The Next Revolution in Medical Devices: Self-Design and Prototyping

Posted on September 27, 2010 by Steven F. Palter, MD

have just returned from the Maker Faire and have seen the future of medical device innovation, invention, and design– Self-design and rapid home prototyping. For those unfamiliar with the jargon basically technology now exists that can allow the creation of a working prototype of a device from idea to an actual working hand-held version in a physician-inventor’s own home. This has the potential to democratize the process and eliminate previous massive cost and technological barriers that kept the process inaccessible except to large industry or those with substantial capital resources.

One person I spoke with was calling this the Next Industrial Revolution. To me this is clearly the inevitable technological evolution of design and device innovation following in the exact path blazed by desktop publishing, digital video and computer based editing for movie creation to name just two examples. –And once again it is fueled by the exponential progress in computer power –here married to a fanatical base of innovators driving the creation of the raw tools that will be the assembly line of the future.

What is Maker Faire? Maker Fair just had its first NY exhibit and is an offshoot of Make magazine. MAKE brings the do-it-yourself mindset to all the technology in your life. Think of it as technology-hackers. Its like wood-shop for the 21st century hacker who is building his own radio controlled spy drone or augmented reality device instead of oven mitts and hotplate coasters. AS they write “this is a magazine that celebrates your right to tweak, hack, and bend any technology to your own will. For example, in our first volume, we show you how to get involved in Kite Aerial Photography, how to make a cheap but effective video camera stabilizer, and how to build a device that reads the hidden information stored on the magnetic stripes on all your credit cards.”

Homelab laser engraver/cutter. can carve any substance with laser power and precision. cuts out 3D models too.

But that’s just the beginning. The sophistication of the home creation kits is mind-blowing.

This is a beagleboard. It contains all the power of an entire computer. It was running what looked like a normal desktop with a video capture and object recognition on a version of linux. It costs less than $500 and can be the basis for home-made computer intelligent devices. All open source as well.

At the Faire take thousands of people with this mindset, demos, kits, and lessons to “celebrate arts, crafts, engineering, science projects and the Do-It-Yourself (DIY) mindset.” And as usual for my tech crossovers— add one doctor to the group.

What’s The Medical Significance? As usual I search out emerging technologies not yet used in medicine that have the potential to right now change how we do things. What’s struck me with all I saw was the common theme that anything that was a high tech machine now today can be imagined, designed, researched, 3D modeled, and turned into working prototype all in a home workshop on an inventor’s budget. What’s more this now applies to the physical aspects (ie plastic casing and movable parts) and to the electronics being them embedded operating systems or any myriad of sensors. The theme of the day was that you yourself can see these projects through to this stage and there is a thriving community and ground-swell of momentum to build a grass roots infrastructure to help.

Examples of 3D Prototyping/Desktop Manufacturing:

The left image is a makerbot — you build this machine and then it produces 3d models out of plastic from 3D images on you computer. You can anything from an action figure to a device handle to well– the middle images was made on a higher end system like that shown on the right. here the machine first modeled the bones then applied a tissue layer over it. The system right now can take any 3D dataset from an ultrasound MRI or CT scan and reconstruct 3D tissue or organ models. I’ll follow up in a later post how scientists are using such technologies to literally build artificial organs in the lab– they build the structure then seed it with living cells that create the organ. The maker bot replaces a $100,000 fabricator from a decade ago and costs under $1500– and its all open source.

Could You Cure a Disease With a Device Invention? Does Your Child Think He or She Could? You’d be Surprised? The New Inventor’s Mindset for the 21st Century. You probably grew up thinking devices of all sorts and especially electronics were otherworldly gizmos of incomprehensible complexity of design. The workings of a TV, video camera, or electronic medical diagnostic device where the stuff that only biomedical engineer with a pocket protector and a degree from MIT could have created. Your kids think otherwise. They are comfortable with technology and with programming computers when presented with understandable languages. They can make a webpage. They can edit video and retouch photos. They have a myspace page. They may tinker with remote control toys. Many of them with some practice can create 3D computer graphics. Just recently A Russian amateur filmmaker called Alexander Semenov produced this 2.5 minute bootleg Transformers short with a couple of sub-$1,000 cameras, two hours’ of footage and a month in the home desktop editing suite that many think rivals the effects of a million dollar Hollywood blockbuster.

