Surgery and Operating Room Innovation PDF
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Surgery and Operating Room Innovation Seiichi Takenoshita Hiroshi Yasuhara Editors 123 Surgery and Operating Room Innovation Seiichi Takenoshita • Hiroshi Yasuhara Editors Surgery and Operating Room Innovation Editors Seiichi Takenoshita Hiroshi Yasuhara Fukushima Medical University Tokyo Teishin hospital Fukushima Chiyoda-ku Fukushima Tokyo Japan Japan ISBN 978-981-15-8978-2 ISBN 978-981-15-8979-9 (eBook) https://doi.org/10.1007/978-981-15-8979-9 © Springer Nature Singapore Pte Ltd. 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore Preface The development of surgery has been associated with the invention of opera- tive procedures, which often occurs through the emergence of novel medical technology or new discoveries in the field of medicine. Until recently, the quality of surgery has mainly depended on the surgeon’s skills, built on his own talent and experience. Because of this, the refinement of surgical procedures has been more important than their reform. Surgery has not changed rapidly or dramatically thus far. These days, however, surgi- cal techniques have become increasingly dependent on sophisticated medical instruments equipped with advanced specifications. As a result, sudden prog- ress or emergence of operative procedures often takes place because the improvement of medical instruments has been accelerated by the advance- ment of technology. Robotic surgery is only one example among many. In fact, prior to the emergence of robotic surgery, surgical procedures using specific endoscopes and various types of forceps had been introduced in thoracic and abdominal surgery and their use had rapidly prevailed. Consequently, laparoscopic and thoracoscopic surgery replaced conventional laparotomy and thoracotomy over a short period. However, that was only the beginning of innovations in surgery brought about by the invention of medical instruments. After a while, once novel surgical procedures using surgical robots emerged for patients with prostatic or gynecological disease, these surgical procedures have in turn spread like lightning all over the world. Finally, robotic surgery has replaced laparoscopic surgery, which had been performed until then. Because the emerging procedures have also improved outcomes, surgery assisted by surgical robots has become the de facto standard for prostate cancer. Thus, surgical innovation, i.e., the emergence of new medical instruments, has caused a paradigm shift in surgery. Innovation in surgery is not limited to the surgical skills performed using novel medical instruments, but also extends to the environment surrounding the operation in the operating room (OR). Inventive ideas for surgical treat- ment can change the shape and structure of the OR. For instance, a much cleaner OR environment is needed than before in association with advance- ment of biomedical technology, such as tissue engineering and regenerative medicine. Because tissue and cell handling is generally carried out in a clean cell processing facility called a Cell Processing Center (CPC), the OR should be sited in the vicinity of the CPC for tissue and organ repair or its implanta- tion. In this facility, a wide variety of biomaterials are created including v vi Preface bladders, small arteries, skin, and grafts of cartilage and trachea for regenera- tive medicine performed in the OR. Another example of OR innovation is that currently, thanks to navigation technology, the diagnostic imaging data acquired preoperatively enables sur- geons to safely perform neurosurgery and orthopedic surgery. In the OR con- nected with a cloud database using information and communication technology (ICT), they can use those imaging data more easily with improved accessibility in the OR. More recently, as diagnostic imaging machines such as CT or MRI tend to be sited in the OR, surgeons can obtain information on diagnostic images immediately after their acquisition and use those data for the patient right in front of them. In the near future, they will be able to utilize visual images for the operation even more dynamically, using virtual reality technology. OR innovations can make it possible for surgeons to perform more precise and safer surgery than ever before. The chapters in this book are just a part of the whole story. Nevertheless, the examples presented here illustrate how innovations in surgery and the OR are ongoing and will continue to change surgical procedures and the OR envi- ronment. Those changes will inevitably influence both present and future sur- gery, although it is not easy to predict tomorrow’s surgery accurately. The emerging procedures, such as surgery using virtual reality technology, new surgical instruments and materials, or regenerative medicine, might no longer be considered surgery, but no matter what the novel treatment is called, doc- tors can take part in innovations in surgery themselves if they would like to. We hope that this book will improve understanding of surgical procedures and OR innovation in the emerging field of surgery. Chiyoda-ku, Tokyo, Japan Hiroshi Yasuhara Fukushima, Fukushima, Japan Seiichi Takenoshita Contents Part I Surgical Devices and the Operating Room 1 Lightweight Carbon-Reinforced Resin Surgical Instruments . . 3 Eiji Mekata, Atsushi Yamada, Masaaki Shimagaki, Takahiro Kajiyama, and Tohru Tani 2 Forceps-Type Palpation System for Laparoscopic Surgery . . . . 