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Digital Issues

Coming Soon: An Intubation Robot?

The team of Canadian researchers that created "McSleepy," an automated anesthesia system, has built a remote-controlled robot designed to intubate patients with more precision than human hands can.

The robot, called the Kepler Intubation System, treated its first patient this month in Montreal General Hospital under the guidance of anesthesiologist Thomas Hemmerling, MD, of McGill University.

Dr. Hemmerling controlled the 1-armed robot with a joystick from a remote workstation. He says the robot's precise handling, the use of a joystick and video image will level the playing field among anesthesia providers with varying skill levels in intubating patients.

"One day, it might actually be the standard practice of airway management," says Dr. Hemmerling in a statement.

Kent Steinriede

The Technology to Improve Orthopedic Outcomes

"Patient John," a 64-year-old outdoor educator, walked into San Francisco Surgery Center for a partial knee replacement on April 5, walked out of the center on crutches within 3 hours of surgery and completed a 5-mile hike the next week, all thanks to the robot-guided surgical system that made the minimally invasive procedure possible.

San Francisco Surgery Center is the first ASC to host the outpatient partial knee replacement procedure, which goes by the proprietary name Makoplasty, after the company that makes the robotic technology. For the procedure, orthopedic surgeon Kevin Stone, MD, used CT scans of the patient's anatomy, a computer monitor and a robotic, surgeon-controlled arm to resurface only the diseased portion of the knee, keeping healthy bone and tissue intact. "In the past, surgeons used cutting guides, which at times could not be accurately adjusted in multiple planes on the operating table," explains a press release from the Stone Clinic announcing the achievement.

The computer-assisted technology "means a much greater level of precision and accuracy in a much smaller incision area than I would have had using traditional instruments and techniques," says Dr. Stone. A traditional partial knee replacement also would have required a 1- to 2-day hospital stay. (You can see "Patient John" discuss his surgical experience here.)

SFSC Administrator Jeff Wong admits that the cost of the Makoplasty system approaches 7 figures when you factor in price, insurance, taxes and shipping, while the procedure is reimbursed the same as a traditional partial knee replacement is. But the investment was worthwhile, he says, because of the robot-assisted procedure's ability "to get very precise and consistent results in joint replacement," and to deliver the cost-saving benefit of letting patients return home the same day. "We feel it's something that will pay itself off in a matter of a couple years," he says.

Irene Tsikitas

FDA Cites Manufacturers for MRSA Misstatements

The U.S. Food and Drug Administration has issued warnings to 4 manufacturers whose hand sanitizer and antiseptic products aren't as antibacterial as they claim to be.

The products' labeling and marketing promote their effectiveness in preventing infections from methicillin-resistant Staphylococcus aureus, E. coli and the H1N1 virus. However, the FDA says it has not seen any evidence supporting these statements and has ordered the companies to stop making the claims.

The products at issue include the CleanWell Company's All-Natural Hand Sanitizer, Foaming Hand Sanitizer, Hand Sanitizing Wipes and Antibacterial Foaming Hand Soap; JD Nelson and Associates' Safe4Hours Hand Sanitizing Lotion and First Aid Antiseptic Skin Protectant; Tec Laboratories' Staphaseptic First Aid Antiseptic/Pain Relieving Gel; and the G.H. Tichenor Antiseptic Co.'s Dr. Tichenor's Antiseptic Gel.

Healthcare professionals are asked to report any adverse events involving these products to the FDA's MedWatch program.

David Bernard

October 21st E-WEEKLY

InstaPoll: Grade Your Anesthesia Providers

Now's your chance to let the world know what you really think of your anesthesia providers. Rate them from 1 to 5 in this week's InstaPoll and check back in this space next week for the results. Remember, voting is anonymous.

Dan O'Connor

News & Notes

  • Tip of the week Are your post-op patients and PACU nurses on the same page when it comes to pain assessments? Placing a laminated card with several easily understood pain scales at each bedside can make sure that groggy and possibly language-impaired patients can make their needs accurately and consistently known to busy nurses, says Kelli Sheeran, RN.

  • Ultrasound boosts nerve block success Some anesthesia providers swear by ultrasound guidance for the placement of peripheral nerve blocks, but is the technique really any better than nerve stimulation? Yes, say researchers from Johns Hopkins University in a meta-analysis of 16 randomized controlled trials published in the Journal of Clinical Anesthesia. Overall, they found ultrasound guidance to be associated with an increased rate of successful PNBs compared to nerve stimulation and other non-ultrasound methods. Specifically, ultrasound was significantly more successful than non-ultrasound methods for the placement of brachial plexus, sciatic popliteal and brachial plexus axillary nerve blocks, but not brachial plexus infraclavicular nerve blocks.

  • J&J considering Synthes buy? Johnson & Johnson is reportedly in talks with Synthes over a possible buyout of the West Chester, Pa.-based medical device manufacturer, though both parties declined comment this week. Synthes makes components for treating bone fractures and traumatic injuries.
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