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Archive Hot Technology 2020

On Point: Early Adopters Will Lead the Way

Embrace innovation to improve every aspect of surgical care.

Jihad Kaouk

Jihad Kaouk, MD


Cleveland Clinic
POWER OF ONE Jihad Kaouk, MD, and a team of Cleveland Clinic surgeons successfully performed the world's first robotic single-port kidney transplant in November 2019.

We are entering a new and exciting era of surgery. Cutting-edge technology that seemed like it was straight out of a sci-fi movie just a few years ago is being used with great regularity in ORs across the county. Robotics, virtual reality and the visualization capabilities of 4K ultra-high definition video and augmented reality are improving the precision, safety and overall outcomes of surgery. In fact, technology is directly responsible for transforming traditionally inpatient procedures to same-day surgeries that can be done at virtually any hospital outpatient department or standalone ASC.

Implementation of the latest technology is critical in health care. As more facilities embrace game-changing surgical devices and tools, the cost of new technology will decrease, spurring widespread accessibility to several exciting developments being brought to the OR table.

In surgery, if we're still doing what we did five years ago, we're missing something.
  • Robotics. The surgical robot has come a long way since it first arrived in surgery. Twenty years ago, robotics enhanced human capabilities with the platforms simply by following the movements of the surgeon. Today, image-guidance improves the precision of robots, which guide the surgeon along preplanned surgical pathways. Advances in the technology have allowed my department to shift approximately 50% of our robotic procedures to outpatient ORs. It’s why my team and I were able to perform the world’s first single-port kidney transplant, during which we placed surgical instruments and the donor kidney through a 4cm incision in the patient’s abdomen. The procedure minimized tissue trauma and resulted in minimal post-op pain, allowing the patient to recovery without taking opioids.
  • Virtual reality. These technologies are helping to train an entire new generation of surgeons. Virtual reality lets physicians watch renowned surgeons perform complex procedures from anywhere in the world through headsets or training modules that simulate surgical procedures in great detail, allowing the physicians to get a feel for the surgery without using costly bone models or cadavers for practice. A recent UCLA study that assessed virtual reality as a training tool showed very promising early results. It’s leveling the playing field among our young physicians and decreasing the learning curve faster than we ever thought possible.
  • 3D printing. Engineers are using 3D printing technology to create accurate, three-dimensional models of patients’ anatomy, which can be used to create customized implants for procedures like total joint replacements. Surgeons are also using the technology to practice procedures on exact replicas of a patient’s individual anatomy in order to determine the best approach and the instruments needed to achieve positive outcomes.
  • Artificial intelligence. Thanks to devices such as the OR black box — a shoebox-size device that captures video and audio recordings of everything that happens during surgery to identify near-misses, understand surgical risks and mitigate them accordingly — we can standardize safety and process confirmation through complex, reliable algorithms.
  • Superior imaging. Laparoscopic surgery is optically driven. As a result, the clarity of ultra-high definition monitors is stunning, offering views four times the pixels of standard HD. That difference allows surgeons to distinguish finer patterns and structures of tissue and critical anatomy. What’s more, systems that route video and images to large screens hung throughout the OR make it easy for staff to share information in real time. Augmented reality — which incorporates a variety of patient data such as MRIs and CT scans to create specific anatomical features and overlays those features on the patient — takes visualization to the next level, allowing surgeons wearing specially designed headsets to see under the surface of organs and directly into blood vessels and tumors. This 360-degree view bolsters precision, limits incisions and reduces the risk of complications.

Look to the future

When it comes to surgical technology, there’s a cycle that plays out time and again. Innovators develop the technology and early adopters jump right into the fray, eagerly looking to test and validate the tools that make them more efficient and more effective providers. Off on the sidelines stand the naysayers, paralyzed by skepticism and already complaining of the added cost. “The way we’re operating now is good enough,” they say.

If your facility has the means and the infrastructure to invest in new technology, I highly recommend you do so — for the sake of patients. We should strive to do our best today, but keep our eyes open wide for what’s coming next, so we can continue to evolve and provide superior care. In surgery, if we’re still doing what we did five years ago, then we’re missing something. Strive to be the early adopters. Facilities that embrace revolutionary technology will remain on the cutting-edge of care. OSM

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