market, EnduraT scrubs outlast the competition. Our advanced, synthetic material is abrasion- and tear-resistant and has the most uniform strength in both directions.

EnduraT scrubs can be washed at cooler temperatures and dry faster than traditional scrubs. This requires less energy and can result in savings to your hospital.

Product page: Endura™ Performance Apparel

Press release: Cardinal Health launches new products for the operating room

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Friday, January 30, 2009

Endorsement Shines Bright Future for Single Port Laparoscopy

Cambridge Endo, a Massachusetts firm, is proud to have its single port laparoscopic technology selected by the Cleveland Clinic as one of the "game changing innovations" of 2009 at the clinic's Medical Innovation Summit. The Single-Site Surgery/Single Port Access system, driven by the company's proprietary Autonomy™ Laparo-Angle™ Instruments, allows for nearly scarless surgeries that patients are particularly excited about.

From Cambridge Endo's press release:

Inderbir S. Gill, M.D., Chairman of Urology at the Cleveland Clinic commented, "[we] performed LESS live-donor nephrectomies in nine consecutive kidney donors for kidney transplantation. All aspects of kidney harvesting were completed though the navel. Instead of a visible six-inch scar and a six-week recovery period, patients recovered within two weeks and had a tiny scar hidden by their belly button. Because it only uses one port with multiple channels for the surgeon to simultaneously pass various surgical instruments, LESS may also reduce complications that might occur after traditional open and even laparoscopic abdominal surgery. My patients report less discomfort and have faster recoveries compared to those undergoing traditional laparoscopy." According to the clinic, the return to work time for single port surgery donors is about 17 days vs. 51 for traditional multi-incision laparoscopic procedures.

Video of a single port simple nephrectomy:

Press release: Cleveland Clinic Selects Laparoendoscopic Single-Site Surgery (LESS) as One of the Top Ten Innovations of 2009

Product page: Single Port Access Surgery (SPA), Autonomy™ Laparo-Angle™ Instrumentation

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Wednesday, January 21, 2009

Under Development: New Laparoscopic Access Port for Da Vinci Robot

SurgiQuest, Inc. is building a custom laparoscopic port for Intuitive Surgical's Da Vinci robotic system. Based on SurgiQuest's AirSeal, the goal of the new product is to provide single port access with a clearer camera view and a greater range of motion.

From the AirSeal product page:

Better Visibility
AirSeal™ re-circulates and filters peritoneal gas providing for improved visibility— instead of venting it into the room — creating a safer work environment for the patient and the entire surgical staff.

Keeps scope free from obstructions: Since the system does not require valves or gaskets, your instruments move smoothly through its invisible barrier without debris and tissue fragments adhering to your scope and obstructing your vision.

Greater Control, Better Access

Maintain a stable pneumo: AirSeal™ monitors abdominal pressure in real time, which allows your insufflator to adjust as needed to ensure a stable pneumo.

Provides greater freedom of movement: AirSeal’s invisible barrier lets you insert gauze, mesh or drains — even multiple instruments — without friction and interference and with greater freedom of movement.

Video demonstrating the current AirSeal model:

Press release: SurgiQuest Signs a Development and Supply Agreement with Intuitive Surgical for MIS Access Utilizing the AirSeal(TM) Technology

Product page: AirSeal

Image: SurgiQuest's current AirSeal device

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Tuesday, January 20, 2009

TrEndo Tracking System Helps Surgeons Practice, Evaluate Technique

To help surgeons practice skills needed during laparoscopic, arthroscopic, and other minimally invasive surgeries, a research group at the University of Delft has been refining a device called TrEndo Tracking System. The unit is designed to bring objectivity in assessing how well a particular surgical task is conducted.