Understand that the next generation of design and creation tools will use these same sorts of visual programming language and are just as accessible. I walked through the exhibits with a 6 and 9 year old. By the end of the day the 6 year old had soldered an LED lit circuit board to make an electronic toy (parts cost $1), both had piloted radio controlled robots complete with sensors, and had begun to design autonomous robotic creatures– and they had never done this before. I was recently asked to give a talk to a group of 4th graders working on the Lego First competition. This is a robotics competition for kids to build working devices. There are more than 10,000 teams competing this year. This year’s theme is biomedical research. They kids were instructed that they have the tools to invent a device that could solve a medical problem. They don’t believe only MIT engineers solve problems. They expect to. Remember who invented youtube and facebook.

home kit for sensor based mobile search and rescue bot. The same sophistication as a military robot and the same technology as in implantable body rovers being developed.

robotic arm prototype- could model prosthetics

home made kit for scanning tunneling microscope for research uses. A scanning tunneling microscope (STM) is a powerful instrument for imaging surfaces at the atomic level. Its development in 1981 earned its inventors the Nobel Prize in Physics in 1986. For an STM, good resolution is considered to be 0.1 nm lateral resolution and 0.01 nm depth resolution.With this resolution, individual atoms within materials are routinely imaged and manipulated. This is now a do-it-yourself kits for under $200 all open source design and technology

First Disposable Single Use HD Endocopic System-DITM Exclusive

Posted on March 8, 2010 by Steven F. Palter, MD

Docinthemachine first exclusive report!

Olive Medicalhas developed a single use HD endoscopic camera system for surgical applications. Traditional endoscopic camera systems consist of a camera head with a coupler to attach it to the scope and a camera control unit. Camera head and control systems typically cost in the $30, 000 range. olive’s approach is to make the camera had single use and delivered in a sterile peel pack ready for the operating room. They intend to deliver such a system at under $300 per case — less than 1% of a current cost to purchase a system. What’s more the system is native HD at up to 1080 resolution. I had a chance to speak with them about the system and they claim they are using a native HD imaging sensor chip. if so, they would be the first surgical camera system to do so. All other HD systems available today do not natively sense in 1080 but rather employ post imaging processing to upscale and modify the image. Their camera unit also includes integrated still image capture software eliminating the need for yet another $10,000-$30,000 box – although with obviously less features (no video, printer, etc). Their fulls specs include :

Full 1080p Video Output
2 DVI and 2 HDMI Outputs
Touch Screen LCD Interface
Integrated Storage of 40 Images

Following the disposable razor model, they would provide the camera control box to the facility for minimal (or no cost) and camera heads would be purchased per use. Following the green bandwagon they intend to accept the cameras back after use for reprocessing. Of course the obvious thought would be for a facility to just buy a few $300 cameras and use them over and over again. They have addressed this issue with some novel patented software that recognizes if the unit is shut off and watches and limits use until its factory reset. The team at Olive includes several ex-stryker hardware and software engineers so they know the traditional market well.

The idea of disposable systems is not new. Over the years I have seen many disposable laparoscopes and hysteroscopes and even limited use imaging systems. Many years ago I presented at the AAGL conference the first ever fully digital scope with a cmos image sensor and LED illumination. At that time I predicted that such a set up by eliminated camera control and illumination box requirements would enable the entire thing to become wireless and disposable. More recently more recently an Italian group wrote about such a disposable system viewed through a PC that achieved only VGA resolution. Olive has upped the ante by designing something at a fraction of the cost at true HD definition! They have some video on their website but its not labeled which one is recorded with which camera so I can’t link here yet.

This is a totally logical progression as Moore’s law gets applied to medical imaging in the OR. Chip fabrication follows Moore’s Law with dropping cost and doubling performance every 2 years. The expensive parts of these systems are now basically computer chips and related hardware. Therefore as technology accelerates we’ll see exponential advances in performance and miniaturization for lower costs. Given Imaging and others have produced disposable self-contained pill-cams that have a low cost cmos chip and LED illumination in a swallowable capsule. Chip CMOS sensors with integrated processing leverages consumer-based electronic technology advances (and economies of scale) as well as trickle-down military imaging technology. HD (and beyond) sensors are going to get very cheap in the future for these markets- not to mention the demand for real time HD video imaging on cell-phone cameras as wireless bandwidth goes beyonf 3G. The sensors really are basically the same.

