Best Medical Technologies of 2016

ULTRASOUND

While imaging the body using ultrasound is nothing new and improvements to this technology has been ongoing for many years now, there is a slew of new developments that give this modality new superpowers.

Healcerion and Clarius introduced wireless ultrasound transducers that don’t come with a screen, but instead use your choice of tablet or smartphone as the interface. Because of their small size and extreme portability they can be used virtually anywhere and may point to doctors soon carrying ultrasound devices as commonly as they do stethoscopes now.

A couple of interesting specialized applications of ultrasound include the Bindex device for osteoporosis screening and the Signostics Uscan for imaging and measuring the bladder. Both products provide a great deal of automation when performing the exam and help produce diagnoses without clinicians having to perform manual calculations.

A nifty augmented reality system from Victor Skobov, a student and computer tinkerer, overlays ultrasound images on top of what is being scanned. While we’re not yet sure what this is useful for, it’s pretty cool, and in this case it is enough reason for us to put it on the list.


AR and VR

Speaking of augmented reality, and its older brother virtual reality, over the past year these technologies have matured sufficiently to be useful in clinical medicine, medical education, and for improving patient satisfaction. In April the first live cancer surgery was broadcast via virtual reality to anyone in the world wearing a Google Cardboard or any similar virtual reality viewer. You can download the VRinOR app on your smartphone to check out previous recordings of surgeries and future live streams for yourself.

Microsoft’s Hololens augmented reality system has been used by Cleveland Clinic and Case Western Reserve University to create the HoloAnatomy app for studying the human body. Given the opportunity, we tried and reviewed the Hololens with consideration for what it can do for the future of medicine.

In terms of practical applications for virtual reality, it is already being used successfully to distract children from needles, injections, and transfusions. This will only be more common as calming down kids has been a perennial problem in medicine, and virtual reality turned out to be a cheap and easy technology to introduce into the clinic.

Most strikingly, though, virtual reality in combination with EEG (electroencephalography) actually helped patients with serious spinal cord injuries to restore movement to what seemed like permanently paralyzed legs. This was done without any implants or any other surgical interventions and seemed nothing short of a miracle.


PROSTHETICS AND MIND CONTROL

Since we’re talking about treatment for paralysis, let’s review some of the incredible developments that are letting people regain abilities that they lost due to serious injury or disease.

light-bulb-prostheticBut first off, to celebrate and promote the most promising powered prostheses, this year marked the inaugural Cybathlon in Zurich, Switzerland. Folks with all kinds of physical limitations, along with engineers and rehab specialists, competed in powered  prostheses races, bike races in which the participants’ leg muscles were activated using electric stimulators, and powered wheelchair races, among other tournaments. Our hope is that the Cybathlon will be a rival to the Paralympics, demonstrating what modern technology can achieve when men are free to develop and use tools to improve each other’s lives.

A great deal of research has led to people now controlling prostheses and using a computer through thought alone. Just this week we reported on a European collaboration that developed a brain-controlled arm and hand exoskeleton that let patients with quadriplegia use their own arms with amazing precision. Not only were they able to use a spoon and drink from a cup on their own, they were even able to pick up and munch on crunchy potato chips without making a terrible mess. There were no brain implants used, but instead a conventional brain-wave reading EEG cap was connected to a computer that interpreted the intentions of the users.

At Johns Hopkins University, scientists placed a high-density electrocorticography arra over the brain of an epileptic patient undergoing an unrelated procedure, and they were able to gather brain signals related to individual finger movement. They then had the volunteer move the fingers of a robotic hand at will, demonstrating the clear potential for prosthetic arms with highly dexterous finger control.

A locked-in woman suffering from ALS is now able to type, and therefore communicate with others, via a wireless device implanted at the University Medical Center Utrecht in The Netherlands. Albeit she only types a couple of letters a minute, the device she uses is fully implanted and connects wirelessly to an external antenna. This is a big achievement, as previous attempts at this involved the patient having power and data wires coming out of the body.


DRONES

Unmanned Aerial Vehicles, better known as drones, are beginning to play an important role in bringing medical care to people in emergencies, helping to link remote communities with distant clinics, and delivering medicine and patient samples to and from regional hospitals.

Earlier this month William Carey University College of Osteopathic Medicine introduced a drone system that transports an emergency medical kit along with a Google Glass device to people stranded in hard to reach places. Paramedics can have a hard time rescuing someone in a forest or on top of a hill, but a drone can get there quickly. Once on site, one of the people near the injured individual would put on the Google Glass and be connected to a remote physician who can see the scene and guide treatment until paramedics can get there.

While this drone is yet to prove itself in practice, Vayu, a young drone company based in Michigan, has already been delivering blood and stool samples from patients in remote Madagascar villages to an area hospital. They developed a drone that can take off vertically and then fly to its destination more than 40 miles (60 Km) away while carrying 4.5 lbs (2 Kg) of patient samples or medical supplies. Moreover, the drone is essentially fully automated, taking off, flying to its destination, and landing all on its own. The only interaction required is to program where it should land and to recharge the batteries between flights. While this is already happening in Madagascar, regulatory restrictions in many parts of the world don’t yet permit autonomous flying contraptions. We hope that changes on that front will come soon and these kinds of drones will be another way to quickly get care to people, for example, in rural Montana.


