WILL INCISIONS BECOME A THING OF THE PAST? THE EVOLUTION TO NON-INVASIVE FOCUSED ULTRASOUND
Two key milestones changed the face of modern surgery - anesthesia and aseptic technique. With these developments, surgery became more and more invasive because the patient felt no pain and was able to survive the surgery. Today there is a new technology that is redefining surgery – MR-guided focused ultrasound.
The word surgery means working or done by hand.
When we hear the word surgery, we think of an intervention with some level of invasiveness in a sterile operating room. The word evokes, on one hand, an image of the expert skilled hands of a surgeon, and on the other, stitches, bandages and usually extensive recovery for a patient.
In medicine, technological innovation is often needed to blaze the trail towards change. Imagine for a moment that a physician can see inside a patient’s body, treat a medical condition without making an incision and the patient returns home the same day.
As early as Hippocrates, instruments were used to see disease without an incision.
The lack of a good light source to see inside the human body was a key obstacle. Credit for the development of modern endoscopy goes to Philip Bozzini (1771-1809) for an invention which redirected light to the observer’s eye from internal cavities using candles and mirrors. Primarily for urology and gynecology procedures using existing orifices, variations of the device continued to be used over the course of the next 100 years.
In the early 1900’s, surgery continued to evolve when Hans Christian Jacobeus, a Swedish surgeon, coined the phrase “laparoscopy” (laparothorakoskopie). Laparoscopic, or keyhole surgery, required only several small holes to insert surgical instruments and a light source inside the body.
It took many advances over decades for the lap approach to become standard treatment.
The slow, gradual pace of acceptance of minimally invasive surgery was due in part to the limitations of the technology available. It was actually only in the mid-1980s that the video technology necessary for modern laparoscopic surgery was developed. Over the last several decades, there has been a huge growth in minimally invasive surgery. This growth has been pushed forward by advancements in imaging and technology, which allowed small probes and catheters to be directed through the body without the need for traditional surgical incisions. This evolution continued into the 1990’s with the introduction of robotic-assisted surgery, which continues to evolve today.
Non-invasive surgery - leaving the patient whole.
INSIGHTEC is leading a new and exciting revolution in patient care. By leveraging focused ultrasound and MRI technologies, surgeons now have the ability to see and treat while leaving the patient whole. Focused ultrasound waves safely pass through tissue and bone. Only where the waves converge is the tissue heated to temperatures high enough to cause thermal ablation, destroying the target cells. MR imaging not only enables high resolution visualization of patient anatomy, but also provides continuous real-time thermometry.
Non-invasive surgery places the patient in the center of care and holds the potential to safely treat millions of patients. Overall, with no surgical incisions and guided by real-time MR imaging, the risks of bleeding and infections are reduced or eliminated, hospitalization is minimized or avoided altogether and patients can quickly return to their lives. Today, these capabilities are treating essential tremor, painful bone metastases and uterine fibroids.
Kobi Vortman, INSIGHTEC’s founder, is known to say that someday the idea of making an incision in a patient’s body will be a thing of the past, a part of history.