Futuristic Therapies

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Futuristic Therapies. Technological Advances in Intestinal Surgery. “What is now proved was once only imagin’d”. William Blake, The Marriage of Heaven and Hell (1790). Colon &Rectal Surgery: Early 1900’s. Anastomoses. Anastomoses: NOT SAFE Functional preservation: NOT RELEVANT - PowerPoint PPT Presentation

Transcript of Futuristic Therapies

  • Futuristic Therapies

  • Technological Advances inIntestinal SurgeryWhat is now proved was once only imagindWilliam Blake, The Marriage of Heaven and Hell (1790)

  • Colon &Rectal Surgery: Early 1900sAnastomoses: NOT SAFEFunctional preservation: NOT RELEVANTTechnical aspects SIMPLER: AnastomosesFunctional PreservationTechnical Aspects-Knife-Scissors-Clamp-Thread & Needle

  • Total Colectomy 2007 (Laparoscopic)

    Main blood vessels: sealed by bipolar energyClampclipsneedlethreadscissorsNO!

  • Key Technologies: Near FutureOptics/Image ProcessingEnergy devices(e.g. harmonic scalpel, Bipolar energy)New Anastomotic devicesEndoscopy/laparoscopy combinationsOR Future

  • New LaparoscopesSmaller, better optical properties (HDTV)Magnification 15-20X and more!Flexible

  • Future of imaging: HD Better resolution/color reproductionStandard DefinitionHigh Definition

  • CCD-compatible HDTVVideoprocessor for HDTV signal processingImage output with HDTV picture signalsDisplay on HDTV -compatible monitorEICP-D to record HDTV digital signals in DVDSI to record HDTV digital signals in server via networkFACTORS

  • Applications of Narrow Band Imaging

  • Potential of the intra/post-operative NBI colonoscopyNormal Light SourceNBIAnastomosis after sigmoidectomy

  • In Vivo Imaging of Ovary: MouseImages: Rebecca M. Williams, Andrea Flesken-Nikitin, Alexander Nikitin, Watt W. Webb and Warren R. Zipfel, Cornell University, 2005, 9-P41-RR04224-18.Multiphoton imaging

  • Endoscopy in the ORORGI LabLaparoscopyOpen

    Endoscopy Invasiveness Less Invasive More TherapeuticFUTURE

  • Combined CO2 Colonoscopy & Laparoscopy

  • 23ExposureSurgical Control1Endoscopic polypectomy

  • Confirm the best position of the ileostomyCombined procedure: Stoma requiredTip of endoscope

  • OPERATING ROOM of FUTUREWOK: Wall of Knowledge (multiple flat screens)Input:OPTICS, XRAYS, MEDICAL RECORDConsultations(Pathology,other specialists)Teaching input from remote siteBluetooth technologies (phone,data, images)

  • OPERATING ROOM of the FUTUREWall of KnowledgeTelestration

  • Other Future InitiativesTelepresenceRoboticsExpert surgeon can enter the remote ORPerform surgical actionsAssist the team thereRobots will:Make complex decisionsParticularly impt in battlefield or disaster situations

  • Summary: Colon & Rectal Disease TreatmentIncrease in the incidence of C&R diseases (worldwide), particularly cancerMinimally Invasive Surgery: More commonCornell must assume a leadership role in the development of this field

    In order to maximize HD-TV performance, it is necessary to make the entire endoscope system HDTV-compatible.One, the number of pixels must be increased in a CCD.Two, a video processor must digitally process HD-CCD signals without deterioration and output in HD-TV signals.Three, the monitor receives HD-TV signals and displays the image with high resolution.Four, the recording device has two (2) types; Stand-Alone type, recording a HD-TV still image digitally onto DVD, and, Network type, recording on a server through network.As you can see, the entire system has to be upgraded.