Surgery Theater Blog

1. The bacteria that you carry with you everywhere, in and on your body make up WHO YOU ARE! 2. Life would be impossible without them. 3. Many diseases such as cancer, immune disorders, mood disorders, diabetes and many more are starting to be linked to the type of Microbiome you have. 4. There are 10X more microbes in your body then human cells.  5. We are just starting to understand the complex role they play in the human disease and wellness.

Everyone knows that running puts a pounding on your knees.  The constant pressure of slamming your foot against a surface can cause many parts of the knee to break down, and one of these places is the patellofemoral junction. The patella is your kneecap and serves to protect the joint against blows from the front. However, it articulates with the lower part of the thighbone, or femur, creating a joint of sorts that can cause pain under pressure. You don’t need to be a runner to experience patellofemoral pain, or runner’s knee.  Any activity that puts stress on the joint, such as skiing, cycling, football, basketball, and other sports can cause this joint to stress.   In fact, the causes of patellofemoral pain can arise from injury, but tight thigh muscles and flat feet are also known causes of this condition.   In addition, if the patella comes out of alignment or dislocates, it can cause stress and pain at this juncture.  You don’t need to be an athlete to experience runner’s knee, especially if your have flat feet or weak muscles in your leg.

What Will I Feel?

Pain is the most common complaint among those who have runner’s knee.  Sometimes the pain only occurs on movement or the activity that caused the problem.  

In many cases, though, the pain can be felt at rest.  Most of the pain will center on the patella, and it will be worse when the patella is moved around in its socket.  You may also experience redness and swelling in your knee, particularly after a round of running or exerting yourself.  

The pain will occur primarily where the kneecap meets the end of the thighbone, and it isn’t likely to cause pain in other parts of the knee.  That isn’t to say that runner’s knee can’t be present with other problems, such as ligament issues, though.

For this reason, it is important to get a full examination by your doctor.  They will ask you to sit, stand, squat, and otherwise manipulate the knee.  You will also be asked if certain activities, such as walking up stairs, cause the pain to become worse, and the doctor will want to know your exercise history to pinpoint the cause.  

The best way to determine what is causing your pain is an MRI.  Magnetic resonance imaging can view the soft tissue of the knee, visualize the patellofemoral junction, and rule out any other cause of knee pain.

What Can I Do?

Fortunately, the treatment for runner’s knee is nonsurgical.  You can prevent this common knee complaint by stretching and warming up before doing strenuous activity. 

In addition, working to increase the strength of the thigh muscles will protect this joint and keep you from injuring it.  However, if you already have pain around your kneecap, you still don’t have to worry about surgery.  The first line of treatment is RICE.  This means rest, ice, compression, and elevation, and the use of over the counter pain medicines. 

Rest and ice are pretty self-explanatory, but compression means using an ACE bandage to force the swelling out of the knee.  Elevation means lifting the knee above the level of the heart to discourage swelling, as well.

In cases where these methods don’t work, you may need to have a course of physical therapy.  You will work on the strength of your leg muscles and learn how to protect your knee during the activity that caused the problem.  In severe cases, you may need surgery.  

Using minimally invasive arthroscopic surgery, ragged pieces of cartilage and other debris can be cleaned out of the space.  You may also qualify for surgical realignment of the patella, but either of these surgeries is rare.  

Most runner’s knee resolves with rest and non-steroidal anti-inflammatory medications.  Only for the most elite athletes or the most severe damage is surgery even considered an option.

Ultra thin patches will be able to keep track of what's happening inside your body. (University of Illinois, Urbana-Champaign)

Forget Wristbands, Health Trackers of the Future Will Be Skin Patches

Thin as a human hair and applied like temporary tattoos, they'll be able to monitor everything from heartbeats to brain activity to muscle tremors As trendy as health-tracking bracelets may be, it might not be long before they seem as dated as dial-up Internet and as subtle as a boom box.

An even more sophisticated type of wearable tech is evolving quickly, one that while barely noticeable, could transform personal health care.  It’s the electronic skin patch, and two studies published this month hint at what may be possible with this rectangle of soft, flexible material filled with tiny components. Able to stick to—and move with—a person’s skin like a temporary tattoo, the latest models show that these patches could provide a wide range of medical treatment—from gathering, storing and transmitting data about what’s going on inside a person’s body 24/7 to detecting when that person needs medication and then dispensing it.

Based on research published in the journal Science, a device developed jointly by engineers at the University of Illinois at Urbana-Champaign and Northwestern University could have a broad application, capable of tracking vitals and muscular activity, but also of monitoring symptoms related to a specific illness.   

For instance, the lead scientists on the project, John Rogers at Illinois and Yonggang Huang at Northwestern, say their patch proved to be just as accurate as conventional equipment in recording EKGs of heartbeats and EEG readings of brain activity—which means that kind of data could be gathered without a person needing to get wired up in a doctor’s office or clinic. That, Huang points out, makes the patch particularly well-suited for situations where a doctor needs to collect data from a patient over a long stretch of time, such as when diagnosing sleep or heart problems, or conditions such as Parkinson’s disease.