The unit is not yet FDA approved. While I have seen videos I have not yet had he unit in a live lab evaluation so the final grading will ultimately rest of real world image quality, resolution, color fIdelity, and light sensitivity. I know several of the major traditional manufacturers have seen the unit. I can only imagine them buying to squash it. Such a low cost device certainly does not fit in with the traditional low volume high cost + service contract scope camera model used today.

What’s the Sensor?–They obviously would not verify to me the sensor inside the unit– no company ever does. I usually find out once the camera is released and a competitor cuts one open and sends me detailed photos and spec sheets. I did do some hunting around and was able to verify there are now American company produced CMOS imaging chips natively 1080p60. They make a standard 2/3 inch chip imaging max at 2112 x 1188. The ones I saw are 2.1-2.5 megapixel. The same fabricators also produce a 1/3 inch version. Researching this i got quite excited about he prospects for using these chips for consumer electronics in ultra-low cost HD camcorder/still devices. Flipvideo has some competition coming!

Such a device if the quality and reliability is there could be very attractive to many facilities battling down time service and sterilization issues. This could enable higher throughput in the OR with less capital outlay and lower manpower. The other (even larger in my opinion) potential market is office-based facilities which now primarily bag or high level disinfect such systems. This would be a very attractive alternative for them. Until now capital equipment requirements have been a barrier to entry for many doctor’s (and vet) offices. Ob Gyn , urology, orthopedics, ENT, general surgery, ICU’s and the ER among others are specialties are those where there is currently a significant application for imaging in the non-OR setting. This low cost idea is not alone- several companies have introduced low cost integrated camera-view- display units based on cmos- such as the tower-free hysteroscopy system with LED LCD screen and CMOS. The difference with Olive’s approach is single use eliminates the sterilization costs and they are offereing it for less than 10% of the cost of even the ultra-low cost systems coming out. Just look at the price of computer LCD panels and HD camcorders (10% where they were recently) and you can appreciate the technology price advances pushing this model.

Don’t underestimate the difficulty of sterilization. While many current ystems are labelled as autoclavable most facilities have found that significantly reduces the lifespan. In january the FDA shut down the use of one of the most common OR scope-camera disinfection systems from Steris used in 23,000 sites. This whole issue is a subject of an upcoming post but basically the FDA said Steris made too many changes since approval of the device– so it not the same device anymore and shut the thing down! While the issue is being resolved it has been a nightmare for case preparation and opens up the reexamination of sterilization. Up until now disposable of resposable systems have not been attractive because they were priced at >10% of system costs. Now Olive is getting to the <1% price point – and that’s a different story.

I look forward to some hands on testing…

Free DITM Podcast With Jeff Cohen-CEO Halt Medical on Medical Device Invention Process

Posted on December 3, 2009 by Steven F. Palter, MD

I’m so excited to share with you my latest docinthemachine podcast with Jeff Cohen — serial entrepreneur and current CEO of Halt Medical (a gyn fibroid treatment statup), Voyage Air Guitar (the world’s best foldable guitar), and Nashville publishers Savannah Music Group just recorded live at the 38th Global Congress of Minimally Invasive Gynecolog in Orlando Florida.

You might recognize Jeff who was recently featured on ABC’s Shark Tank where he turned down the shark’s offer of $500,000 for his guitar idea. In the podcast we discussed the unique opportunities and challenges of medical device development- and innovation in general.

I was immediately struck by Jeff’s unique perspective and vision when I met him. He has innovated in so many different areas and has successfully partnered with physician inventors for blockbuster devices.

Topics We Cover in the Podcast:

What’s unique about medical device development and how the potential returns differ from other industries
Advice for the physician/inventor where to go with your idea–pitfalls, how to protect your intellectual property and how to partner and start a company
Is your idea good enough to form a company?
The dangers of big companies and the opportunities of start-ups
All you need is a fantastic idea and where to go from there
What to look for in a business partner
What’s similar between innovation in any industry-medical, music publishing, and internet?
What is the unique opportunity in today economic climate?

Hope you enjoy and get inspired… All you need is a great idea– and as Jeff says- I believe everyone has one.

You can listen to the podcast below or download it in 3 versions — a single file or split into part 1 and 2.