17 Michitaka Fujiwara, Yoshihiro Tanaka, and Tomohiro Fukuda 3 Ultrahigh Definition (8K UHD) Video System and Video-Assisted Surgery in the Near Future . . . . . . . . . . . . . . . . . 27 Toshiyuki Mori, Hisae Aoki, Toshio Chiba, Hiromasa Yamashita, and Kenkichi Tanioka 4 Monitoring of Surgeon’s Surgical Skills Using Internet of Things-Enabled Medical Instruments . . . . . . . . . . . . 33 Yuki Ushimaru, Yuichiro Doki, and Kiyokazu Nakajima Part II M edical Materials and Regenerative Medicine 5 Regenerative Medicine in the Operating Room at Present and in the Near Future . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Kengo Kanetaka and Susumu Eguchi 6 Surgery and Operating Room for Restoring Organs: Organ Regeneration by Tissue Engineering in the Near Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Mitsuo Miyazawa, Masato Watanabe, Yoshihisa Naito, Yasumitsu Hirano, Keizo Taniguchi, Takehiro Okumura, Kaname Maruno, and Shozo Fujino vii viii Contents Part III A rtificial Intelligence and Virtual Reality 7 Extended Reality (XR:VR/AR/MR), 3D Printing, Holography, A.I., Radiomics, and Online VR Tele-M edicine for Precision Surgery . . . . . . . . . . . . . . . . . . . . . . . 65 Maki Sugimoto 8 Application of AI in Endoscopic Surgical Operations . . . . . . . . . 71 Norihito Wada and Yuko Kitagawa Part IV N avigation Surgery 9 Application of ICG Fluorescent Endoscope Systems in Identifying Small Lung Cancers on the Periphery of the Lungs in Thoracoscopic Surgery . . . . . . . . . . . . . . . . . . . . 81 Yasuhiko Ohshio 10 Novel Multispectral Device for Quantitative Imaging of Tissue Oxygen Saturation and Hemoglobin as Surgical Navigation Device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Yasuhiro Haruta, Ryosuke Tsutsumi, Kuriyama Naotaka, Hajime Nagahara, and Tetsuo Ikeda 11 Clinical Benefit of Mixed Reality Holographic Cholangiography for Image-Guided Laparoscopic Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Michiko Kitagawa, Maki Sugimoto, Akiko Umezawa, and Yoshimochi Kurokawa Part V R obotic Surgery 12 Development of Laparoscopic Surgery by Means of Foldable Small Humanoid Robot Hands with Tactile Sensation for Laparoscopic Surgery . . . . . . . . . . . . . . . . . 115 Masaya Mukai, Ryu Kato, and Hiroshi Yokoi 13 Robotic Surgery: Currently and in the Near Future . . . . . . . . . . 125 Masaaki Ito Part I Surgical Devices and the Operating Room 1 Lightweight Carbon-Reinforced Resin Surgical Instruments Eiji Mekata, Atsushi Yamada, Masaaki Shimagaki, Takahiro Kajiyama, and Tohru Tani 1.1 Introduction obviously reduces the physical load on medical staff when carrying and washing the instruments Surgical instruments such as Adson and DeBakey [9]. It is also crucial for mass transport in criti- tweezers, forceps, needle holders, and Cooper cal situations with significantly degraded hospital and Metzenbaum scissors are widely used in function such as large-scale natural disasters and common or complex surgical procedures [1–7]. infectious diseases [10, 11]. Magnetic resonance These instruments are generally made of stain- imaging (MRI) requires non-ferromagnetic less steel and have high stiffness for durability materials for MRI safety [12, 13], and computed and long-term stability, smooth surface process- tomography (CT) requires reducing metal arti- ing for ergonomic design and easy washing, facts [14]. The stainless steel instruments require and high heat-resistance for repeated autoclave continuous maintenance to maintain their func- sterilization [8]. This metal material enables the tion although there has been an issue of lacking tweezers to be used conveniently as soft coagula- skilled maintenance staff. tion probes for hemostasis by bringing monopo- Recently, titanium or ceramic materials have lar electric cautery into contact with them while been used for them [13, 15, 16] which can par- pinching tissues by the tweezers. tially contribute to these challenges but their Technical challenges for these metal instru- mass production cost precludes their stockpile ments are weight saving and compatibility with for disasters. Polyamide (PA) resin [17, 18] some imaging modalities. The weight saving claimed weight saving and imaging compatibil- ity but unfortunately involved losing their high stiffness, reusability, and the convenience of soft coagulation probing. E. Mekata (*) The goal of this study was to develop nonme- Department of Comprehensive Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan tallic surgical instrument prototypes as potential e-mail: [email protected] solutions that were lightweight and reusable with A. Yamada · T. Tani wide variation and comparable with stainless Department of Research and Development for steel surgical instruments in terms of usability Innovative Medical Devices and Systems, Shiga and performance. We evaluated their mechanical University of Medical Science, Otsu, Shiga, Japan performance compared to conventional surgical M. Shimagaki instruments and their usability was evaluated by Frontier Medtec Co., Ltd., Otsu, Shiga, Japan multiple surgeons in an animal study. T. Kajiyama Nissei Industries Ltd., Ome, Tokyo, Japan © Springer Nature Singapore Pte Ltd. 2021 3 S. Takenoshita, H. Yasuhara (eds.), Surgery and Operating Room Innovation, https://doi.org/10.1007/978-981-15-8979-9_1
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