The press office from TU Delft explains:

... there are currently two safe training methods for minimally invasive surgery. The first is the so-called box trainer, an enclosed rectangular box in which trainee surgeons can practise performing basic manipulative tasks with the surgical devices, such as picking up and moving objects. As they do this, they can be assessed by an experienced surgeon. Clearly, this is a somewhat subjective process.
The other option is the virtual reality trainer, employing computer simulations, which allows for excellent recording and analysis of the surgeon's actions. However, this training method still has the major disadvantage that it lacks realism. For example, users feel no tactile response when performing surgical tasks.

Thus both of these training methods have their drawbacks. The Delft doctoral candidate Magdalena Chmarra has sought to change this situation by developing a training tool that is realistic for the surgeon and at the same time records and analyses the motion of the instruments manipulated by the surgeon. This is accomplished with an inexpensive and relatively simple tracking device known as the ‘TrEndo’. A TrEndo incorporates three optical computer-mouse sensors which record the movements made by the surgeon in all directions.

The TrEndo has been extensively tested by medical staff at Leiden University Medical Centre, who rate the device highly. The movements that they performed with the TrEndo felt no different from those undertaken with the actual surgical devices. TrEndo is currently undergoing further fine-tuning at TU Delft.

The TrEndo helps to identify the key factors underlying the basic skills required by surgeons, thus paving the way for objective benchmarking of their competence in the field of minimally invasive surgery. By means of motion analysis, Chmarra has therefore succeeded in arranging the basic skills of the participating trainee surgeons into a classification system which ranks them as being either expert, intermediate or beginner.

Press release: New training method helps surgeons evaluate their own minimally invasive surgery skills

More details about the project are here...

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Tuesday, January 13, 2009

Triangular Prostatic Stents to Go On Market in Europe

Israel's Allium Ltd. won the European CE mark for the company's triangular prostatic stent for patients with benign prostatic hyperplasia (BPH) or with advanced prostate cancer.

From the product page:

Allium's prostatic stents have a large caliber triangular cross-section to match the contours of the prostatic urethral lumen and have the ability to exert varying degrees of radial force depending on the anatomy. For example, higher radial force in its main body and lower radial force in the area near the external sphincter to prevent sphincteric dysfunction. These characteristics enable the Allium Prostatic Stents to conform to the prostatic urethra, allow an excellent flow and offer a much improved comfort than existing stents, all these without geopardizing the voluntary continence mechanism.

Triangular Prostatic Stent...

Flashback: CE Approved Allium Stents

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Monday, January 5, 2009

Amimon's High Definition Wireless Video Goes Clinical

Stryker Endoscopy is launching a wireless high definition monitor for the clinical world. Utilizing wireless technology from Israel's Amimon Inc., the monitor can receive signals up to 1080i, which means uncompromising quality in OR imaging with fewer tangled cables getting in the way.

AMIMON has granted Stryker Endoscopy exclusive access to AMIMON’s technology for the medical endoscopy market.
“Only AMIMON’s High-Definition Wireless Technology is capable of transmitting the surgical video with no perceptible lag or interference throughout the entire operating room. This will allow surgeons greater flexibility in positioning the surgical display while operating. In addition, the hospitals and surgery centers will save the hassle and cost of routing DVI cables through the ceilings and overhead booms,” said William Chang, Stryker Endoscopy’s Vice President of Research & Development and Chief Technology Officer.

AMIMON WHDI™ Technology - Overview ...

Press release: Stryker Endoscopy Launches the World's First High-Definition Wireless Surgical Display With AMIMON Inc.'s High-Definition Wireless Technology ...

Globes: Wireless video co Amimon wins deal with Stryker...

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Wednesday, December 3, 2008

Zonare Shows Off Proprietary Ultrasound Technology

At the RSNA 2008 conference this week, ZONARE Medical Systems out of Mountain View, California is showing off its latest ultrasound transducers and image processing software for improved image quality. The company describes its z.one ultrasound system as "smaller, lighter, more maneuverable, and nimbler than any system of equivalent image quality."

