Philips recently announced the release of an enhancement to its Azurion imaging system – the FlexArm. Developed in partnership with the Miami Cardiac & Vascular Institute, the technology allows a clinician to image a patient from every possible angle without having to move the patient or table. Given the proliferation of minimally invasive procedures possible under image guidance, technologies to simplify and streamline these sometimes complex procedures are likely to be welcome.
During product development, extensive collaboration was conducted between engineers and potential users of the system, to assess their needs in patient imaging. The potential of image-guided therapy is largely dependent on the quality and ease of imaging, and the new system can provide full body coverage from both sides of the table at the flick of a switch.
In fact, one of the features of the system is that advanced positioning in multiple dimensions is possible using just one controller, and the designers made significant efforts to ensure that it was simple and intuitive to use. As an operator moves the imager, it automatically maintains image beam alignment with the patient.
Not having to reposition a patient means that each can be positioned for maximal comfort during an imaging session, and helps to avoid mishaps such as accidental pulling of tubes or wires. However, this increased maneuverability also has the potential to enhance workflow efficiency during complex procedures where clinicians need to rapidly and conveniently visualize features of interest.
See a video below about the technology:
Medgadget had the opportunity to ask Dr. Barry Katzen, founder and Chief Medical Executive of Miami Cardiac & Vascular Institute, some questions about the technology.
Conn Hastings, Medgadget: What have been the limitations of traditional imaging systems?
Barry Katzen, Miami Cardiac & Vascular Institute: In the past, we’ve been greatly limited in our procedures by equipment intended for other purposes. The equipment had limited geometry, which inhibited our ability to see inside the body.
By partnering with Philips to develop the Azurion with FlexArm, we saw a significant opportunity to change the way we perform minimally invasive procedures by creating a unique device.
Medgadget: How has the Flexarm helped in this context? How does the system work?
Barry Katzen: With Azurion with FlexArm, our idea was to design something that would allow us to get complete visibility throughout the body while being able to work in a surgical environment.
As a result, Azurion with FlexArm has several significant advantages over general technology currently available to medical professionals in the field. The FlexArm is very simple to operate, allowing the user to move the stand and the positioning device with a single button. Users can also position the stand to rotate and be able to see inside the patient through multiple angles in a way that we could not do before, and without colliding into other physicians or staff present in the room. The device also has the ability to be moved out of the way in case we need to perform more complex surgery, and it can easily be moved back in if we need to combine it with an endovascular procedure.
Medgadget: What features did end-users request during the development process? What challenges did you encounter during the design process?
Barry Katzen: The thought process that went into the design of the device, in terms of creating something new versus modifying an existing solution, is one of the unique attributes of the Azurion with FlexArm.
One of the great things about this project is that the end-users were involved from the beginning of the process. Before completing any design, we conducted surveys with interventionalists in radiology and cardiology, as well as other disciplines involved in image-guided therapy, to understand the limitations of existing technology. There was also a huge amount of observation of existing technology and physicians in the workplace to identify key opportunities for improvement.
For example, in reference to the workplace, there has been an increasing incidence of muscular skeletal problems and back injuries among medical professionals as a result of working in environments that are not conducive to performing long and complex procedures. Therefore, we were interested in improving the environment ergonomically, making it simpler for physicians to perform their procedures by having full vision of the body in a friendlier work environment.
In terms of the challenges, we got a lot of feedback from the engineers involved that the design we had in mind would not be possible. However, I am thrilled to say that, in the end, we worked together to figure out a solution and achieve the impossible.
Medgadget: How will the system help save time and money? How does it enhance the patient experience?
Barry Katzen: One of the best ways that technology can save time and therefore money is by improving workflow and allowing us to perform procedures in a faster and more efficient manner. The device allows us to see better and faster, enabling us to perform procedures more precisely and effectively. In addition, Azurion with FlexArm also supports the pre-surgery process. For example, depending on the type of procedure and how the physician has the room set up, the technologist just has to insert the name of the procedure the doctor is going to perform into the device’s software, and the device will automatically be positioned accordingly. This presents a significant potential to reduce overall procedure time – not the actual working time, but the set-up time, which allows greater room utilization.
In terms of the patient experience, one of the unique aspects of this design is that most of the fluoroscopic rooms have a floating table where staff must move the patient into the x-ray beam. Azurion with FlexArm works the opposite way. The patient remains more or less fixed and it is the imaging device and environment that moves according to where physicians need it. This is especially important in very complex procedures where the patient is connected to various monitors or tubes and moving him/her risks disconnecting the lines and potentially creating problems. Azurion with FlexArm creates a much more analogous surgical environment where the patient stays in one position and it is the imaging system that moves around.
Medgadget: Is the FlexArm system easy to use? Does it require much training?
Barry Katzen: The hallmark of Azurion with FlexArm is its ease of use. Some aspects of the device and the imaging system do require some training; however, the actual geometry and the stand itself requires five to 10 minutes to be up and running.
Product page: Azurion with FlexArm…