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The Da Vinci XI is a specialist robot
The Robot operated by surgeons which has the ability to make extremely small incisions. The advance means patients previously requiring invasive surgery with long recovery times can now undergo more delicate treatments.
Surgeons at The Royal Marsden, the hospital where the Da Vinci XI has been trialed, say the machine pushes the boundaries of modern surgery and will vastly enhance cancer treatment.
Dr Pardeep Kumar, consultant urological surgeon at the hospital, explained the robot's main function.
"[The surgical robot] acts as an extension of the surgeon's hands and allows us to carry out complex surgeries through tiny incisions. It miniaturizes the movements of the surgeon who control it."
"Our patient today has cancer of the colon and they've had several surgeries in the past. That means usually we would tackle this operation with a large open incision that extends from the ribs right down to the belly button."
He praised the "control and accuracy" of the machine. The technology means patients can "wake up from surgery with little or no pain and recover incredibly quickly."
Patient cured of Ebola in Germany treated with biofiltration device
A Ugandan man hospitalized in Germany for the Ebola virus was treated with a biofiltration device that the creators believe will change the landscape in the fight against viral pathogens.
The Aethlon Medical team has created a device called the Hemopurifier, which works on the established infrastructure of dialysis machines already located in hospitals and clinics.
Cancer Gene Therapy and Cell Therapy
Cancer is an abnormal, uncontrolled growth of cells due to gene mutations and can arise in most cells. No single mutation is found in all cancers. In healthy adults, the immune system may recognize and kill the cancer cells; unfortunately, cancer cells can sometimes evade the immune system resulting in expansion and spread of these cancer cells leading to serious life threatening disease. Approaches to cancer gene therapy include three main strategies: the insertion of a normal gene into cancer cells to replace a mutated gene, genetic modification to silence a mutated gene, and genetic approaches to directly kill the cancer cells.
Furthermore, approaches to cellular cancer therapy currently largely involve the infusion of immune cells designed to either (i) replace most of the patient's own immune system to enhance the immune response to cancer cells, (ii) activate the patient's own immune system (T cells or Natural Killer cells) to kill cancer cells, or (iii) to directly find and kill the cancer cells. Currently multiple promising clinical trials using these gene and cell based approaches are ongoing in patients with a variety of different types of cancer. The strategies, associated challenges, and clinical trial progress are summarized here.
Feb.10, 2014
A British surgeon has used 3D scanning and 3D printing techniques to create a new pelvis for a patient who had lost the whole right side of his pelvis to cancer.
The patient in his sixties had been diagnosed with a rare bone tumour called chondrosarcoma. "Since this cancer does not respond to drugs or radiotherapy, the only option was to remove half of the pelvis," said Craig Gerrand to Telegraph, a consultant orthopaedic surgeon at Newcastle Upon Tyne Hospitals NHS Trust.
Surgeon Craig Gerrand with a model of a half-pelvis | Image: Telegraph
With traditional methods the patient's pelvis would be replaced by hand-made implants that do not fit perfectly, so Gerrand offered the patient innovative reconstruction using 3D printing. Gerrand and his team scanned the patient's pelvis allowing them to measure exactly how much bone would be removed. Then the 3D scans were processed and sent to British company Stanmore Implants in Elstree. Specialists at Stanmore Implants used 3D printing to make a bespoke model of a half-pelvis in titanium powder.
The titanium pelvis was coated with a mineral into which the remaining bone could grow. The implant was then robotically inserted into the patient. The surgeon can cut the bone exactly using surgical navigation technology, in which images of the pelvis are uploaded on to a computer to create a model on the screen. Afterwards a standard hip replacement was fitted into the new titanium socket.
Such implants can be made to last longer and have surfaces that mesh better with bone than those manufactured by other methods. The patient is now able to walk with the aid of a stick.
3D printing technology has two beneficial features: 1. It can print specific structures; 2. It is capable of producing porous metal that allows bone to grow into the metal pores, and enhance the strength of the implant.
In August 2013, a Chinese team, led by Dr. Liu Zhongjun at Peking University Third Hospital in Beijing, used a porous 3D printed titanium implant to fit to anatomical structure of a vertebra for a spinal fracture patient.
"In the past we used clinical titanium mesh, but with the growth of bone, titanium mesh could easily get stuck into the bone and cause collapse. 3D printed implants fit the bone completely. And as a result, not only the pressure on the bone is reduced, but it also allows the bone to grow into the implants."
"In this aspect, 3-D printed implants are more reliable than traditional ones,"
Womb transplants into 9 Swedish women successful first major experiment to test whether women with transplanted wombs can give birth
Nine women in Sweden have successfully received transplanted wombs donated from relatives and will soon try to become pregnant, the doctor in charge of the pioneering project has revealed.
The women were born without a uterus or had it removed because of cervical cancer. Most are in their 30s and are part of the first major experiment to test whether it's possible to transplant wombs into women so they can give birth to their own children.