From the press release:

New Transducer Technology The C4-1 is a small footprint, curved array transducer designed by ZONARE's acoustic engineers. It offers physicians improved access and imaging performance resulting in improved penetration with sensitive Doppler imaging. All ZONARE customers worldwide have access to this new technology on their current z.one ultrasound platform.
ZONARE is also showing its new L14-5w high resolution, high frequency transducer, which offers broad bandwidth for improved imaging of small parts, breasts and superficial anatomy. Its wide field of view has an aperture of 55mm offering virtual apex capability, and it has 10 frequencies including three fundamental, one tissue harmonic, two compound imaging and two each for color Doppler and PW Doppler modes.

Elastography and 3D Imaging
The z.one ultrasound system will feature new elastography applications that enable qualitative visual assessment of the mechanical stiffness properties of tissue. The high resolution elastography images are generated and visualized using a variety of grayscale and colorized maps and the L10-5 and L14-5w transducers are supported. Clinicians using the new applications report that this technique may provide significant new diagnostic information.
The comprehensive 3D ultrasound imaging capabilities are available for the z.one ultra system with primary applications for obstetrical imaging during the second and third trimester. The new C8-33D curved linear transducer offers mechanical sweep array, 3D fetal surface rendering, 3D Multi Planar rendering and additional diagnostic tools. The new 3D imaging capabilities are also available for general abdominal ultrasound imaging. ZONARE's 3D ultrasound imaging expands the clinical utility of the z.one ultra system and may reduce exam time, enabling physicians to spend additional time on patient care.

Proprietary Software
The difficult-to-image patient population makes up a large percentage of patients examined with ultrasound today and includes people who are overweight, elderly, muscular, or who have a thick body wall. Traditionally, a definitive ultrasound diagnosis for this patient group was challenging and often these patients were referred for more expensive testing. ZONARE has engineered new proprietary software for ZONE Sonography technology and, when combined with the company's new C4-1 transducer, clinicians have a new tool to image their most technically difficult patients with advanced image clarity.

Press release: ZONARE Medical Systems Introduces Advancements for z.one Ultrasound Platform at RSNA ...

Product page: z.one Ultrasound Platform ...

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Wednesday, November 26, 2008

Vaginal Cones by GlysBy: Add Color (and Pelvic Strength) to Your Life

At the recently concluded Medica 2008 conference, Italian firm GlysBy was showcasing to the world its pastel-colored collection of vaginal cones, devices that the company says can aid to prevent incontinence by strengthening pelvic floor muscles.

Here's what GlysBy says you will get if you exercise "just 10 minutes a day":

This set of Pelvic-Floor Training Aids comprises four tampon-shaped cones that differ in colour and weight:
Colour Weight: yellow 20g, blue 34g, green 50g, purple 68g

How do the Pelvic-Floor Training Aids work?
Exercising with Pelvic-Floor Training Aids helps us become aware of our pelvic floor and helps train the muscles of the pelvic floor. The cones work as follows:

If a cone is inserted into the vagina, it tends to slip out again. It is then prevented from slipping out by repeated muscular reflexes (“bio-feedback phenomenon”) and, throughout the course of exercising, by increasingly conscious muscular contractions. Drawing together and tensing the muscles of the pelvic floor trains and strengthens these muscles, similar to body building with weights. Exercising may thus at first give rise to sensations of pain in the pelvic area (muscular soreness). At the same time, however, awareness of the pelvic floor will be improved.

How to use the Pelvic-Floor Training Aids
The woman starts by testing the strength of her pelvic floor. This can be done by inserting the yellow (lightest) cone deep into the vagina (see illustration, comparable with inserting a tampon).
Should she be able to keep this cone in place for approx. 1 minute in a standing position, she may try the next heavier cone (green first, then blue and purple last). The cone that she can only just hold shows you how strong your pelvic floor is and she should start exercising with this cone.

