Medical Device Daily

ATLANTA – Haptics is the area in bio-medical engineering focused on developing instruments and devices reliant on mimicking the sense of touch. And Randal Wolf, MD, told attendees at the first American International Medical Summit (AIMS) on Biotherapeutics and Medical Designs Tuesday, on the conference's second day, that they “better be ready” for haptic technology

Wolf, professor of surgery and bio-medical engineering and director of the Center for Surgical Innovation at the University of Cincinnati (Cincinnati), took on the topic of “Tactile Feedback in Robotic and Minimally Invasive Surgery” and told attendees to “be responsive to change,” such as the use of haptic technology. That change, he said candidly, will include “a lot of bumps in the road.”

Surgeons, he said, now rely primarily on their vision for feedback to know if they are making all the right moves and decisions during invasive procedures. Five years from now, that may not be the case as new haptic technologies are being developed.

Devices that are tactile-manipulated are necessary because “there are times with instruments in a beating heart where you can't see the instruments,” he said. If a surgeon doesn't have hearing and doesn't have sight, he or she “must have touch.”

In Wolf's vision of the future, this type of technology will produce gloves designed that are so sensitive that they can replicate the finger movements hitting keys on a trumpet. The only difference is there will be no trumpet. Instead, the movements will be used to create a binary code that signals a device on a computer to make the assigned sounds.

Surprisingly, he said that much of the innovation for such devices is coming out of the gaming industry and, more generally, from Hollywood and its innovations and the realms of the digital and virtual.

“The path goes from Hollywood to medicine,” Wolf said, later adding that for about every $100 that goes into technology development in Hollywood, about $1 of it will end up going to medicine.

And the technology and engineering behind such devices – such as for application in haptics – is expected to be “the next big breakthrough not only in medicine but all across the [technological] spectrum,” Wolf said.

Wolf said that when medical people hear the term “robotics” mentioned in connection with surgery, they are most likely to think of the daVinci Surgical Systemby Intuitive Surgical (Sunnyvale, California).

However, he noted that, more precisely, the da Vinci system is actually a “telemanipulator.” And he said that instruments such as the da Vinci system will ultimately use touch from the surgeon's hand and then be translated to a binary code of zeros and ones used to trigger movement in a robot.

He noted also that this combination of devices will include the ability to deliver therapeutics and conduct diagnostic tests.

Among the places where much of this research is taking place is the touch lab at the Massachusetts Institute of Technology (Cambridge, Massachusetts).

Other areas of robotic technologies for medicine that he projected being put into this category, and now under development, include biomechanics, neurophysiology and pyschophysics.

“In the future, you will also use your imagination, perhaps as much as touch,” he said.

Also speaking at the conference was Khusrow Niazi MD, assistant professor of medicine at Emory University (Atlanta), who discussed “Catheter-Based Limb Revascularization.”

Niazi said that atherosclerosis is a systemic vascular problem that is estimated to affect 12 million people in the U.S., with 2 million are actually diagnosed. The aging Baby Boomers are driving the increase in peripheral artery disease (PAD).

“It's a disease that's going to be with us, and it needs to be vanquished,” Niazi said, noting that survival with atherosclerosis is 12 times worse than it is with breast cancer, for example.

As a result of the increase in cases of atherosclerosis, “amputation rates are going up in this country,” he said.

Furthermore, there are few ways to diagnose and treat the disease, he said, although magnetic resonance angiography has revolutionized the approach to diagnosing the disease, he said.

Among the systems he listed for treating the disease are the Viabahn stent-graft by W.L. Gore & Associates (Flagstaff, Arizona), the PolarCath Peripheral Dilatation System developed by CryoVascular Systems (Los Gatos, California) and the SilverHawk plaque excision system by FoxHollow Technologies (Redwood City, California).

The inaugural AIMS meeting is being presented by The Woodruff Health Sciences Center of Emory University, Emory University and Emory Healthcare (all Atlanta).

The keynote speaker on Tuesday was Miriam Provost, deputy director of the Office of Device Evaluation of the Center for Device and Radiological Health, on the topic “Developing Innovative Devices to Meet Public Health Needs: The FDA Perspective.”

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