DITM Podcast Jeff Cohen CEO-complete interview [ 26:09 ] Play Now | Play in Popup | Download

DITM Podcast Jeff Cohen CEO-interview part 1.mp3 [ 12:32 ] Play Now | Play in Popup | Download

DITM Podcast Jeff Cohen CEO-interview part 2.mp3 [ 13:37 ] Play Now | Play in Popup | Download

New Program for Centers of Excellence in Minimally Invasive Gynecologic Surgery Launched at International Congress of the AAGL

Posted on November 23, 2009 by Steven F. Palter, MD

BREAKING NEWS: First description- full free slideshow with audio of project and podcast

I am honored to share with you on docinthemachine.com my Presidential Report from the CGE of the launch of the Center of Excellence Program of the AAGL CGE. With 38 years leadership in Gyn Minimally Invasive Surgery the AAGL is uniquely qualified to share its educational mission by verifying those Centers that meet these standards.

The AAGL Global Society for Gynecologic Minimally Invasive Surgery Launches Center of Excellence in Minimally Invasive Gynecologic Surgery Program at Annual Meeting November 16-20, 2009 in Orlando, Florida —dedicated to establish and verify standards at surgical facilities and hospitals.

(click green play arrow to hear presentation audio and automatically advance slides)

The primary objective of the AAGL and its professional interest partner the Council of Gynecologic Endoscopy (CGE) is to promote the adoption of minimally invasive gynecologic surgery with its reduced morbidity, shorter post-operative recovery time, less invasiveness, and reduced costs.

Our Analysis of patient and provider needs worldwide showed that there are widely divergent qualities of practice and that patients and providers have difficulty in identifying excellence. There is a lack of national standards to improve outcomes. While payors seek to control costs/outcomes patients lack access to the educational resources to direct them to the appropriate center to meet their needs in many cases. As I stated in my address:

We recognize in the modern era of health care we have a unique opportunity as well as an obligation to use our educational resources and multidisciplinary expertise to help promote those systems and procedure which can improve patient outcomes in women’s health while reducing costs to both patient, payor, and society as a whole.

The CGE has therefore launched two new programs to address these needs.

First is an individual registry of physicians based upon peer review of operative experience and complications. The CGE, founded in 1996 has over 1100 individual gyn surgeons who have meet its standards. The new program integrates an evaluation based on today’s complexity of procedures in minimally invasive surgery. It is a tiered system with 3 levels of practice (based on procedure complexity) and 4 areas of proactive experience and specialization (General Gynecology Procedures, Fertility Enhancement Surgery Procedures, Repair of Pelvic Floor Defects & Urogynecology Procedures, Gynecologic Oncology Procedures)

Second is a Center of Excellence Program In Minimally Invasive Gyn Surgery. This is in recognition of the modern notion that to achieve best-in classs surgical outcomes requires not only an expert surgeon, but an integrated multidisciplinary surgical facility with systems and procedures in place to maximize quality cost effective safe outcomes for patients.

9 Requirements: Areas of Review To Qualify as a COEMIG:

Institutional Commitment to MIGS
Director of Division
Medical Staff Physician Qualifications
-Dedicated Educational Program
-Formalized Credentialing Guidelines & Systems to Introduce New Procedures
-Procedures for Minimizing Complications
Sufficient Experience with Procedures
A Full Complement of required Non-Surgeon Consultative Staff
Ancillary Staff
-Dedicated Team-Based Concept
-Dedicated non-physician Educational Program
Equipment Guidelines
-Availability & maintenance
Treatment pathways
-Linked to Peer reviewed Practice Guidelines
HIPAA Compliant prospective Outcomes Data Tracking

In my presentation launching this program at the AAGL annual meeting I shared

The AAGL is extremely excited and totally committed to the concept of Gynecologic Minimally Invasive Surgery Centers of Excellence. It represents a unified vision for women’s health that integrates our entire educational mission and expertise over the past 38 years.

First Ever Global Opportunity for Standards of Excellence:I was equally excited to present the concept to the Affiliated Societies of the AAGL which is made of representatives of National Minimally Invasive Gyn Societies from around the World. Our dedication to this concept and recognition of its value was shared by representatives of Partner Societies from South America, Europe, and Asia. We agreed to work together collaboratively to establish a shared Global Standard and to establish a shared program to advance Women’s health under the AAGL CGE COEMIGS program in cooperation with each Nation’s Society.

