Huntermovers544

1. Micromate For Microload
2. Micrometer Symbol
3. Micromasters

In the first publication of this Value-Based Robotics series, we have analyzed several factors that constitute barriers to establishing Value-Based Robotics as a reality. One of them was that there is insufficient evidence on clinical benefits to justify an investment on robotics.

Interventional Systems tackles this challenge by offering a miniature robot with all the key features that make it the perfect smart assistant for image-guided surgeries, Micromate™, while at the same time decreasing the need for high initial and running costs (but that is for another blog post).

These are key points in our goal to make medical robotics the standard of care instead of the exception. Something that seems impossible, until it is not.

Micro:Mate is a tiny micro:bit I/O expansion board for learning electronics and building DIY projects. Micro:Mate expands 6 sets of 3-pin I/O interfaces, capable of connecting DFRobot Gravity series modules, servo motors, sensors and jumper wires.Additionally, Pin 8, 12, 16 support voltage switch between 3V-5V, allowing up to 5V 2A digital (PWM) output. Microwave ovens are a time-saving addition to the modern kitchen. From handy countertop microwaves to convenient over-the-range models, there’s a style for every space.For even better cooking results, opt for a convection microwave oven that combines fast cooking power with the browning and crisping ability of a traditional convection oven.

Better clinical outcomes

We are in the cusp of the minimally invasive surgery era, where higher accuracies and faster recovery times allow for less time spent in inpatient care. High accuracy is crucial in image-guided surgery. Inaccuracies, low diagnostic yield and incorrect initial treatments make for repeated interventions, increasing costs and pose logistic and personal burdens for the clinic and the patient, while subjecting all parties involved to further unnecessary radiation.

When compared to the state-of-the-art:

• • More accurate: published studies demonstrate that Micromate™ is 50% more accurate than state-of-the-art techniques^1,2,3 (patient-mounted or freehand needle guidance solutions) for percutaneous image-guided procedures, often achieving average accuracies within 1mm along the trajectory and the planned target position. This gives physicians increased confidence that their surgical plan will be successfully executed, especially for procedures that require the placement of multiple (and often perfectly parallel) needles.
  • Lower complication rates: an average of around 4% of complication rates on stereotactic surgeries using Micromate™ have been described^4,5,6, corresponding to a reduction of complication rates of up to 43%, comparing with the state-of-the-art⁷.
  • As minimal as minimally invasive can be: Micromate™ provides a universal needle-guide set for percutaneous procedures and, fueled by its high accuracy, smaller incisions for stereotactic procedures can be achieved⁴.
  • Lower radiation exposure: a physician’s exposure to radiation can be reduced by virtually up to 100%, as Micromate™ can be remotely controlled from outside the intervention room under live imaging. As for the patient, a radiation decrease of up to 84% has been documented, mostly due to the faster alignment speed, when compared to free-hand alignment techniques^2,8.

A truly enabling technology

Clinical evidence shows Micromate’s irrefutable advantages in terms of accuracy, invasiveness and radiation exposure.

But patient-centric care also requires physicians to resort to three other dimensions of their skillset: technical skills (to align instruments to the surgical plan and maintain that alignment), and intellectual and clinical skills (to treat the patient and make intra-operative decisions that may impact the therapy).

We have designed Micromate™ to take over the technical skills, by performing highly accurate movements and maintaining a working channel for instrument insertion and guidance.

Due to its small form, Micromate™ fits inside the gantry or between a patient and the C-arm detector, which allows the alignment to be executed under live imaging. Potential deviations are corrected live and immediately.

This frees physicians to focus on do what they do best: treat the patient. This means not only defining the surgical plan, evaluating its condition and looking out for complications, but especially manually delivering the instrument.

Despite autonomous instrument insertion being a very recent trend for percutaneous procedures, physicians still rely on the haptic feedback while delivering instruments. It is even possible to differentiate between different tissues during instrument insertion, based on the tissue’s resistance – for example, this is used to detect when a biopsy needle enters a tumor.

Micromate™’s disposable needle guides have been designed to hold instruments with a user-adjustable gripping force, allowing to find an optimal compromise between play-free guidance while keeping the much-needed haptic feeling.

Finally, the instrument can be inserted under live imaging as well, which brings additional, real-time information to help physicians deliver the instruments to the desired target location.

Micromate™ is not meant to replace the physician, it’s meant to enable their skills while providing assistance (as a stable third hand) on the most difficult step of the workflow, without requiring significant adaptations.

Sources:

[1] Dorfer, C., Minchev, G., Czech, T., Stefanits, H., Feucht, M., Pataraia, E., … & Wolfsberger, S. (2017). A novel miniature robotic device for frameless implantation of depth electrodes in refractory epilepsy. Journal of neurosurgery, 126(5), 1622-1628.

[2] Workflow for CT-guided robot assisted needle placement, Gernot Kronreif, Martin Kornfeld, Martin Fürst, Wolfgang Ptacek, Michael Vogele [@Hamlyn Symposium]

[3] Czerny, C., Eichler, K., Croissant, Y., Schulz, B., Kronreif, G., Schmidt, R., … & Zangos, S. (2015). Combining C-arm CT with a new remote operated positioning and guidance system for guidance of minimally invasive spine interventions. Journal of NeuroInterventional Surgery, 7(4), 303-308.

[4] Minchev, G., Kronreif, G., Ptacek, W., Dorfer, C., Micko, A., Maschke, S., … & Wolfsberger, S. (2019). A novel robot-guided minimally invasive technique for brain tumor biopsies. Journal of Neurosurgery, 132(1), 150-158.

[5] Legnani, F. G., Franzini, A., Mattei, L., Saladino, A., Casali, C., Prada, F., … & Wolfsberger, S. (2019). Image-Guided Biopsy of Intracranial Lesions with a Small Robotic Device (iSYS1): A Prospective, Exploratory Pilot Study. Operative Neurosurgery, 17(4), 403-412.

[6] Minchev, G., Kronreif, G., Martínez-Moreno, M., Dorfer, C., Micko, A., Mert, A., … & Wolfsberger, S. (2017). A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot. Journal of neurosurgery, 126(3), 985-996.

[7] Formenko A, Serletis D. Robotic stereotaxy in cranial neurosurgery: a qualitative systematic review. Neurosurgery. 2018;83(4):642-650.

[8] Kroes, M. W., Busser, W. M., Fütterer, J. J., Arntz, M. J., Janssen, C. M., Hoogeveen, Y. L., … & Kool, L. J. S. (2013). Assessment of needle guidance devices for their potential to reduce fluoroscopy time and operator hand dose during C-Arm Cone-Beam computed tomography–guided needle interventions. Journal of Vascular and Interventional Radiology, 24(6), 901-906.

Vibration Monitoring

Micromate| Vibration and Air Overpressure Monitor

With Micromate®, Instantel® has redefined industry standards for functionality and ease of use. Micromate provides reliable regulatory compliance monitoring with an ISEE or DIN Triaxial Geophone and ISEE Linear Microphone. Small enough to fit in your hand, Micromate is the first monitor in the industry to provide a touch screen interface. Support of USB 2.0 allows use of memory sticks and approved external devices such as USB hubs, modems, printers and GPS (sold separately). The Micromate is designed for ruggedness and reliability, the cornerstone attributes of Instantel products.

Please contact for further information on Instantel Sales and Rentals.

Specifications

Micromate For Microload

Micrometer Symbol

Micromasters

Please Note: GEOKON maintains an ongoing policy of design review and reserves the right to amend products and specifications without notice. Various instruments are discontinued over time and replaced with new, updated models.