The woman should exercise at least twice a day in a standing position or when walking. At the beginning she may only be able to hold the cone for a very brief period. The exercising time should be increased gradually until the cone with which you are exercising can be held for approx. 10 minutes per exercising session for several days in succession. Once this stage has been achieved, she may exercise with the next heavier cone.
It may be helpful to use lubricating gel when exercising with Pelvic-Floor Training Aids particularly in the event of vaginal dryness.

How does exercising success become apparent?
Upon regular exercise, the muscles of the pelvic floor will usually become considerably stronger after a mere few weeks. According to numerous clinical studies, atony of the bladder can thus be improved.

To learn more about the device, that bears the European CE Mark of approval, check out the product page: Vaginal Cones by GlysBy...

Press release...

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Monday, November 24, 2008

Vacuum Erection Pumps + PDE5i Medications = A Pleasant Combination

Augmenting PDE5i treatments (i.e. Viagra® or Cialis®) with TIMM Medical Tech's ErecAid® vacuum erection device can greatly improve patient satisfaction, according to a new study lead by Dr. Arthur Burnett, Professor of Urology at Johns Hopkins School of Medicine.

Burnett says that the study "confirms an earlier trial that many patients can achieve excellent results using ErecAid(R) as an addition to oral PDE5i therapy. Based upon these results, I would encourage physicians treating ED to consider the importance of this approach in their treatment protocols and to discuss this option with their patients."

From the press release:

The phosphodiesterase five inhibitors (PDE5i) such as Viagra(R) and Cialis(R) have become a major resource in the management of ED. Unfortunately, 30-50% of men report inadequate results with these oral medications. When patients fail to respond to the oral medications, physicians are often forced to consider more invasive and more complicated second line agents such as penile injections or urethral suppositories.
Investigators at four separate study sites evaluated 69 men aged 36 to 82 with ED of diverse etiology who had responded inadequately to PDE5i therapy. Study subjects were allowed to continue use of PDE5i's but were instructed to use the ErecAid(R) device as an adjunct to their current oral medication. Study subjects were assessed using three validated measurements of erectile function and sexual satisfaction: the International Index of Erectile Function (IIEF-5), the Sexual Encounter Profile (SEP-2 and SEP-3) and the Global Patient Assessment Scale (GAPS).

After 4 weeks of supplemental treatment with ErecAid(R), the IIEF-5 score improved substantially from a baseline of 9.0 to 17.6 (p<0.001). Moreover, of the 34 subjects unable to achieve an erection satisfactory for intercourse at baseline (SEP-2 response of "no"), 27 subjects (79%) reported erections satisfactory for intercourse following the addition of ErecAid(R) (p<0.001). Finally, of 42 subjects reporting no or slight response to PDE5i at baseline (GAPS responses of "not at all" or "slightly"), 31 (74%) reported moderate or great improvement (GAPS responses of "moderately" or "greatly") at the end of the 4 week study (p<0.001).

Product page: Osbon ErecAid Vacuum Therapy System...

Press release...

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Somatom Definition Flash: All Around Dual Nature CT

In about a week, at the upcoming 94th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), Siemens will roll out the Somatom Definition Flash, a new dual source, dual detector CT scanner. The machine is so fast that patients don't have to hold their breath during chest scans, and the bed moves through the scanner at about twice the speed of conventional models, likely eliminating claustrophobia in most patients.

Some technical info about the scanner from Siemens' press release:

a man or a woman?

The fastest scanning speed in CT (43 cm/s) and a temporal resolution of 75 ms, enable for example complete scans of the entire chest region in just 0.6 seconds. Thus, patients are no longer required to hold their breath during the exam the way they had in the past. At the same time, the Somatom Definition Flash operates at an extremely reduced radiation dose. For example, a spiral heart scan can be performed with less than 1 millisievert (mSv), whereas the average effective dose required for this purpose usually ranges from 8 mSv to 40 mSv. The new CT scanner will be available for sale in the first quarter of 2009.