I will share further details of the program with you here as they are released!

Details of the society are are on the website of the AAGL

Information on the CGE

Information and Applications for the COEMIG Program

AAGL CGE COEMIGS Program Launch Information [ 10:57 ] Play Now | Play in Popup | Download

New Endometriosis Fertility Scoring System Predicts Fertility: Exclusive Podcast With Author

Posted on November 20, 2009 by Steven F. Palter, MD

In a docinthemachine exclusive first I am excited to share with you a new endometriosis scoring staging system that is the first ever to predict a patients chance of getting pregnant without IVF.

The EFI or endometriosis fertility index was just presented by Dr David Adamson, a fertility specialist at the 38th annual Global Congress on Gynecologic Minimally Invasive Surgery– the annual meeting of the AAGL in Florida. As a fertility specialist and surgeon myself it was starred on my agenda not to miss as a highlight of the entire congress. Here’s all the details of his presentation and the scoring system.

Here’s my podcast interview with the lead author Dr Adamson just after he gave his talk at the 38th AAGL Global congress in Orlando

Dr David Adamson Endometriosis Fertility Index Podcast with Docinthemachine.com [ 17:12 ] Play Now | Play in Popup | Download

New Groundbreaking Endometriosis Staging System Presented is 1st to Predict Fertility- First Anouncement

Posted on November 19, 2009 by Steven F. Palter, MD

BREAKING NEWS

Why Its Important: Every staging system up to now were made by committee trying to guess what would be an important factor– but none have ever directly predicted a patient’s chance of pregnancy– they main thing they need to know. This study was mathematically devised and DOES the allow a patient to know her direct chance of having a baby after surgery!!!

In this post I’ll review his findings and share the scoring forms and data. My next post will be an exclusive podcast interview I just did with the author of the importance of this major breakthrough. The paper is being released today as “in press” in the journal “Fertility and Sterility” of the ASRM (here’s the link) — but you’ll need a membership to access it. I’ll post the final pubmed links when it comes out in print.

Background- What’s endometriosis? Endometriosis is a devastating disease where the cells that normally line the uterus and grow each month in preparation for a baby grow abnormally outside the uterus on it surface or on the tubes ovaries or other internal organs. These cells bleed cyclically each month internally an cause inflammation resulting in pain, infertility , and damage to other organs. It affects 5% of the population who have no symptoms but up to 25-33% of women with infertility or pelvic pain. A valuable resource is the endometriosis association who I work with frequently.

Lead Author–is my friend collegue and mentor from a distance Dr David Adamson. He’s and ob gyn fertilit specialist who is on the faculty of both UCSF and Stanford and who specializes in both fertility and reproductive surgery — he’s served as president of both our fertility society ASRM and our surgical society AAGL.

The Results– Predicting Fertility: Chances of pregnancy by Stage

DITM Podcast on Future of Video for Entertainment & Medicine With Sony Exec

Posted on November 12, 2009 by Steven F. Palter, MD

I have been getting great feedback on my DITM medical technology podcast which starts the podcast series I’ll be doing regularly. Several people wrote to ask if I could post a version with just the interview since they loved it so much and wanted to share that segment. The original podcast starts with FDA approvals then has an interview with Sony Exec Bob Ott on the future of video technology in entertainment and medicine that we did a the NAB broadcast meeting in Vegas.

Here’s an edit version with just the interview enjoy and share with your friends!

Standard Podcast [ 15:35 ] Play Now | Play in Popup | Download

Docinthemachine MedTech Podcast!

Posted on November 10, 2009 by Steven F. Palter, MD

Here’s the latest installment of the docinthemachine podcast. In this installment I review new FDA device approvals and then present an interview about HD technology for entertainment and medicine with Bob Ott (vice president of broadcast and professional audio/video products for Sony Electronics) recorded at the National Association of Broadcasters (NAB).

docinthemachine november 2009 [ 19:35 ] Play Now | Play in Popup | Download

First Ever Surgical Video in 4k Ultra High Def- Hollywood and Doctor Team Up for Revolutionary Projects on Future Visualization in Medicine

Posted on November 4, 2008 by Steven F. Palter, MD

our digital cinema control room- Sony controls

For the first time ever Hollywood’s digital vanguard has teamed up with a surgeon to use tomorrow’s cinematic tools to revolutionize visualization in the operating room. We successfully filmed produced and played a 4k digital cinema movie of a live human surgery. This was an amazing collaboration between a fertility surgeon, the AAGL endoscopy society, Sony Medical & Broadcast divisions, Red Digital Cinema Camera Company, FotoKem, Vincent Pace films, USC professor Richard Weinberg, and the NBA just to name a few! We also showed the largest medical 3d displays ever.

