Futuristic Therapies

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Ithaca 7.2007 Futuristic Therapies Futuristic Therapies

description

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

Page 1: Futuristic Therapies

Ithaca 7.2007

Futuristic TherapiesFuturistic Therapies

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Technological Advances inIntestinal Surgery

““What is now provedWhat is now proved was once only imagin’d”was once only imagin’d”

William Blake, William Blake, The Marriage of Heaven and Hell (1790)The Marriage of Heaven and Hell (1790)

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Colon &Rectal Surgery:

Early 1900’s1900’s

•Anastomoses: NOT SAFEAnastomoses: NOT SAFE•Functional preservation: NOT RELEVANTFunctional preservation: NOT RELEVANT•Technical aspects SIMPLER:Technical aspects SIMPLER:

Anastomoses

Functional PreservationTechnical Aspects

-Knife-Scissors-Clamp-Thread & Needle

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Total Colectomy 2007Total Colectomy 2007 (Laparoscopic) (Laparoscopic)

Main blood vessels: Main blood vessels: sealed by bipolar energysealed by bipolar energy •Clamp

•clips•needle•thread•scissors

NO!NO!

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Key Technologies: Near FutureKey Technologies: Near Future

1.1. Optics/Image ProcessingOptics/Image Processing2.2. Energy devices(e.g. harmonic scalpel, Energy devices(e.g. harmonic scalpel,

Bipolar energy)Bipolar energy)3.3. New Anastomotic devicesNew Anastomotic devices4.4. Endoscopy/laparoscopy combinationsEndoscopy/laparoscopy combinations5.5. OR FutureOR Future

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New Laparoscopes

•Smaller, better optical properties Smaller, better optical properties (HDTV)(HDTV)•Magnification 15-20X and more!Magnification 15-20X and more!•FlexibleFlexible

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Future of imaging: HD- Better resolution/color reproductionStandard Definition High Definition

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CCD-compatible HDTV

Videoprocessor for HDTV signal processing

Image output with HDTV picture signals

Display on HDTV-compatible monitor

EICP-D to record HDTV digital signals in DVD

SI to record HDTV digital signals in server via network

FACTORS

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Applications of Narrow Band Imaging

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Potential of the intra/post-operative NBI colonoscopy

Normal Light SourceNormal Light Source NBINBI

Anastomosis after sigmoidectomyAnastomosis after sigmoidectomy

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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.

epithelium

breathing artifact

corpus luteum

20 m

Multiphoton imagingMultiphoton imaging

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Endoscopy in the OR

OR

GI LabLaparoscopy

Open

Endoscopy

“Invasiveness”

Less Invasive

More Therapeutic

FUTURE

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Combined CO2 Colonoscopy & Laparoscopy

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2

3

ExposureExposure

Surgical ControlSurgical Control

1 Endoscopic polypectomyEndoscopic polypectomy

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- Confirm the best position of the ileostomy

Combined procedure: Stoma required

Tip of endoscope

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OPERATING ROOM of FUTURE

• WOK: Wall of Knowledge (multiple flat WOK: Wall of Knowledge (multiple flat screens)screens)

• Input:Input:– OPTICS, XRAYS, MEDICAL RECORDOPTICS, XRAYS, MEDICAL RECORD– Consultations(Pathology,other specialists)Consultations(Pathology,other specialists)– Teaching input from remote siteTeaching input from remote site

• Bluetooth technologies (phone,data, Bluetooth technologies (phone,data, images)images)

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OPERATING ROOM of the FUTURE

Wall of Knowledge

“Telestration”

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Other Future InitiativesOther Future InitiativesTelepresence RoboticsRobotics

Expert surgeon can Expert surgeon can •““enter” the remote ORenter” the remote OR•Perform surgical actionsPerform surgical actions•Assist the team thereAssist the team there

Robots will:Robots will:•Make complex decisionsMake complex decisions•Particularly impt in battlefieldParticularly impt in battlefield or disaster situationsor disaster situations

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Summary: Colon & Rectal Disease Treatment

• Increase in the incidence of C&R diseases Increase in the incidence of C&R diseases (worldwide), particularly cancer(worldwide), particularly cancer

• Minimally Invasive Surgery: More Minimally Invasive Surgery: More commoncommon

• Cornell must assume a leadership role in Cornell must assume a leadership role in the development of this fieldthe development of this field