Theme 2: Interventional Technologies
Please note this presentation contains some graphic images.
Minimally invasive and robot-assisted surgical techniques are still evolving and there is a huge potential market for improved systems and techniques. The limitations of laparoscopic surgery illustrate the present problems, with an urgent need for better surgical planning techniques, improved pre-operative and intra-operative imaging accuracy, and tailoring of operations to patient-specific anatomy and physiology.
Research and technology need:
In minimally invasive surgery, there is a need for stereotactic and robotic assist devices, integrated 3-D imaging and intuitive, artificial intelligence-based consoles for surgical planning. In the field of intensive care, personalised responses to real-time monitoring data are vital to reduce costs and improve outcomes for patients.
New Zealand’s role:
Our research team has expertise in surgical techniques and physiological modelling which is the basis for the new technologies developed.
Developments already in use or being clinically trialled in New Zealand and internationally include:
- methods of controlling blood sugar levels in intensive care patients – SPRINT and STAR,
- a blood glucose control system for extremely pre-term infants under 1.5kg birthweight - GRYPHON, and
- a model-based system for controlling ventilator settings in intensive care and thus markedly improving the duration of hospital stay and the outcome for the patient – CURE.
Surgical expertise and computer modelling techniques are also being used to develop improved, personalised planning prior to liver surgery, an area where the mobility of the organ and individual patient variations present considerable difficulty in conventional surgery. Data can be collected and used to construct 3-D images of blood-flow dynamics in surgical scenarios at various levels of detail, including systemic circulation, intra-hepatic vasculature and locally within each liver segment. These research areas rely heavily on the associated technical skills of the CMDT team in image acquisition, remote monitoring, design and manufacturing.
New Zealand collaboration in relation to liver surgery involves surgical teams in a number of district health boards, and industrial partners in this area include Siemens. The physiological modelling projects have seen SPRINT and STAR used in hospitals in NZ, Hungary, Belgium, the US and the UK, GRYPHON in NZ and Hungary, while CURE is being clinically trialled in both Christchurch and Belgium. The research team also has active collaborations on device development with departmental Chairs in Gastroenterology and Cardiac electrophysiology at the Mayo Clinic, and active academic collaborations with universities in the US, Belgium and Australia.