New developments in technologies are changing every area of life—including medicine. From utilizing machine learning in order to develop personalized cancer treatments, to artificial intelligence that scans hundreds of images in seconds for busy radiologists, to handheld devices that can stream data to doctors’ smartphones for faster diagnoses, a wide range of technologies is changing the ways healthcare is delivered. These innovations advance and improve care for patients while they increase doctors’ efficiency, largely because the technology enhances the skills of the doctor who uses it.
For neurosurgeons operating on the spine and brain, the highest possible degrees of precision and safety are required. Technology that can help neurosurgeons operate and deliver excellent outcomes for their patients in shorter timeframes, without the use of radiation, are major advantages for everyone in the operating room. At Rochester Regional Health’s Unity Hospital, neurosurgeons are using an innovative software platform to help them navigate exactly where they need to operate for spinal and brain surgeries.
Unity is using the 7D Surgical System, which is the first navigation system of its kind, and Unity is one of only 13 hospitals in the country to adopt the platform.
Dr. Anthony Petraglia, a neurosurgeon with Unity, said the technology is “paving the way for safety in spine surgery. Safety is number one, always when we’re taking care of patients. The 7D Surgical System allows us to provide the same excellent level of service, as always, but with that much greater accuracy when we’re placing instrumentation around the spine.” The system is also being used for cranial surgeries at Unity.
The 7D Surgical System eliminates the intra-operative CT (computed tomography) and fluoroscopy that surgeons traditionally used to “register” the patient’s surgical area. The system is a machine-vision image-guided surgery platform (MvIGS) that uses only visible light to help surgeons pinpoint exactly where to operate, in real time.
This means that, unlike conventional image-guided systems, there’s no radiation involved, so it’s not only safer, but also much faster—a surgeon can accurately determine the surgical area on the spine or cranium in less than 20 seconds. The system acts as a detailed GPS (global positioning system), similar to the technology being used in self-driving cars. Using four flash registration cameras, surgeons can pinpoint the exact areas to use their surgical tools.
For spinal surgeries, this flash registration digitizes the patient’s anatomy and automatically matches it with a pre-operative CT scan. Unlike conventional IGS (image-guided surgery) systems that depend on time-consuming intra-operative devices that emit radiation or laborious point-matching techniques, McIGS uses just visible light to easily register patients. And surgeons can update the registration at any time in just seconds, for any reason, such as recovering from a bumped reference point, using what 7D Surgical calls FlashTM Fix.
The 7D System saves even more time with real-time implant sizing during surgery, reducing the need for pre-operative planning. The system is also a plus for complicated surgeries, which are often the case when patients have multiple comorbidities—other chronic diseases or conditions—like Dr. Petraglia’s patient Bob Brown, who also has rheumatoid arthritis.
After Brown fell in the shower and fractured the C1 vertebrae in his neck, Dr. Petraglia turned to the new 7D Surgical System to place pins that allowed Brown to heal his fracture and his pain. In fact, he was home again just 24 hours later. “Every case is different, but for patients that typically undergo a surgery like this, it can a be two, three, or even a four-day stay in the hospital,” said Dr. Petraglia. “We saw Bob the next morning and he was up walking, moving, doing everything and ready to go.”
For cranial surgeries, the 7D System is equally fast, efficient and accurate for registration of both the facial area via the skin and the skull of a patient. It removes the need to use traditional sponge fiducials on the skin—markers that act as reference points in the field of view of an imaging system. Instead, the 7D digitizes over 300,000 points using the system’s advanced cranial software algorithms, which are captured automatically. The 7D’s dual-plane reference array also allows for seamless transition between facial and posterior fossa—the small space in the skull found near the brain stem and cerebellum—registrations. With totally contactless registration, the 7D’s virtual fiducials use the patient’s own anatomy for extremely accurate FlashTM registrations and enables a sterile workflow.
In addition, the 7D’s instantaneous linked registration technology removes the need for inefficient and time-consuming image fusion. Its advanced technology enables navigation with layered CT and MRI datasets registered directly to the patient in real time. This in turn removes the errors associated with traditional image fusion, because the 7D Surgical System registers directly to the patient in just seconds.
Another plus: the 7D Surgical System allows doctors to see that they’ve performed the operation correct without having to check an X-ray after the fact, another way this system reduces radiation exposure.
Whether the system is used for spinal or cranial surgeries, the 7D delivers a wide range of benefits to surgeons, operating staff and patients. Because it’s radiation-free, it eliminates intra-operative CT or fluoroscopy used for registration, and reduces radiation exposure to everyone in the operating room. Its FlashTM Registration allows surgeons to perform faster, more accurate image-guided surgeries. And with the machine vision technology embedded right into the attached surgical light, there are no line-of-sight issues for surgeons and reduced need for technical staff and equipment. Foot pedals allow the surgeon complete control from the surgical field. The end result is successful surgeries that are faster, more accurate and more cost-effective, and much safer, with patients that are able to leave the hospital sooner.
According to Paul Maurer, MD, Chief of Neurosurgery at Rochester Regional Health, this innovative technology is quite similar to aviation and works to enhance the surgeon’s abilities. “New technology in an aircraft doesn’t replace the pilot, it augments the safety…what this technology allows is for a surgeon to have incredible precision,” said Dr. Maurer.
The 7D Surgical System is just the most recent addition in Rochester Regional Health’s history of adopting innovative technologies to advance care for patients. These range from advanced electrostatic technology with the Clorox® Total 360® System for advanced cleaning disinfecting protocols, to earning HIMSS7 validation, the industry’s highest standard for electronic medical records adoption. Since 2008, when Rochester General Hospital acquired the da Vinci system for minimally invasive surgeries, Rochester Regional Health has also ranked among the top one percent of hospitals in the US for robotic surgery volume.