ASA Monitor June 2023, Vol. 87, 16–17.
New system improves visualization in transforaminal lumbar interbody fusion procedures
DePuy Synthes Research & Development has developed the TELIGEN™ System for advanced visualization experience and user-centric procedural control in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) procedures. Lower back pain is the leading cause of years lived with disability globally, affecting approximately 577 million people worldwide. MIS-TLIF procedures have evolved to reduce complications seen with open TLIF, but still present limitations such as a lack of consistent visualization, a steep learning curve that may result in complications, and pain and fatigue for surgeons performing the procedure. Spine surgeons trained in MIS-TLIF procedures often work with an overabundance of instruments due to a lack of procedural and technological standardization and customization, as well as hard-to-maneuver microscopes that provide a limited view into the surgical site. The TELIGEN system includes a tower consisting of a camera control system, a VueLIF-T™ Procedure Kit with a disposable HD camera, a TELIGEN™ Clear Discectomy Device, and patient-based disposable ports and other enabling components. The TELIGEN VUE™ Camera eliminates the need for a microscope and can provide surgeons with an expanded field of view and unobstructed visualization. The TELIGEN System enables hands-free visualization during the procedure and offers a multi-directional view on a screen for all circulating staff to follow. The camera has an integrated cleaning feature to eliminate the need for manual cleaning. The System also contains a heads-up display to afford an ergonomic posture during the procedure and a reduced number of instrument trays to facilitate a more streamlined OR.
Non-invasive electromyometrial imaging tool maps labor uterine contractions
National Institutes of Health-funded researchers have developed electromyometrial imaging (EMMI) to create real-time, three-dimensional images and maps of contractions during labor. The noninvasive imaging technique generates new types of images and metrics that can help quantify contraction patterns, providing foundational knowledge to improve labor management, particularly for preterm birth. Current clinical methods to measure contractions provide limited details, such as contraction duration and intensity, while also being invasive. The study team tested EMMI among a group of 10 women with healthy pregnancies. EMMI integrates two types of noninvasive scans – a fast anatomical MRI to obtain an image of the uterus at 37 weeks gestation, and a multichannel surface scanning electromyogram that uses sensors placed along the belly to measure contractions during labor. These data are then combined and processed into three-dimensional uterine maps, with warm colors denoting areas of the uterus that are activated earlier in a contraction, cool colors indicating areas that are activated later, and gray areas showing inactive regions. A sequence of maps is generated over time, creating a visual timelapse that shows where contractions start, how they spread and/or synchronize, and potential patterns that are associated with a typical pregnancy versus one with complications. EMMI data suggests there is no fixed, pacemaker-like region in the uterus that initiates labor. The study team observed varied patterns of contractions and metrics among the 10 study participants, with some similarities between women who had never given birth and those who had. An EMMI contraction atlas generated from healthy pregnancies could serve as a resource to understand and diagnose preterm labor, and possibly identify patients who would benefit from an induction versus those who may need a cesarean section.
Abbott receives FDA approval for surgical aortic valve replacement implant
Abbott has received FDA approval for their latest line of bioprosthetic surgical implants, designed for patients with a leaky or narrowed aortic valve. The Epic Max is a stented, tissue-based valve recommended for patients who need a replacement but shouldn’t take a regimen of blood thinners. Although less-invasive approaches to treating damaged heart valves have developed in recent years, open cardiac surgery is sometimes a patient’s best option. The Epic Max also features a low-profile frame to not get in the way of any future transcatheter-based heart procedures and preserve the patient’s options for heart valve management over the course of their lifetime. The approval of Epic Max follows Abbott’s September 2021 approval for the Epic Plus, an upgrade to the company’s line of heart valves. That included devices for replacing the aortic valve – which helps direct blood from the left ventricle out to the rest of the body – as well as its nearby mitral valve, which lets in oxygenated blood from the lungs. Both the Epic Plus and Max have been approved for cases of regurgitation and stenosis that narrows the size of the opening and hampers blood flow.