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Futuristic Therapies

Futuristic Therapies. Technological Advances in Intestinal Surgery. “What is now proved was once only imagin’d”. William Blake, The Marriage of Heaven and Hell (1790). Colon &Rectal Surgery: Early 1900’s. Anastomoses. Anastomoses: NOT SAFE Functional preservation: NOT RELEVANT

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Futuristic Therapies

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  1. Ithaca 7.2007 Futuristic Therapies

  2. Ithaca 7.2007 Technological Advances inIntestinal Surgery “What is now proved was once only imagin’d” William Blake, The Marriage of Heaven and Hell (1790)

  3. Ithaca 7.2007 Colon &Rectal Surgery: Early 1900’s Anastomoses • Anastomoses: NOT SAFE • Functional preservation: NOT RELEVANT • Technical aspects SIMPLER: Functional Preservation Technical Aspects -Knife -Scissors -Clamp -Thread & Needle

  4. Ithaca 7.2007 Total Colectomy 2007 (Laparoscopic) Main blood vessels: sealed by bipolar energy • Clamp • clips • needle • thread • scissors NO!

  5. Ithaca 7.2007

  6. Ithaca 7.2007 Key Technologies: Near Future • Optics/Image Processing • Energy devices(e.g. harmonic scalpel, Bipolar energy) • New Anastomotic devices • Endoscopy/laparoscopy combinations • OR Future

  7. Ithaca 7.2007 New Laparoscopes • Smaller, better optical properties (HDTV) • Magnification 15-20X and more! • Flexible

  8. Ithaca 7.2007 Future of imaging: HD • Better resolution/color reproduction Standard Definition High Definition

  9. Ithaca 7.2007 FACTORS EICP-D to record HDTV digital signals in DVD Display on HDTV-compatible monitor Image output with HDTV picture signals Videoprocessor for HDTV signal processing CCD-compatible HDTV SI to record HDTV digital signals in server via network

  10. ` Ithaca 7.2007 Applications of Narrow Band Imaging

  11. Ithaca 7.2007 Potential of the intra/post-operative NBI colonoscopy Anastomosis after sigmoidectomy NBI Normal Light Source

  12. In Vivo Imaging of Ovary: MouseImages: Rebecca M. Williams, Andrea Flesken-Nikitin, Alexander Nikitin, Watt W. Webb and Warren R. Zipfel, Cornell University, 2005, 9-P41-RR04224-18. 20 mm breathing artifact epithelium corpus luteum Multiphoton imaging Ithaca 7.2007

  13. Ithaca 7.2007 Endoscopy in the OR “Invasiveness” Open Laparoscopy GI Lab Less Invasive Endoscopy FUTURE OR More Therapeutic

  14. Ithaca 7.2007 Combined CO2 Colonoscopy & Laparoscopy

  15. Ithaca 7.2007 1 Endoscopic polypectomy 2 Exposure 3 Surgical Control

  16. Combined procedure: Stoma required Ithaca 7.2007 Tip of endoscope • Confirm the best position of the ileostomy

  17. Ithaca 7.2007 OPERATING ROOM of FUTURE • WOK: Wall of Knowledge (multiple flat screens) • Input: • OPTICS, XRAYS, MEDICAL RECORD • Consultations(Pathology,other specialists) • Teaching input from remote site • Bluetooth technologies (phone,data, images)

  18. Ithaca 7.2007 OPERATING ROOM of the FUTURE Wall of Knowledge “Telestration”

  19. Ithaca 7.2007 Other Future Initiatives Telepresence Robotics • Robots will: • Make complex decisions • Particularly impt in battlefield • or disaster situations • Expert surgeon can • “enter” the remote OR • Perform surgical actions • Assist the team there

  20. Ithaca 7.2007 Summary: Colon & Rectal Disease Treatment • Increase in the incidence of C&R diseases (worldwide), particularly cancer • Minimally Invasive Surgery: More common • Cornell must assume a leadership role in the development of this field

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