A minimally invasive surgical approach developed by head and neck surgeons at the University of Pennsylvania School of Medicinehas been cleared by the U.S. Food and Drug Administration (FDA). The Da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California) has been cleared for TransOral otolaryngologic surgical procedures to treat benign tumors and select malignant tumors in adults.

Drs. Gregory S. Weinstein and Bert W. O’Malley, Jr. of the University of Pennsylvania School of Medicine’s Department of Otorhinolaryngology: Head and Neck Surgery founded the world’s first TransOral Robotic Surgery (TORS) programat Penn Medicine in 2004, where they developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, voice box, tonsil, tongue and other parts of the throat. Since 2005, approximately 350 Penn patients have participated in the world’s first prospective clinical trials of TORS. These research trials compromise the largest and most comprehensive studies of the technology on record.
“TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality of life issues,” said Bert O’Malley, Jr., MD, professor and chairman of Penn Medicine’s Department of Otorhinolaryngology:Head and Neck Surgery.

“It is very exciting that a concept conceived at PENN, evaluated in pre-clinical experimental models at PENN, tested in clinical trials at PENN, and then taught to key surgeons and institutions both within the U.S. and internationally has been officially recognized by our federal governing agencies and peers around the world as a new and improved therapy for select neck cancers and all benign tumors.”

45,000 Americans and approximately 500,000 people worldwide are diagnosed with head and neck cancers each year. Head and neck tumor treatments often involve a combination of surgery, radiation therapy, and chemotherapy. In many cases, surgery offers the greatest chance of cure; yet conventional surgery may require an almost ear-to-ear incision across the throat or splitting the jaw, resulting in speech and swallowing deficits for patients. In comparison, the minimally invasive TORS approach, which accesses the surgical site through the mouth, has been shown to improve long term swallowing function and reduce risk of infection while speeding up the recovery time. When compared to traditional surgeries, after their cancers have been removed successfully, patients have been able to begin swallowing on their own sooner and leave the hospital earlier. TORS outcomes are markedly improved when compared to standard chemotherapy, radiation or traditional open surgical approaches for oropharyngeal cancer.

“Based on our data and patient outcomes, coupled with the national and international enthusiasm and interest for TORS, we are changing the way oropharyngeal cancer and tumors will be treated now and in years to come,” noted Gregory Weinstein, MD, FACS, professor and vice chair of the University of Pennsylvania School of Medicine’s Department of Otorhinolaryngology: Head and Neck Surgery, director of the Division of Head and Neck Surgery and current president of The Society of Robotic Surgery. “We are already investigating new TORS treatments for other conditions such as sleep apnea, and collaborating with colleagues in Penn Neurosurgery to use TORS to remove skull base tumors and repair cervical spine disease.”

The Penn TORS program developed an international training program that has trained numerous surgical teams from 12 different countries, many of whom have started establishing TORS programs at their respective institutions. With the FDA clearance of the da Vinci System for transoral otolaryngology, Penn Medicine will immediately expand its well established training program to include surgical teams from the United States.
Dr. Weinstein and O’Malley have no financial ties or consulting agreement with the surgical company. 
For more information about the Penn TORS Program, please visit http://www.uphs.upenn.edu/pennorl/research/tors/ or call 215-349-5390.
A 2005 Penn Medicine press release on TORS can be found online at: http://www.uphs.upenn.edu/news/News_Releases/may05/TORS.htm

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $3.6 billion enterprise.

Penn’s School of Medicine is currently ranked #3 in U.S. News & World Report’s survey of research-oriented medical schools, and is consistently among the nation’s top recipients of funding from the National Institutes of Health, with $367.2 million awarded in the 2008 fiscal year.

Penn Medicine’s patient care facilities include:

• The Hospital of the University of Pennsylvania – the nation’s first teaching hospital, recognized as one of the nation’s top 10 hospitals by U.S. News & World Report.
• Penn Presbyterian Medical Center – named one of the top 100 hospitals for cardiovascular care by Thomson Reuters for six years.
• Pennsylvania Hospital – the nation’s first hospital, founded in 1751, nationally recognized for excellence in orthopaedics, obstetrics & gynecology, and behavioral health. 

Additional patient care facilities and services include Penn Medicine at Rittenhouse, a Philadelphia campus offering inpatient rehabilitation and outpatient care in many specialties; as well as a primary care provider network; a faculty practice plan; home care and hospice services; and several multispecialty outpatient facilities across the Philadelphia region.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2009, Penn Medicine provided $733.5 million to benefit our community.

Intraoperative diagnostics have long since become standard in modern clinical work and boost precision in surgery. A unique hybrid solution is now being offered by Siemens and TRUMPF: The C-arm and the operating table are capable of communicating one with another; their motions are precisely coordinated. This opens the door to new, integrated diagnostic and surgical techniques and at the same times offers hospitals maximum flexibility in patient positioning, regardless of the surgical discipline involved.

