Author: fidelmac

Strategic acquisition of Dutch multispectral imaging leader drives growth of Olympus’ Surgical Endoscopy business

TOKYO/HAMBURG- Olympus Corporation recently announced that it has entered into an agreement to acquire Quest Photonic Devices B.V. for up to EUR50 million including milestone payments to strengthen its surgical endoscopy capabilities.

Quest’s lead product line is the Quest Spectrum Fluorescence Imaging System, which enables fluorescence-guided surgery for open and minimally invasive procedures. Kanichi Matsumoto, global head of Surgical Endoscopy at Olympus, said: “We are delighted to incorporate Quest’s advanced FIS capabilities into our comprehensive medical imaging portfolio. The combination of the Quest Spectrum product line’s leading FIS technologies with Olympus’ existing laparoscopic imaging system VISERA ELITE II will enable Olympus to offer surgeons a wide range of high quality fluorescence imaging solutions.”

https://www.olympus-global.com/news/2021/nr02031.html

“It is imperative to understand that the term “elective “surgery does not mean optional surgery, and rather implies that a procedure is not immediately indicated in response to a limb- or life-threatening emergency. A current estimate suggests that more than 50% of all elective surgical cases have a potential to inflict significant harm on patients if cancelled or delayed.”

The authors suggest a pragmatic guide based on underlying risk stratification and resource utilization will help support  access to timely and appropriate surgical care to  patients, while maintaining an unwavering stewardship for scarce resources and emergency preparedness. The authors have developed a tentative decision-making algorithm based on elective surgical indications and predicted perioperative utilization of critical resources.

https://www.researchgate.net/publication/340322330_How_to_risk-stratify_elective_surgery_during_the_COVID-19_pandemic

The purpose of this study was to describe the most important steps in the performance of Near-infrared fluorescent cholangiography (NIFC).

The ten steps identified as critical when performing NIFC during LC are

1. Preoperative administration of ICG,
2. Exposure of the hepatoduodenal ligament,
3. Initial anatomical evaluation,
4. Identification of the cystic duct and common bile duct junction,
5. Identification of the cystic duct and its junction to the gallbladder,
6. Identification of the Common Hepatic Duct,
7. Identification of the common bile duct,
8. Identification of cystic artery and optional performance of arteriography 
9. Time‑out before transection and re‑identification of Calot’s triangle structures
10. Evaluation of liver bed and identification of accessory ducts

Conclusions: Routine use of NIFC is a useful diagnostic tool to better visualize the extrahepatic biliary structures during LC. The implementation of specific standardized steps might provide the surgeon with a better algorithm to use this technology and consequently reduce the incidence of BDI.

https://pubmed.ncbi.nlm.nih.gov/33475844/

Acknowledging that COVID-19 may be here to stay, this paper has laid out a series of steps to prepare patients for elective surgery following their COVID illness. The evaluation, outlined in a The Journal Perioperative Medicine, is believed to be the first published protocol laying out a COVID-era path forward in American medicine. “We think this is groundbreaking,” said senior author Avital O’Glasser, M.D., associate professor of medicine (hospital medicine) in the OHSU School of Medicine. “We are hoping other clinics and surgical centers can use this to keep their patients safe.” Researchers combed through data published worldwide about health outcomes of patients who underwent surgery following illness.

Among the key recommendations:

• Minimum recovery time: The protocol calls for waiting a minimum of four weeks from the initial COVID-positive test for patients who had an asymptomatic infection and six to eight weeks for those who were more severely ill, “acknowledging that there is currently little data on the timeframe of recovery.”
• Evaluation: Patient history and physical assessment to determine any potential complications of surgery and to determine whether a patient has returned to their “pre-COVID” baseline health.
• Objective testing: The protocol includes guidance for specific tests such as blood work based a patient’s age, severity of symptoms, whether it’s a major or minor procedure, and whether it includes putting a patient under general anesthesia.

The protocol does not account for patients who have not recovered from the illness, known as COVID long-haulers. Co-first authors on the study are Naomi Bui, M.D., an OHSU resident in anesthesiology, and Mareli Coetzer, D.O., an OHSU resident in internal medicine.

https://perioperativemedicinejournal.biomedcentral.com/articles/10.1186/s13741-020-00172-2

KARL STORZ Endoscopy-America, Inc., announced the launch of their  latest advancement in endoscopic imaging. The IMAGE1 S™ Rubina™ multimode visualization system combines state-of-the-art 4K resolution with enhanced fluorescence-guided imaging using near-infrared light and indocyanine green dye (NIR/ICG). The system uses unique and proprietary dual-4K sensors and dual-LED light technology to toggle seamlessly between white-light and fluorescence modes, without the lag or mismatched frames that are common with alternative technologies.

https://www.businesswire.com/news/home/20210105005791/en/KARL-STORZ-Announces-Breakthrough-Imaging-Technology

Summary.  

The pandemic has wreaked havoc with health care systems’ surgical staffs. Some clinicians are fatigued and stressed, and many are out of practice. They are having to contend with large backlogs of procedures that were postponed. And they have to contend with the ongoing pandemic, with all its uncertainties. To keep surgical staffs and patients safe during these difficult times, health systems should take four steps: make risk visible; ensure that staffs are abiding by existing procedures and protocols and adopting new ones when the need arises; double down on efforts to address psychological safety and the added stress; and be transparent and account for the current environment.
https://hbr.org/2020/11/how-to-safely-restart-elective-surgeries-after-a-covid-spike

Hospital leaders across the country have been rushing to implement ramp up strategies to reopen elective surgeries. While there are many good reasons to ramp back up quickly (health concerns and revenue shock), it is important that speed does not overtake strategy. Restarting elective surgery haphazardly may result in unintended consequences and create bottlenecks that impede overall hospital operations. Researchers suggest five strategies that healthcare leaders can employ today to meet their clinical objectives, while aiming for better operational efficiency and equity in access to care: Develop consistent, transparent, and bias-aware algorithms for surgical prioritization; expand surgical capacity by transitioning to outpatient care; form dedicated teams to improve operating room efficiency; think beyond the traditional five-day work week; focus on simplifying patients’ surgical care experience.  

https://hbr.org/2020/08/covid-19-created-an-elective-surgery-backlog-how-can-hospitals-get-back-on-track?autocomplete=true