The gantry (i.e., the X-ray detector system surrounding the bore) rotates about its own axis in just 0.28 s. It is this extraordinary rotational speed that enables a scan speed never before attained in CT (i.e., up to 43 cm per second) and temporal resolution of 75 milliseconds. The patient is moved through the CT tube more than twice as fast as with any conventional system. At the same time, scans acquired with the Somatom Definition Flash require a much lower radiation dose than conventional scans. While the average effective dose for a heart CT scanner ranges from 8 mSv to 40 mSv, the new Siemens CT scanner gets by with less than 1 mSv. In comparison: The X-ray radiation that everyone is exposed to each year from natural sources amounts to 2 mSv to 5 mSv. The dose values of the new Siemens CT scanner, thus lie far below those of an intracardiac catheter examination, thus opening up possibilities for using CT scanners for routine cardiological examinations.

Due to the high scanning speed, it is now possible to acquire scans of the thorax, the heart or both at the same time in fractions of a second. For example, thorax examinations now only require a scan time of 0.6 seconds. As a result, patients no longer have to hold their breath during the scan. This offers considerable advantages, especially in cases involving the elderly, children, emergency, and ICU patients.

It is also possible to perform whole-body scans extremely fast: For example, a person with a height of 6 feet 6 inches can be scanned in less than 5 seconds. Until now, such whole-body examinations took more than 10 minutes to perform from patient preparation to diagnosis. With the Somatom Definition Flash, this process is completed in just a few minutes. This represents an advantage, especially for emergency medicine since, until now, physicians often had to forego this examination method due to time pressure. Furthermore, it is no longer necessary to sedate children prior to the examination, since they no longer have to remain still. The high scanning speed also makes it possible to cover large areas measuring up to 48 cm with 4D imaging (3D plus time). The areas scannable using conventional systems are limited to a maximum of 16 cm due to the detector size involved.

A scan of the entire heart can be performed in only 250 milliseconds, which is less than half a heart beat. In addition, it is possible for physicians to reliably display a heart with a fast pulse or an irregular heart beat without using beta blockers, thus simplifying the workflow and yielding clinical and financial advantages. Owing to its high scanning speed, the Somatom Definition Flash also features new possibilities for performing CT examinations of the heart in the sub-mSv range. This represents a much lower radiation dose than is obtainable with conventional systems, which require doses ranging from 8 mSv to more than 40 mSv. For the first time ever, the heart can thus be examined at a radiation exposure level that is three times lower than the background radiation a person naturally absorbs in a year.

The second generation of Dual Energy imaging will introduce a new imaging quality. The contrast in CT scans will be increased without having to apply the higher radiation dose previously required. This is achieved via a new, selective photon shield which blocks unnecessary parts of the energy spectrum. It thereby provides improved separation of the two simultaneous scans with low and high photon energy, without causing a higher radiation exposure than would result from an individual, conventional CT examination with only one energy source. Thus, the Somatom Definition Flash can always provide a double contrast which, for the first time ever, can also be used to classify the chemical composition of tissues via a CT scan in routine daily work. Subsequently, It could also be used to reconstruct unenhanced CT images without contrast media not having to perform an additional examination.

Gene Ostrovsky, one of our editors, joined Dr Val Jones of Better Health in a conversation with Dr. André Hartung of Siemens about the new machine. You can read the interview or listen to the podcast at Better Health...

Press release: Flash Speed. Lowest Dose (.pdf)...

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Friday, November 21, 2008

TruSystem 7500: New OR Table from TRUMPF

Thanks to its modular design, this new OR table from TRUMPF can accommodate almost all known surgical positions, and can provide an optimal operating environment for all kinds of cases, from hip pinnings to robotic prostatectomies.

In surgery, no operation is identical to another. So it's not just surgeons and staff who need to be flexible – that requirement applies to OR tables as well. For the TruSystem 7500 OR table system, TRUMPF offers universal OR tabletops with a variety of application options, and special OR tabletops for specific requirements. Depending on the desired application and budget, from an extensive product line users can put together the precise OR table that fits their individual needs.

