Thursday, 13 November 2014
Google’s founders like to hype the company’s ethos around “moon shots” and “big bets.” Microsoft founder Bill Gates recently made a “call for crazy ideas” related to the Bill & Melinda Gates Foundation’s Grand Challenges inGlobal Health program,
All of the talk of big dreams and far out ideas got us asking: What seemingly crazy medtech concepts are now showing promise of actually becoming a reality?
1. Robot Anesthesiologists
Who ever thought that an anesthesiologist could be replaced with a machine? But that is exactly what is happening in the case of colonoscopy and esophagogastroduodenoscopy procedures and the Sedasys System produced bySedasys, a division of Johnson & Johnson’s Ethicon subsidiary.
The system received FDA pre-market approval last year after 14 clinical studies involving nearly 1,800 patients. It could be game-changing because it would eliminate the need to have a highly paid anesthesiologist in a room for some types of procedures.
Sedasys "is a great way to improve care and reduce costs," J&J CEO Alex Gorsky said in an interview with the Wall Street Journal.
An important point is that Sedasys is not a closed loop system. It will never increase drug delivery; rather, it only restricts, suspends, decreases, or stops the propofol infusion, depending on patient physiology. A clinician needs to intervene to increase drug delivery.
2. A Contraceptive Implant with Remote Control
A contraceptive implant could deploy birth control hormones for up to 16 years. If a patient wants to stop taking the hormones, they could switch the delivery of them off via a remote control. Developed by MicroCHIPS, a startup based in Lexington, MA, the chip could deliver more than birth control: an array of drugs or hormones would be compatible with the system.
The idea behind the implant is certainly represents outside-of-the-box thinking, and as such, it should come as little surprise that the technology has won the attention of Bill Gates, who as we mentioned earlier is hunting for innovative medical technologies to help the developing world.
3. Autonomous Robot Surgery
Would you trust a robotic surgeon? Researchers at the University of California at Berkeley seem to think you might. They have taken the daVinci surgical robot from Intuitive Surgical (Sunnyvale, CA), which has always been controlled by a human, and adapted it to do a range of actions autonomously. If the technology takes off, surgeons in the future might leave routine tasks such as suturing, cutting, and tissue removal to robots.
Because programming the robot to operate is understandably no easy feat, the researchers have relied on a “Learning By Observation,” where finite sub-trajectories are identified and a finite state machine is created for eachsubtask.
Interest in the technology has been catalyzed in part by the Ebola epidemic in West Africa.
The Cal-MR program is being funded by the National Science Foundation, companies like Intuitive Surgical and Google, and private individuals.
4. MRI Guided Robot Could Destroy Brain Tumors while Preserving Healthy Tissue
Researchers at Worcester Polytechnic Institute have received a $3-million NIH grant to study a minimally invasive method of destroying brain tumors while preserving healthy tissue surrounding them. Led by professor Gregory Fischer, PhD, the technology couples a robot designed to be used within an MRI scanner and an ultrasound probe that can deliver interstitial high-intensity focused ultrasound at the tumor, heating only malignant tissue—even in deep-seated irregularly shaped tumors.
The tumor can be pinpointed using real-time MRI data. Such real-time imagery is invaluable, Fischer says. “Once a hole is made in the skull, for example, the brain may swell and shift, and even images acquired just prior to the surgery will no longer be accurate,” he said in a press release. “Live images enable real-time control and a high degree of accuracy.”
5. Glucose Reading Contact Lenses
It has become a major goal in diabetes treatment: Finding ways for diabetics to test blood glucose levels without constantly pricking themselves with needles.
Perhaps one of the most far out ideas has come out of Google, and it involves electronics-embedded contact lenses able to read blood glucose through tears. The technology, though, obviously has potential, because Novartis and itsAlcon eye care division have inked a deal to license the “smart lens” technology for all ocular medical uses.
6. Sensors Embedded into Pharmaceuticals
The FDA in 2012 approved Proteus Digital Health's ingestible biosensor for monitoring drug compliance. The technology blurred the line between the world of pharmaceuticals and medical devices in the way that no medical device had before.
The edible sensor is the size of a grain of sand. And being made mostly of silicon, it is pretty much the same composition as a grain of sand, too. It does not contain a batter. Rather, two conductive materials, one on each side, power the sensor for a short period of time after getting wet in the stomach. The company’s disposable, body-warn patch captures and relays physiological responses and receives information from the ingestible sensor.
The company has entered partnerships with companies like Otsuka Pharmaceutical and Novartis to advance concept of sensor-containing drug capsules.
And Proteus is just one of many pioneers in the medical-device-as-a-pill space. Covidien announced in late 2013that it was spending $860 million to buy Yoqneam, Israel–based Given Imaging, maker of the PillCam swallowed capsule endoscope. Covidien executives were obviously making bet that people would much rather swallow a pill-sized camera than undergo a traditional colonoscopy.
Meanwhile, Carnegie Mellon University's Chris Bettinger and Jay Whitacre have found that cuttlefish ink provides just the right chemistry and nanostructure to power tiny, ingested electronic devices.
7. Tiny Pacemakers That Don’t Need Leads
Leads, those wires that connect pacemakers to the heart, have always proved problematic for pacemaker developers. So it’s probably no surprise that one of the major pacemaker makers, Medtronic, would engage in its own internal Manhattan Project-type effort to solve the problem. The result was the the large vitamin-sized Micratranscatheter pacing system (TPS) that is only one-tenth the size of a standard pacemaker and can be implanted inside the heart using a catheter. It is presently the subject of a global clinical trial.
St. Jude Medical meanwhile acquired Nanostim, a Milpitas, CA–based company that has a AAA battery-sized device (shown here) that won European Union approval.
In the case of the Medtronic Micra, designers concentrated on the systems linking the Micra in order to miniaturize it. Instead of developing each component technology on its own path, the Medtronic team sought "deep miniaturization" as it worked to pull together the electronics, battery technology, packaging, electrodes, and case, and build them together as a system.
8. The Luke Bionic Arm
Manchester, NH–based DEKA said that it worked with BrainGate because it saw the advantages that mind control could play in its advanced bionic arm prosthetic, which the FDA approved this year.
DEKA developed its Luke Arm (named after Luke Skywalker in “Star Wars”) with financial support from the U.S. Defense Advanced Research Projects Agency (DARPA), which has been seeking to replace the hook prosthetics for amputee vets that haven’t changed much since World War II, or the U.S. Civil War for that matter.
“One of our dreams for the Luke Arm [as the DEKA Arm System is known informally] since its inception has been to provide a limb that could be operated not only by external sensors, but also by more directly thought-driven control,” Dean Kamen, the Segway founder who started DEKA, said in 2012.
9. Headache Zapper
Cluster headaches have been nicknamed “suicide headaches” because they can be so debilitating. A company known as Autonomic Technologies Inc. (Redwood City, CA) has developed a neurostimulator to zap cluster headaches. The device can be implanted via oral surgery. The ATI Neurostimulation System consists of aneurostimulator smaller in size to that of an almond that is implanted above the second molar, where it makes contact with the sphenopalatine ganglion nerve bundle. The device works with a handheld remote controller.
10. A Neurostimulator for Epilepsy
In November 2013, the FDA approved NeuroPace’s implantable, closed-loop, responsive neurostimulator system (RNS) to treat some adult patients with drug-resistant epilepsy. The device is unique in that it responds to neurological activity, unlike other neurostimulators for epilepsy, which intermittently shut on and off throughout the day. A video from the Cleveland Clinic notes that the device helped reduce the average frequency of epileptic seizures by 44% at one year and 53% at two years in one study.