Contract manufacturing
Endoscopes are a common sight in operating theatres, where minimally invasive surgery is favoured when possible.
this enthusiasm makes sense far beyond the specifics of ISOs. Typically offering fully customisable products, contract manufacturers can craft machines expressly suited to the most technical of surgeries – hardly irrelevant when devices sometimes encompass 60 wires smaller than the diameter of human hair. Just as crucially, contract manufacturers can make machines more cheaply, especially when so-called ‘full service’ options allow R&D teams to focus exclusively on developing new products. In short, it’s no wonder that contract manufacturing is going from strength to strength. Research and Markets recently found the global medical devices contract manufacturing sector is due to enjoy CAGR of 10% from 2020 to 2026. This booming market is reflected elsewhere too; there are currently around 6,000 contract manufacturers to choose from, while individual firms are confident enough in the future to invest millions in new production facilities. And if contract manufacturing is proving a major boon to minimally invasive devices, Gomes is no less excited by the arrival of new technology. “Robotics are revolutionising the way that minimally invasive surgery is carried out,” she says. “The introduction of robotic systems has made previously complicated operations or procedures – that were unsuitable for minimally invasive surgery – possible. The technology used for minimally invasive surgery continues to advance and this offers the potential to make optics and imaging more accurate and efficient.” Once again, her point is being dramatically reflected in the real world. To give one example, Pennsylvania company Globus Medical created ExcelsiusGPS, a product that allows doctors to
Medical Device Developments /
www.nsmedicaldevices.com
complete complex spine surgery using a robot, with each miniscule cut guided using a similar technology to GPS.
Data-led surgery
Despite the clear advantages in terms of accuracy, robot-led surgery is far from perfect. For one thing, surgical instruments risk damaging nearby nerves and tissues. For another, training remains expensive, even as human error can turn robots into death traps. In both these cases, however, ones-and-zeros could soon come to the rescue. Fundamentally, this can be understood in terms of how medical robots have traditionally operated. As Gomes explains, most have typically performed as “master-slave” systems, whereby robots only follow the movements carried out by an attendant doctor. But in future, the BSI expert suggests “these robotic systems have the potential to perform autonomous actions with the use of AI, big data and machine learning”. The implications here are obvious. Rather than relying on fallible human interventions, robots could instead learn from previous operations exactly where to inject or how hard to slice. Big data may eventually even presage a world where robots can complete certain operations without any human intervention whatsoever, at least when it comes to simple procedures like closing port sites or tying sutures. There’s also evidence that AI can help in more subtle ways. In minimally invasive colonoscopies, for instance, machine learning could help surgeons identify potential polyps. If only the workers on those twentieth-century production lines could come back and see that. ●
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