TruSystem 7500 is consistently designed to simplify the everyday clinical work of physicians and staff, and to support them in their daily tasks. OR tabletops with up to three motorised joint pairs make it possible to use remote controls to position the patient quickly, safety and precisely. Manual adjustments to the tabletop are reduced. Staff can program the adjustment speed of all tabletop motors as needed. To return to the zero position, all motors in the tabletop work simultaneously, saving time.

A novel feature is the third motorised joint pair between the lower and upper back plates, which enables new positioning options. For thoracic surgeries, for instance, the patient's ribcage can be stretched precisely to the desired degree by pushing a button, so it can be opened more easily. Complicated positions, such as the side thorax position, can be assumed quickly, precisely and conveniently for both patient and staff. The patient also benefits from ergonomic, safe positioning, since the lengths of the individual tabletop segments correspond to the average distances between joints in the human anatomy.

TruSystem 7500 has universal coupling points, which have proven their worth in other TRUMPF OR tables. This latest OR table system is thus compatible with the entire TRUMPF accessory line, as well as with all other TRUMPF OR tables. The mechanically encoded coupling points prevent disallowed configurations of the table. Thus new and existing customers can quickly familiarise themselves with operation of the table. Moreover, they benefit from the option of combined use with predecessor models, and thus from the safety of investment in TRUMPF products. This philosophy permeates the entire TRUMPF medical technology portfolio.

One special feature of the “ST 26” special OR tabletop: First, the Trendelenburg capability is split between the column and the top. Besides the 45 degrees offered by the column, the tabletop can be adjusted by another 20 degrees. With the TruSystem 7500, therefore, an extremely low head or foot position of 65 degrees can be achieved. If the user doesn't need this additional functionality, less expensive universal OR tabletops can be selected.

Special TRUMPF positioning accessories can be mounted on the TruSystem 7500 tabletops at any time. A spinal column positioning assembly, an extension unit or carbon elements for intraoperative X-ray diagnosis, for instance, make this jack-of-all-trades a specialist in just moments.

Check out all the available positions and accessories in this product brochure...

Product page: TruSystem 7500...

Press release...

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Wednesday, November 12, 2008

New Cooling Device May Reduce Prostatectomy Complications

Taking the prostate out is not easy, and it is associated with two terrible side effects: impotence, and urinary incontinence. Recently, robotic surgery has been one way to cut down on the complication rate, but it's still not perfect.

The UroCool device from InnerCool, a subsidiary of Cardium therapeutics, is a rectally placed catheter that keeps the prostate nice and frosty during a prostatectomy. The device is theorized to reduce post-op complications and is currently undergoing clinical studies at UC Irvine.

Here's some more info from the press release:

Dr. Ahlering and his colleague Dr. David S. Finley are conducting clinical studies designed to demonstrate safety and confirm the potential benefits of localized cooling during robotic-assisted prostatectomy, which is now the most common surgical technique for prostate cancer. The UroCool(TM) catheter is designed to be placed within the rectal cavity adjacent to the prostate during surgery. UroCool is used in conjunction with InnerCool's Celsius Control Console which circulates cold saline in a closed loop within the catheter to allow for localized cooling. Drs. Ahlering and Finley believe that therapeutic cooling during prostate surgery (which includes both traditional open surgical approaches and the newer robotic-assisted technique) can reduce tissue damage and inflammation and thereby provide a faster return of bladder control (continence) and possibly erectile function (potency). From a practical viewpoint, they liken this concept to icing a severely sprained ankle in order to minimize tissue injury and shorten the recovery process.

The hope is that patients will be more likely to have elective prostatectomies by reducing the complication rate.

Read the press release here...

Image: Prostate cancer cell. (Wellcome-Images)

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