Innovation

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Innovation

• Alfred Cuschieri
• Scuola Superiore di Studi Universitari
• Pisa
• Institute of Medical Sciences and Technology
• Uuniversities of Dundee St Andrews

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Medical Technologies

• Facilitativeimprove the efficiency of
  performance and reduce the level of difficulty of
  execution
• Additivebring technical sophistication and
  accuracy to surgical manipulations but are not
  considered essential
• Enablingmake possible certain surgical
  procedures which would be impossible without
  them/ open new therapeutic options
• Disruptiveunderpins real progress

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Medical Technologies

• Facilitativeimprove the efficiency of
  performance and reduce the level of difficulty of
  execution
• Additivebring technical sophistication and
  accuracy to surgical manipulations but are not
  considered essential
• Enablingmake possible certain surgical
  procedures which would be impossible without
  them/ open new therapeutic options
• Disruptiveunderpin real progress

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Disruptive Technologies
Christensen, Clayton M. (1997). The Innovator's
Dilemma, Harvard Business School Press. ISBN
0875845851.
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Anatomy of Charged Couple Device
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Examples of New Facilitative Technologies

• MAS
• NOTES
• Optical biopsy for laparoscopic oncology/
  vascular surgery
• Capsule endoscopy - microbots
• Non-contact bio-magnetic grasping
• Tissue welding
• Cell poration technologies
• Web-based telerounding

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Video
RP-7 Telerounding robot IntouchHealth
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Johns Hopkins Study (RCT)
Elison et al. Telerounding and patient
satisfaction following surgery
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Microrobots
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Assembling Reconfigurable Endoluminal Surgical
system ARES
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Optical coherence tomography

• Three-dimensional imaging technique with
  ultrahigh spatial resolution even in highly
  scattering media
• Based on measurements of the reflected light from
  tissue discontinuities/ junctions,e.g the
  epidermis-dermis junction
• Based on interferometry - measures interference
  between the reflected light and the reference beam

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Choose light source wavelength

• Light propagation (Monte Carlo simulation)

Absorption
Snake component
Incident light
Ballistic component
Diffuse reflectance
Diffuse transmittance
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Optical Coherence Tomography
Fiber-optic beamsplitter
Broadband source
Tissue
Scanning reference mirror
Detector
Amplifier
Bandpass filter
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3mm optical probe for OCT
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OCT vs. Standard imaging
Standardclinical
Highfrequency
OCT
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Tissue Elastographic Imaging

• Principle tumours are stiffer than
  surrounding normal tissues
• Vibration induces less displacement
• Power Doppler ultrasound with acoustic vibration
• HIFU elastography
• MRI elastograpy

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Basic Principles
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Vibration sonoelastogram breast
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Emerging Interventional Technologies
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(No Transcript)
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Principle of Electroporation L Mir IGR France
A B C
In A, the impermeable membrane prevents drug
entry. In B an electric pulse is applied which
renders the membrane permeable and allows the
drug to enter. In C, the pulse has stopped and
the membrane reseals
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OpistonTM albumin microbubbles filled with
octofluoropropane gas
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Inertial Cavitation of Albumin Microcapsule
Induced by Ultrasound
Video
Under an ultrasound driving field, the
microbubbles resonate, oscillating rhythmically,
or non-linearly, depending on the US field
parameters
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tlt0µs
z0
t4.0µs
Optically Trapped MB
t8.0µs
t10.0µs
HS camera sequence of optically trapped MB at Zo
82 4mµ insonated with NPA of 3.7 1.48 MPa.
Dynamics are almost spherical but surface
phenomena are observed
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Imacon HS camera images time interval of 14.0µs.
Dynamics of optically positioned 4.0µ MB near
substrate and insonated with pulses of 1MHz, PNA
1.39 0.49 MPa
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t 4.0µs
Jet
Impact Point
Funnelling
Individual frame from HS camera sequence
demonstrating needle jet formation as expanded MB
comes in contact with substrate
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Perforation/ injection of cell membrane by needle
jet
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AFM of DU 145cells after sonoporation and
fixation. Sonopores demonstrate distinctive
peripheral lips
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Therapeutic Microbubbles
Latest generation microbubbles target specific
sites via ligands enclose a drug component
embedded within the shell
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Targeted Ferromagetisation of Tissues

• Fe(3)O(4) nanoparticles coated with noble metals
• Coated super paramagnetic ion oxide (SPION)
  nanoparticles
• polyethyleneimine coated magnetic iron.oxide
  nanoparticles (polyMAG-1000)
• iron oxide nanospheres encapsulated in a
  poly(l-lactic acid)polymer
• ferromagnetic water-soluble iron oxide
  nanoparticles derived from human Ferritin

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Magnetotactic Bacteria
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Video
Techologies based on biomagnetics
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Present Situation
Life Sciences
Interaction is fortuitous
Physical Sciences and Engineering
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Interface Science and Engineering New Paradigm
for Innovative Disruptive Bioengineering RD
Life sciences
Interface
Physical sciences