The AAGL reported on this groundbreaking session today . Further details are here and here.

Dual Sony SXRD 4k projectors in 3D scaffold

New cinematic technologies are transforming the film business today. The two major revolutionary developments are 1) ultrahigh definition “4k” technology – which brings resolution to 4 times that of HD and 2) realistic immersive high definition 3D. I set out to introduce these technologies to the medical world and to see if we could for the first time apply them to surgical practice- setting the goal to once again use technological innovation to improve our patient outcomes.

Virtually all of my surgery is endoscopic- performed through tiny telescopes and viewed on a TV monitor. In 2001 I performed the world’s firs HDTV surgery and demonstrated how increased resolution improved the surgeon’s visualization and performance of procedures. For those interested in the history of HDTV surgery and the details of its development further details of my work are here from the New York Times and here from Science Daily and here from MIT Technology Review. Over the past two years I refined this work with even better performing camera systems and this work was featured on 20/20 and on the National Geographic Channel’s first ever HD medical show – Inside the Living Body.

Hollywood is embracing its digital future by adopting (with $1 billion in financing and a follow-up deal by Sony) planned conversion of 20,000 theaters to ultrahigh definition 4k (4096x 2048) video. The revolutionary Red One camera is one of the few that can natively record this type of file. Having heard about it I went to vegas for NAB in April and saw with my own eyes the amazing realistic movies being made with it. While there I met with Ted Schilowitz, Red’s “Leader of the Rebellion” and was ecstatic with his desire to help with with a proof of concept- to film surgery with a 4k camera. I also partnered with Sony’s Medical and Broadcast Divisions who eagerly helped me set up a 4k and 3dHD digital cinema in an international medical conference hall in the Las Vegas Paris Hotel. The theme of my Keynote lecture was “Film and Medicine: From the Past to the Future- Through the 4th Wall.” In this, I traced how cinematic film technology has transformed the teaching and performance of surgery- and how the future will again have revolutionary changes in physician visualization. Our Hollywood partners allowed me to first show jaw-dropping pro-sports and theatrical demos of the technology.

Sony’s digital cinemas allow the next generation of film to be projected at these previously impossible resolutions. We used dual SXRD 4k projectors with linear polarizing filters for 3D HD then went to a single projector for the 4k. 4k footage has to be played off a dedicated media block digital server and we used an LMT-100 like a movie theater would and FotoKem converted the 4k files into a DCP digital cinema package that can be played. For 3d footage we played off an HD SR tape dual stream deck. I’ll post a follow-up explaination of each of these technologies in detail.

By increasing resolution to this level we allow the surgeon to be actually immersed in images that surpass the live surgical experience. The progress from regular surgical film technology is like comparing sitting in an HD home theater to watching a video on a cell phone.

Ultra high resolution digital cameras are transforming the art of cinema. Leading Hollywood directors such as Peter Jackson and Stephen Soderbergh today have just started filming the next generation of cinema blockbusters using cameras with “4K” resolution, four times the resolution of High Definition (HD) with 4096 lines of resolution to give audiences unprecedented realism. The Red One digital cinema camera is the at the forefront of the revolution. Director Soderberg previously described this technology as “This is the camera I’ve been waiting for my whole career: Red is going to change everything….Shooting with Red is like hearing The Beatles for the first time. Red sees the way I see.”

Amazingly, the surgeons in the conference were able to visualize the surgery they were watching better than if they had been in the operating room live. If it can transform the immersive experience of the movies with unprecedented realism wouldn’t you want that degree of vision in your surgeon’s hands? By combining unprecedented resolution and magnification the surgical images were beyond what a surgeon would have standing live in the operating room. Those in the audience predicted this technology would further revolutionize minimally invasive surgery as it becomes incorporated into the OR of the future.

