2021 HEALTHCARE PRODUCT HALL OF FAME “Turnkey Mobile SPD solutions enable
hospitals to maintain 100% surgical volume and a high level of infection control during construction renovations and emergent situations,” Shelton indicated. “A Mobile Sterile Processing Unit is a fully integrated, Mobile SPD that allows for a turnkey pro- cess to continually support the OR without disruption during times of construction, renovation, or emergent situations. The Mobile SPD solution creates value for hospitals by decreasing down-time, lower- ing costs, and creating an environment for continual effective sterilization.” SERS maintains a large eet of mobile SPD units that has responded to facility renovations that have lasted months to years, surgical capacity demand increases and emergencies, including oods from hurricanes and rivers, fires, sewage back- ups, HVAC issues and compliance issues, according to Shelton.
“The STERIS Mobile SPD has supported hundreds of projects over the years and continues to allow clinicians, SPD and Sur- gical departments to maintain a high level of care for patient populations and is truly an innovative product and solution that is unique in the marketplace,” he added.
Capsule endoscopy, a.k.a. pill camera
KEY SUPPLIERS: Capsovision, Chongqing Jinshan Science and Technology, Medtronic (via acquisition of Covidien, which acquired Given Imaging Ltd.), Olympus, IntroMedic
WHY IT MATTERS: By using a small
wireless camera that can be swallowed by the patient a doctor can see inside that patient’s digestive tract, including the esophogas and small intestine. This enables doctors to diagnose cancer, gas- trointestinal ailments and bleeding as well as see polyps more quickly. Capsule endoscopy provides faster access to inter- nal visualization without the need for invasive surgery. Where the diagnostic imaging modalities provide views inside the body from outside the body, capsule endoscopy provides views inside the body from inside the body.
Philip Doyle, Executive Director of Mar- keting for Endoscopy at Olympus Corpo- ration of the Americas, traces the roots of this technology to the early 1950s when the first gastrocamera was developed to allow doctors to see all parts of the gastrointesti- nal (GI) tract. But there were limits. “As technologies evolved through the end of the 20th
century, the endoscope
allowed doctors to reach to the end of the colon and into the stomach,” Doyle said.
“But most of the small intestine remained off limits to endoscopic technology due to its tortuous anatomy that includes 20 feet of loops and turns and a very compact lumen.”
Not all parts of the GI tract were able to be seen without surgery until the advent of the capsule endoscope, which means that diagnosis and treatment of digestive diseases and disorders, such as Crohn’s disease, GI bleeding and small bowel tumors were very challenging, according to Doyle. Doctors were able to see inside the small bowel, courtesy of the capsule endoscope in 2001.
“With this pill-sized, wireless capsule endoscope, the small intestine is fully scanned while the patient is at home, and physicians can process and access imagery without the need for lengthy hospital pro- cedures,” Doyle noted. “Patients wear an antenna belt and a recorder. The pill takes about 8 hours to travel through the diges- tive tract, and once it’s done, the patient gives the equipment back to the physician, who downloads the exam into processing software and reads the exam. There are risks associated with this type of proce- dure, including potential interference with implanted electronic devices and possible retention of the capsule endoscope, which may require open surgery.”
Endoscopic technologies continued to advance enough to allow physicians access to the small bowel for non-surgical treatment, according to Doyle. “With the introduction of balloon-assisted enteros- copy, physicians were able to move the endoscope deep within the small bowel, and now it is possible to perform many minimally invasive treatments of the small bowel, such as removing polyps, opening blockages, sampling tissue, and stopping bleeding, without the need for surgery.” 1, 2 WHAT IF IT DIDN’T EXIST TODAY: With-
out iven maging pioneering the field of capsule endoscopy two decades ago, physicians either would have to rely on the diagnostic imaging modalities such as MR that allow views of organs and soft tissue or at the very least more invasive surgical techniques.
Surgical staple
KEY SUPPLIERS: Johnson & Johnson’s Ethicon division, Medtronic (via acquisition of Covidien, the former U.S. Surgical)
WHY IT MATTERS: Questions might be raised about why the surgical staple makes it into the Hall of Fame earlier than its predecessor, the suture. Fair question. The challenge for the suture is that, by
38 December 2021 • HEALTHCARE PURCHASING NEWS •
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and large, it’s nothing more than “medi- cal/surgical-grade thread” that is part of a much-larger family of products that include rope, string, twine, etc., and is used in multiple industries and markets. But then some might counter with the fact that staples are used in packaging (think corrugated cardboard boxes and contain- ers) and form/paper groupings as well as serving as the brand name for a famous office supply store. gain, fair enough. ut surgical staples represent a noteworthy advancement and alternative to suture in how they function within the anatomy and affect the healing process.
The surgical staple, by and large, offer a number of benefits that differ from tradi- tional suture, which is why it tends to be the tissue closure of choice for minimally invasive surgical procedures. Benefits include convenience and portability in that the surgical stapler can be inserted into the body cavity quickly and activated to connect tissue after an organ has been removed (resection) or sealed (transec- tion). Until absorbable staples were manufactured (like absorbable suture), the surgeon could remove them rather easily and quickly compared to suture. This also meant that the patient spent less time in surgery and under anesthesia, compared to when suture was used. Finally, because of their durability and strength, surgical staples tend to be used on the skin to close skin “under high tension,” such as the scalp for cranial and neurosurgery. During the last decade, the U.S. Food
and Drug Administration has received reports of problems and data involving device malfunctions that led to several major product recalls. The FDA also held public meetings that led to a final guid- ance on labeling as well as reclassifying surgical staplers for internal use as a Class II (moderate risk) medical device from a Class I (low risk) medical device. WHAT IF IT DIDN’T EXIST TODAY: Doc- tors and surgeons still would have access to suture and thread, but that would be the extent of it. One wonders also that if staples weren’t conceived, developed and used as an upgrade to suture would the industry innovate to the point of develop- ing surgical glue, which has been an All- Star nominee for two years? HPN
References:
1. Balloon Assisted or “Deep” Enteroscopy.
ASGE.org. https://
www.asge.org/home/about-asge/newsroom/media-back- grounders-detail/balloon-assisted-enteroscopy. Last Reviewed August 2014. Accessed October 25, 2021.
2. Voelkel J, Di Palma JA, South Med J. 2010;103(10):1045-1048.
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