The goal, he says, is to use “stretchable electronics” to continuously monitor a person’s health without them noticing it, and then have it send that information wirelessly to a computer or smart phone. This patch is the latest iteration of what Rogers, a leader in the field, has called “epidermal electronics.” He contends that components adhered to skin through a patch can provide a richer, more precise set of data than a wristband subjected to random movements.   

The most ingenious aspect of the device is a design that allows sensors, capacitors and batteries to fit into a patch as thin as a human hair while still maintaining the flexibility to move with the skin. The key is the use of microfluidics—the patch is actually filled with fluid in which the components are suspended—and wires folded like origami so that no matter which way the device bends or stretches, they adapt to the motion. That flexibility has allowed the engineers to use cheaper off-the-shelf parts rather than the customized ones in an earlier version. And that makes this patch more commercially viable, although it’s still probably two years away from being available to doctors.

Body language

The other study, which appears in the April edition of Nature Nanotechnology, focuses on the research of a team in South Korea that has developed a somewhat different kind of electronic patch. It addresses a drawback of devices that provide a continuous flow of medication into a patient’s body. The problem is that these drug-delivery systems have no way of checking a patient’s vitals, so they dispense the same level of medication no matter his or her current condition.

Sensors in the patch created by engineers at Seoul National University can, based on tension and compression of muscles, determine when drugs are needed and when they’re not. For example, when a Parkinson’s patient starts to have tremors, the patch can pick up on the motion and distinguish it from normal arm movements, then deliver the necessary drugs. Same thing when someone with epilepsy has a seizure. The device can also store data that can help doctors spot patterns and see how patients respond to medications. The prototype focuses on treating motion disorders, but the researchers say the patch can be adapted to track things like perspiration, temperature, heart rate or blood oxygen levels and use that data to trigger treatment of other conditions.

The researchers acknowledge that their patch is still years away from coming to market. It still doesn’t have the capability to wirelessly transmit the data it captures and stores to another device. But it does add another dimension to what these devices can do. Now a single, two-inch wearable patch can diagnose a condition and treat it.

What they’re wearing

Here’s other recent news on health-tracking devices:

Gut instincts: Researchers at Mount Sinai Hospital in New York are studying whether a patch could be used to treat Crohn’s disease. It’s still not clear what causes the inflammatory bowel disease, but scientists want to see if they can retrain the immune system to work properly by delivering T cells to the gut.

An Apple a day: According to the website 9to5Mac, which tracks what’s going on behind the scenes at Apple, the company is going to plunge into the health-tracking business this fall with the launch of an app called Healthbook. The app will reportedly be able to track all kinds of personal data, including physical activity, heart rate, blood oxygen level, blood pressure, hydration levels, blood sugar and sleep patterns.

Stem Cell in 30 minutes

France implants its first artificial heart!

An artificial heart that can give patients up to five years of extra life has been successfully implanted for the first time.

The heart, powered by watch-style batteries that can be worn externally, was put into a patient at Paris’s Georges Pompidou Hospital.

It uses a range of “biomaterials”, including bovine tissue, to reduce the likelihood of the body rejecting it.

Unlike previous artificial hearts, created mainly for temporary use, the design by the French Carmat biomedical firm is intended to replace a real heart for as many as five years.

Researchers at the Rehabilitation Institute of Chicago RIC, developed the first mind controlled bionic leg. Patient Zac Vawter was the first to test the bionic leg. He states the "bionic leg allows me to seamlessly walk up and down stairs and even reposition the prosthetic by thinking about the movement I want to perform". The team states the device should be available for general public in about 5 years. 

This technology opens up a whole level of hope & possibilities for millions of people around the world. Can you imagine the possibilities this brings. Cheers to the team for an incredible job done. Everyone get ready for Robo Olympics 2020... Read more. 

System Lets Surgeons Image the Brain While they Operate On It

A real-time MRI system can help surgeons perform faster and safer brain operations.

A new system for visualizing the brain during surgery is helping neurosurgeons more accurately diagnose and treat patients and is even allowing them to perform some procedures that until now have been extremely difficult or even impossible.

Neurosurgeons can use the imaging technology during surgeries that require small objects—biopsy needles, implants, or tubes to deliver drugs—to be placed at precise locations in the brain. The system provides live magnetic resonance images (MRI) that allow surgeons to monitor their progress during the operation.  

Typically, neurosurgeons use an MRI before a surgery to plan the trajectory of the operation, based on the brain’s position relative to a guidance frame that’s screwed onto the patient’s skull, says Robert Gross, a neurosurgeon at Emory University. But the brain can shift before the actual surgery takes place, he says, rendering that MRI inaccurate. To check on what’s happening inside a patient’s skull, doctors have to stop the surgery and perhaps even move the patient out of the operating room.