A mighty team
Completely matched to each other are the Artis zee ceiling and Artis zeego X-ray and angiography systems made by Siemens and the version of the TRUMPF operating table engineered especially for these applications, the “TruSystem 7500 for Artis zee systems”. In coupled operation, the Artis control module can steer both units simultaneously. The high-resolution X-ray systems register the position of the operating table and use this information to avoid collisions between the operating table and the C-arm.

The operating table support column is fitted with a one-piece, carbon-fiber-reinforced table top. If desired, a segmented, all-purpose table top may be used instead. Both table tops can easily be changed out with the help of a shuttle.

The complete integration of the operating table into the Siemens angiography systems enables quick rotation and 3D images using the C-arm. The table top with its modular design makes for versatility when positioning the patients, accommodating every surgical discipline. Complicated setups such as the lateral position with elevated thorax can be achieved quickly, precisely and conveniently.

New therapy options
Both surgeons and patients benefit from high-resolution imaging procedures, during and after the intervention, without time-consuming, expensive and potentially risky patient transfers. This also expands the therapeutic latitude for neurosurgery and orthopedics since there, in particular, flexible positioning capabilities play a decisive role.

Flexible use
No matter whether for combined, special-purpose surgery, conventional surgery or pure diagnosis – hybrid ORs can be used in many ways and by many medical disciplines. The operating table concept used by TRUMPF throughout enables universal use. Table tops and components are compatible one with another and can be flexibly configured. In addition to carbon-fiber-reinforced table tops, which permit intraoperative diagnostics with artifact-free X-rays, the surgical staff can also use all-purpose table tops. Patented couplers make it possible to configure these quickly and easily, as may be needed by any given surgical discipline. Thus a table for universal use quickly becomes a special-purpose table. With its many adjustment capabilities, it will do justice to every intervention.

More space in the OR
TRUMPF surgical lights, too, with their extended range of horizontal and vertical motion, expand freedom of movement in the OR. They ensure perfect illumination during both open surgery and interventional procedures. Thus they are available for every hybrid use. The TRUMPF ceiling pendants as well can play an important role in the hybrid operating theater. They can be set up close to the ceiling to avoid collisions with other equipment. Thanks to their long support arms they can quickly be swung out of the scanning range.

Exact planning makes it possible to seamlessly integrate hybrid ORs into the central surgical department and at the same time adhere to all the hygiene concepts and specified work sequences. This makes it possible to achieve a high degree of utilization even in smaller hospitals. That is a great advantage – not just in difficult economic times.

A number of innovative Laser Eye Surgery procedures are widely available today.
There are three main types of Laser Eye Surgery:

PRK (Photo Refractive Keratectomy) has been the standard eye laser surgery for many years.
It involves the complete removal of the epithelium or the outer layer of cells on the eye, with the use of a "cold" laser light.
PRK is mostly used on patients with low to moderate amounts of Myopia Astigmatism.
Below you can watch a video showing a PRK surgical intervention:


LASEK (Laser Assisted Sub-Epithelial Keratectomy) or EPIFLAP (Laser Assisted Epithelial Keratomileusis) surgery involves the fractional removal of the epithelium to reveal the cornea, which is then firmed or reshaped by a laser. The outer layer of cells is then pushed back, and the eye heals shortly after.
LASEK is used on patients with low to moderate amounts of Myopia or Astigmatism.
Below you can watch a video showing a LASEK surgical intervention:


LASIK (Laser Assisted in Situ Keratomileusis) is the newest and most popular type of eye laser surgery. Initially developed by Spanish ophthalmologist José Barraquer, with this procedure a thin layer of the eye's cornea is sliced off to create a flap. This enables the laser to target the tissue underneath. The flap is simply replaced and grows back naturally. Vision is restored almost immediately.
LASIK is usually used on patients with severe Myopia (nearsightedness): -0.75 diopters to 10.0 diopters.
Below you can watch a video showing a LASIK surgical intervention:


Source:
http://lasertherapeutic.blogspot.com

Tiny Robots (8 centimeters long) are being developed at the University of Nebraska to provide remote controlled robot abdomen surgery.

The project's mission is to test new minimally invasive surgery techniques.
Specialized devices for illumination, biopsy, clamping and cauterizing are also planned, some of which could move around the stomach or the abdominal cavity.

Dmitry Oleynikov, director of education and training for the minimally invasive and computer-assisted surgery project asserted that: 

“This is just the start of things to come regarding robotic devices at work inside the body during surgery.”

NASA has shown its interest in the project and said it will teach astronauts to use the robots so that surgeries can be performed in space. They can also be operated from surgeons on Earth, who can control the robots themselves from other locations.

Visit the University of Nebraska to watch an amazing video of a motorized robot doing its job inside a patient's abdomen.

 Microfluidic Lab-on-a-chip
for Chemical And Biological Analysis And Discovery
(Chromatographic Science)