BRAIN ASSESSMENT

brain-sensorThese days it’s becoming easier to analyze the brain for signs of injury. BrainScope just received FDA permission to introduce its first commercialized device, the Ahead 300, in the U.S. It uses a disposable EEG electrode patch that connects to a smartphone to detect abnormalities within a patient’s brain waves.

The Lucid M1 from Neural Analytics, a newly FDA cleared device, relies on Doppler ultrasound to peer through the cranium and measure the activity of blood flow within. The system can be used to quickly identify the presence of broken blood vessels, helping to triage patients soon after appearing in the ER.

A new implant has been developed to measure the temperature and pressure of the brain directly. The device can be left where it was positioned, as it is bioabsorbable and eventually disappears given enough time. So far it was successfully tested on rodents with further testing expected before it’s trialed on humans.

The EYE-SYNC from SyncThink, a Boston, MA firm, was cleared by the FDA. It uses a virtual reality headset with built-in eye trackers to measure how well a person can track an object on the screen. We tried out the device at Stanford, where it’s already being used to screen athletes for concussion. It’s easy to use, takes only a minute to perform the test, and crucially doesn’t require a baseline test to be done when the subject is well. Because the technology within is becoming cheaper every day, we may soon be seeing it on the sidelines of high school football games.


SURGERY

Surgeries are becoming less-invasive and easier to perform thanks to creative ideas and smart engineering. This is an expansive field relying more and more on novel mechanisms that can translate the movement of the hands to instruments inside the body. This year we’ve seen a lot of new surgical devices and had a lot of excellent candidates to choose from.

Any surgeon performing laparoscopic procedures would be amazed by the intuitive controls of the FlexDex instrument platform. Unlike traditional laparoscopy instruments that involve dials, triggers, switches, and knobs, and that are clunky and not at all ergonomic, the FlexDex operates much like how a novice would expect it. As this video demonstrates, a twelve-year-old can be taught to use it in a short amount of time. We tried it ourselves on a visit to FlexDex’s offices in Michigan, and we were able to move objects accurately around a peg board within minutes.

The Levita Magnetic system can eliminate the necessity of a second incision for some laparoscopic surgeries by injecting a detached instrument through the initial incision and then manipulating it using a magnet outside the body. While it only works with certain instruments and for only a small subset of procedures, an option of eliminating incision is always good.

The Amend system offers a minimally invasive procedure for mitral valve repair and replacement via the subxiphoid transapical approach. This involves delivering the firm’s Amend catheter through the chest and into the heart where a D-shaped ring is deployed and positioned to match the annulus of the original valve. A special mechanism provides control for moving and shaping the ring, allowing the physician to affix it accurately to the targeted tissue. If it gains regulatory approval, it may help avoid a great number of open heart surgeries.

Engineers at Rice University turned a shipping container into a mobile surgical instrument sterilization facility. It works on solar power and features an electric water filtration system and an autoclave to prepare the tools. It has already passed multiple trials and showed nearly a perfect ability to sterilize surgical instruments.




DIABETES

Medtronic proudly received FDA approval and introduced the world’s first “Hybrid Closed Loop” insulin delivery system. The MiniMed 670G runs Medtronic’s SmartGuard HCL algorithm that calculates insulin delivery times and dosage amounts, and in the most automated mode the patient has to only input carbohydrate counts following every meal, confirm recommended bolus changes, and once in a while calibrate the sensor. The insulin pump talks to the glucometer and together they help keep sugar levels within a healthy range.

eversense-glucometerThe Eversense glucometer won CE Mark approval to be introduced in Europe. The system includes a sensor, implanted under the skin and swapped out for a new one every three months, and a transmitter attached to the skin that communicates via Bluetooth with a smartphone app that displays the readings. The app can also be programmed to activate an alarm on the phone to warn of abnormal sugar levels and historical data can be shared easily with your doctor.

At the Cardiff University in Wales, researchers developed a non-invasive sensor that is able to measure blood glucose without taking a blood sample. It uses microwaves to penetrate the skin and detect a returning signal. The microwaves are weak enough not to injure tissue, so it should be pretty safe, but the device’s accuracy will have to be proven out.


Et cetera…

At the Wake Forest Baptist Medical center researchers added electrocardiography (ECG) features to a TASER stun gun. A cop that has used it to shock the person can then check on whether the subject is experiencing a subsequent cardiac arrhythmia. This is the first weapon with medical capabilities we’ve ever covered, though a number of years ago we’ve written about a 9 mm handgun designed specifically for people with arthritis.

capsocam-2The Capsocam “swallowable endoscope” has been FDA cleared last month. Inside a device the size of a large drug capsule are four cameras and LED lights that capture the insides of the guts as the pill progresses through the GI tract. While similar devices have been on the market for a few years now, they have a single forward facing camera that doesn’t always produce the best results. The Capsocam’s cameras, which look sideways, get a very up-close and personal view of the interior of the intestines.

Since we mentioned the guts, the Pure-Vu system deserves a mention. Since a lot of patients don’t properly prepare for a colonoscopy by fasting and drinking liquids, the large intestine is too full of faex for proper visualization. The Pure-Vu lets clinicians wash it out from the insides using four sprinklers and a suction system.