To address these issues, researchers have been developing new neurosurgical guidance systems that can work with the strong magnets and electronic signals used by MRI scanners. The medical-device company Medtronic, for example, offers a real-time MRI imaging system for neurosurgery. But Gross says the most useful system on the market is offered by MRI Interventions, a medical device company based in Memphis, Tennessee.

The MRI Interventions system works with conventional MRI scanners. A platform for guiding surgical tools or implants into the brain is affixed to the skull and provides a grid-based system for determining the trajectory. A material in the platform makes the device visible to the MRI scanner. Software from MRI Interventions shows surgeons where their tools are relative to the patient’s brain. That data is displayed on an MRI-compatible monitor to allow surgeons a view of what is happening inside the patient’s skull without interfering with the imaging procedure, which is a problem associated with most electronic equipment. “If the brain has shifted, you will be able to see that inaccuracy in the trajectory,” says Gross, who uses the system along with medical lasers to destroy small regions of brain tissue that cause seizures in epilepsy patients.

MRI Interventions has installed 25 of its real-time MRI guidance systems: two in Europe and 23 in the United States. Often, neurosurgeons rely on patients to be awake during brain operations so the patients can provide behavioral clues as to whether the surgeon is inserting a tool or treatment device into the intended location. For some procedures, the new technology means that keeping patients awake during the operation is no longer necessary.

A new technology is helping brain surgery students improve their skills before they practice on patients.

Dr. Christopher Kaeding, an orthopedic surgeon at The Ohio State University Wexner Medical Center, makes adjustments to Google Glass before performing surgery on Aug. 21, 2013. Credit: Ohio State University Wexner Medical Center

A surgeon at The Ohio State University Wexner Medical Center is the first in the United States to consult with a distant colleague using live, point-of-view video from the operating room via Google Glass, a head-mounted computer and camera device.

"It's a privilege to be a part of this project as we explore how this exciting new technology might be incorporated into the everyday care of our patients," said Dr. Christopher Kaeding, the physician who performed the surgery and director of sports medicine at Ohio State. "To be honest, once we got into the surgery, I often forgot the device was there. It just seemed very intuitive and fit seamlessly."

Google Glass has a frame similar to traditional glasses, but instead of lenses, there is a small glass block that sits above the right eye. On that glass is a computer screen that, with a simple voice command, allows users to pull up information as they would on any other computer. Attached to the front of the device is a camera that offers a point-of-view image and the ability to take both photos and videos while the device is worn.

During this procedure at the medical center's University East facility, Kaeding wore the device as he performed ACL surgery on Paula Kobalka, 47, from Westerville, Ohio, who hurt her knee playing softball. As he performed her operation at a facility on the east side of Columbus, Google Glass showed his vantage point via the internet to audiences miles away.

Ohio State University College of Medicine students watch an ACL surgery transmitted live. Dr. Christopher Kaeding from the Ohio State University Wexner Medical Center performed this innovative surgery while wearing Google Glass. Credit: Ohio State University Wexner Medical Center

Across town, one of Kaeding's Ohio State colleagues, Dr. Robert Magnussen, watched the surgery his office, while on the main campus, several students at The Ohio State University College of Medicine watched on their laptops.

"To have the opportunity to be a medical student and share in this technology is really exciting," said Ryan Blackwell, a second-year medical student who watched the surgery remotely. "This could have huge implications, not only from the medical education perspective, but because a doctor can use this technology remotely, it could spread patient care all over the world in places that we don't have it already."

"As an academic medical center, we're very excited about the opportunities this device could provide for education," said Dr. Clay Marsh, chief innovation officer at The Ohio State University Wexner Medical Center. "But beyond, that, it could be a game-changer for the doctor during the surgery itself."

Experts have theorized that during surgery doctors could use voice commands to instantly call up x-ray or MRI images of their patient, pathology reports or reference materials. They could collaborate live and face-to-face with colleagues via the internet, anywhere in the world.

"It puts you right there, real time," said Marsh, who is also the executive director of the Center for Personalized Health Care at Ohio State. "Not only might you be able to call up any kind of information you need or to get the help you need, but it's the ability to do it immediately that's so exciting," he said. "Now, we just have to start using it. Like many technologies, it needs to be evaluated in different situations to find out where the greatest value is and how it can impact the lives of our patients in a positive way."

Only 1,000 people in the United States have been chosen to test Google Glass as part of Google's Explorer Program. Dr. Ismail Nabeel, an assistant professor of general internal medicine at Ohio State applied and was chosen. He then partnered with Kaeding to perform this groundbreaking surgery and to help test technology that could change the way we see medicine in the future.

First Liver Surgery with iPad in Germany

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Surgeons at Duke University Hospital Implant first US Bioengineered Vein