We then projected the largest high definition (HD) 3d surgical images ever. Wearing glasses reminiscent of today’s 3d Hollywood blockbusters U23D and Journey to the Center of the Earth a standing-room only crowd of 1600 surgeons felt as if they could “reach out and join the operation”. These images were enabled by converting Sony’s ultrahigh definition and 3d theatrical systems to show medical footage in what the AAGL called the “Theater of Tomorrow.” A Vince Pace 3D demo reel showed where Hollywood is going as well with Gwen Stefani concert footage, underwater vistas, and movie clips.

Since laparoscopic surgery is performed by a surgeon watching on a video monitor making the images “better than live” may facilitate teaching and procedures in the future.

The 4K system, manufactured by RED Digital Cinema Camera Company, was used to film Jumper, Crossing the Line, and The Argentine. This recording represents its first use for medicine and biology in the world. In addition to a surgery we showed the first ever 4k microscopy images of single cell organisms ever recorded (from USC).

Stay tuned a for a series of posts coming up this week that will review the session, how we managed the collaborations, the difficulty in executing each of the technologies, and where I predict this is going in surgical visualization.

OLED: The Future of Display Technology- NAB 2008 Update

Posted on April 23, 2008 by Steven F. Palter, MD

This is my second post in a series of updates of exciting new media technology I saw at the 2008 National Association of Broadcasters (NAB) meeting just finishing up in Las Vegas. My intro to the meeting can be found here.

In this post I want to review the most exciting new display technology I saw on multiple fronts at the meeting- and share with you my predictions of how it will be used in medicine in the future. This technology is OLED

OLED represents the next step in the future of video display technology. I have previously written about what the technology is and how it works here. The technology was introduced commercially by Sony at the 2007 CES meeting also in Vegas (the home of all new media conventions). Currently flat panel technology is dominated by LCD’s and plasma displays – the limitations of which have been extensively reviewed elsewhere,

The Importance of Display Technology and its Market:

The display used to watch video is the final link that determines ultimate picture quality. The size of the current consumer flat panel TV market is estimated at $80-$100 Billion. I don’t have to say that number twice to convince you why consumer electronics giants will push the limit of display technologies creating the raw materials for medical displays in the process. This happened with CRT’s, LCD’s , and plasmas in the OR.

Let me be the first to predict- OLED will 100% dominate OR surgical displays as the technology matures. Not to mention the potential for their use in head mounted displays (HMD’s) and alternate display technologies.

I was enormously impressed by several features of the first OLED displays I laid my hands on. – my favorites are highlighted below

Fantastic brightness and contrast ratio. This 11″ model i looked at had a contrast ration greater than 1,000,000:1 (not a typo).
Excellent grayscale
Full-motion video without ghosting
Wide viewing angles from all directions
A wide range of pixel sizes
Low power consumption
Low operating voltages
Wide operating temperature range
Long operating lifetime
A thin and lightweight form factor
Cost-effective manufacturability

Here is an an example of the unbelievable wide viewing angle of OLED displays. When you look at standard LCD displays the brightness and ultimately entire image falls off as you start to look from the side angle. This has been a big problem for me with LCD displays in the OR for endoscopic surgery. When we operate as a team often the assistant or nurse need their own separate monitors since they are unable to get a bright clear image viewing my image from a tangential angle.

The OLED looked even better than this since there is a bit of a glare reflection from my camera’s flash.

Here is a view of just how thin these displays are. The screens themselves can be made 0.3 mm thick in current implementations.

sony pro oled

This was Sony’s implementation of OLED for the broadcast pros demo’d at NAB 2008. The HDVF-EL100 is an OLED viewfinder for pro video TV cameras. The same wide viewing angle, incredibly thin dimensions and low heat that will benefit it in the OR went into choosing it for this use as well.

As Engadget HD said- you can see these OLED displays from a mile away.

I had an opportunity to chat with the engineers about OLED and what is delaying its dominance of the market. They said that currently maufacturing becomes problematic as sizes increase leading also to cost escalations. In addition they are produced in totally new types of production factories which are currently being built- such as the Samsung 8G LCD factory. There is no doubt these issues will be overcome with current development.

Update: for those interested in truely amazing future potential for OLED read here about a version that is on a flexible material that can simply be rolled up in testing now by the US Army.

Also – it appears mainstream OLEDs will hit the consumer markets in large number in 2009-2011. Samsung predicts 2008/2009 while LG predicts a 32 inch version in 2011. Details are here.

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Category Archives: surgery