Life-saving transplants of organs such as hearts, livers and kidneys have been done for decades and doctors are increasingly transplanting hands, faces and other body parts to improve patients' quality of life. Womb transplants — the first ones intended to be temporary, just to allow childbearing — push that frontier even farther and raise some new concerns.
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There have been two previous attempts to transplant a womb — in Turkey and Saudi Arabia — but both failed to produce babies. Scientists in Britain, Hungary, the U.S. and elsewhere are also planning similar operations but the efforts in Sweden are the most advanced.
"This is a new kind of surgery," Dr. Mats Brannstrom told The Associated Press in an interview from Goteborg. "We have no textbook to look at."
Brannstrom, chair of the obstetrics and gynecology department at the University of Gothenburg, is leading the initiative. Next month, he and colleagues will run the first-ever workshop on how to perform womb transplants and they plan to publish a scientific report on their efforts soon.
He said the nine womb recipients were doing well. Many already had their periods six weeks after the transplants, an early sign that the wombs are healthy and functioning. One woman had an infection in her newly received uterus and others had some minor rejection episodes, but none of the recipients or donors needed intensive care after the surgery, Brannstrom said. All left the hospital within days.
None of the women who donated or received wombs have been identified. The transplants began in September 2012 and the donors include mothers and other female relatives of the recipients. The team had initially planned to do 10 transplants, but one woman couldn't proceed due to medical reasons, university spokesman Krister Svahn said.
The transplant operations did not connect the women's uteruses to their Fallopian tubes, so they are unable to get pregnant naturally. But all who received a womb have their own ovaries and can make eggs. Before the operation, they had some removed to create embryos through in vitro fertilization. The embryos were then frozen and doctors plan to transfer them into the new wombs, allowing the women to carry their own biological children.
1 in 4,500 born without womb
The transplants have ignited hope among women unable to have children because they lost a uterus to cancer or were born without one. About one in 4,500 girls are born with a syndrome, known as MRKH, where they don't have a womb.
Fertility experts have hailed the project as significant but stress it's unknown whether the transplants will result in healthy babies.
The technique used in Sweden, using live donors, is somewhat controversial. In Britain, doctors are also planning to perform uterus transplants, but will only use wombs from dying or dead people. That was also the case in Turkey. Last year, Turkish doctors announced their patient got pregnant but the pregnancy failed after two months.
"Mats has done something amazing and we understand completely why he has taken this route, but we are wary of that approach," said Dr. Richard Smith, head of the U.K. charity Womb Transplant UK, which is trying to raise $823,000 US to carry out five operations in Britain.
He said a womb transplant was like a radical hysterectomy but it requires taking a bigger chunk of the surrounding blood vessels to ensure adequate blood flow, raising the risk of complications for the donor. Smith said British officials don't consider it ethical to let donors take such chances for an operation that isn't considered life-saving.
Smith said the biggest question is how any pregnancies will proceed.
"The principal concern for me is if the baby will get enough nourishment from the placenta and if the blood flow is good enough," he said.
Anti-rejection medicine
All of the women who received womb transplants will need to take anti-rejection medicines, but Smith said data from women who have received kidney transplants doesn't suggest their babies are at any increased risk from the drugs.
Brannstrom said using live donors allowed them to ensure the donated wombs were functional and didn't have any problems like an HPV infection.
Doctors in Saudi Arabia performed the first womb transplant in 2000, using a live donor, but that uterus had to be removed after three months because of a blood clot.
Brannstrom said he and his colleagues hope to start transferring embryos into some of their patients soon, possibly within months. The Swedish researchers and others have previously reported successful uterus transplants in animals including mice, sheep and baboons, but no offspring from the primates were produced.
After a maximum of two pregnancies, the wombs will be removed so the women can stop taking the anti-rejection drugs, which can cause high blood pressure, swelling and diabetes and may also raise the risk of some types of cancer.
© The Associated Press, 2014
Trials to begin on new degradable surgical implant
By Adam Brimelow Health Correspondent, BBC News
Researchers in Oxford have developed a degradable implant which they say has huge potential to improve surgical success rates.
The protective patch, which wraps round soft tissue repairs, will be trialled in patients with shoulder injuries.
It is hoped in time this approach could help patients with other conditions including arthritis, hernias and heart defects.
The implant has been developed using a mix of modern and ancient technology.
Kevin Senior experiences pain every time he lifts his right arm. He has torn the tendons in his shoulder. Mr Senior, who is 59, is a plumbing engineer, so this gives him serious difficulties in his work.
Bowel cancer incidence statistics
Incidence statistics for bowel cancer by country in the UK, age and trends over time are presented here. There are also data on lifetime risk, the distribution of cases, by geography, socio-economic variation, and prevalence. The ICD codes for bowel cancer (sometimes called colorectal cancer) are ICD-10 C18-C20 (which includes cancers of the colon, rectum and rectosigmoid junction).
The latest incidence statistics available for bowel cancer in the UK are 2010. Find out why these are the latest statistics available.
http://feeds.bbci.co.uk/news/health/rss.xml?edition=uk
Copyright © 2013 UK Surgeon Guide
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