The “Incisions and insights – medtech engineers and medical practitioners in dialogue” workshop series continued in June 2018, focusing on the heart, lungs and thorax. BioRegio STERN Management GmbH is organising this exceptional series of events in collaboration with the Inter-University Center for Medical Technologies Stuttgart-Tübingen (IZST) and the Verein zur Förderung der Biotechnologie und Medizintechnik e. V. (Society for the Promotion of Biotechnology and Medical Technology). This fourth event once again saw medical directors and senior consultants meet with medtech engineers directly at operating tables in Anatomy to discuss the innovations they desire and need.

The specialists from University Hospital Tübingen have already dubbed the series of events “Make a wish”, as it gives them the opportunity to express their wishes to medtech engineers for new or improved instruments and equipment unfiltered by purchasing or marketing departments. The fourth workshop in the series focused on the heart, lungs and thorax. Alongside the live streaming of surgery and practical exercises in the operating theatre at the Institute of Clinical Anatomy and Cell Analysis, the medical directors and senior consultants from University Hospital Tübingen Dr. Helene Häberle, Senior Consultant Surgeon at the Intensive Care Unit, Prof. Alfred Königsrainer, Medical Director of General, Visceral and Transplant Surgery, Prof. Christian Schlensak, Medical Director of Thoracic and Cardiovascular Surgery, and Prof. Roland Syha, Head of Interventional Radiology, discussed potential innovations. During this session, Prof. Peter P. Pott, Head of the Institute of Medical Device Technology at the University of Stuttgart, explained what is technically feasible. Prof. Arnulf Stenzl, Medical Director of the University Department of Urology and Head of the Inter-University Center for Medical Technologies Stuttgart-Tübingen (IZST), co-chaired the workshop together with the host Prof. Bernhard Hirt, Director of the Institute of Clinical Anatomy and Cell Analysis. Around 40 medtech company representatives attended the event, which offered them an impressive range of incisions and insights.

A surgeon got straight to work on artificial heart implantation and minimally invasive lung and oesophagus surgery on an anatomical specimen.
While feeding a tube into the trachea, he explained to the medtech engineers – and to medical students linked via live stream – why a second working channel would be useful: “A further piece of equipment, such as forceps, often needs to be inserted. This may also result in bleeding, which blocks the one channel.” During the subsequent demonstration of a minimally invasive lobectomy – the removal of an organ lobe – the operating team explained the need for a second camera in order to monitor inside the thorax from an additional angle. A stapler that can attach staples and bend 90 degrees was also added to the wish list, as was a cleaning function for the camera lens. However, the surgeons′ discussion with Prof. Pott quickly revealed that much of what is technically feasible is not at all practicable in everyday surgery. “Extra functions require cables and switches. Yet at the same time, the equipment is expected to become increasingly smaller and easier to handle.” Physical limitations also curb miniaturisation: “A camera lens can only be reduced in size to a certain extent, otherwise it no longer transmits anything,” explained Prof. Pott.

The subsequent artificial heart transplant once again showed that the surgeons attach great importance to small and agile instruments to open up the chest as little as possible, as this is often associated with major discomfort for patients. To implant the 200-gramme artificial heart, just two incisions are needed. Unfortunately, one of these remains permanently open, as the control and battery power cables need to be fed outside. “Of course there’s already the option of a cable-free power supply for hearing aids, for example,” said Prof. Pott. “If this fails, the patient no longer hears anything. But if this fails in the case of the heart, the patient expires.”

The demand for innovation is therefore high, giving developers and users plenty to discuss, and this is unlikely to be exhausted at the next event in February 2019, which will focus on “Extremities and the musculoskeletal system”. “As far as we know, there’s no comparable event anywhere else in the world,” explained Dr. Klaus Eichenberg, co-organiser and Managing Director of BioRegio STERN Management GmbH. “Surgeons are calling for new processes and instruments. I’m confident the local medtech businesses will take up this challenge and bring to life some of the ideas that were first formulated here.”