Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Clinical Engineering Project - Laparoscopic Surgery

No description
by

Amnon Ariel

on 14 June 2013

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Clinical Engineering Project - Laparoscopic Surgery

ELIGIBILITY
PREPARATION
HOSPITAL STAY
POST OPERATIVE
MORTALITY
Largest Hospital in northern Israel
36 Hospitalization wards
80,000 Hospitalized patients per year
Surgical Wing

35,000 surgeries per year

12 operation rooms.

Divided to 3 separate clusters

Each cluster has it's own service unit

Full functionality during war time

150 surgeons

40 anesthetists

80 nursing staff & technicians
OBESITY
Omri Funaro, Dave Goldberg, Amnon Ariel
20.05.2013
Dr. Bshara
The 21st Century Epidemic
EAT ME!
25
EAT ME!
SOLUTIONS?
1000 Doctors & 1500 Nurses
BACKGROUND
Established 1938
Dr. Bachos
Endocrine, Abdominal wall Reconstruction & Laparoscopic
Micro rectal surgery, Adrenal & Thyroid
Sea Side
Pancreatic & Bile
Dr. Kluger
Liver
Dr. Kakashvilli
Trauma & Enhanced Monitoring
Dr. Mekel & Dr. Duek
New wing - opened 2005:
General Surgery Section

Surgical specialty that focuses mainly on abdominal contents

One big general surgery section

Divided into two departments
Laparoscopic
HYPERTENSION
85%
35%
ISCHEMIC HEART
10
10
30% Of Israeli Adults are Overweight (BMI>25)
15% Are Classified as Obese (BMI > 30)
40-50 BMI: Morbidly Obese
BMI
What is Laparoscopy?
TYPE II DIABETES
77%
ISHCEMIC STROKE
200%
1961
13%
1978
15%
1991
23%
20
50-60 BMI: Super Obese
%
CONS
PROS

SIDE EFFECTS

COMPLEXITY

EFFICACY

COST

RISK

SUCCESS RATE

ENDOCRINE

RECOVERY

DRAMATIC
PATIENT DATA
Potential Complications

Post-operative infection

Minor bleeding and bruising around
the site of the incision

Nausea and vomiting

Damage to an organ,

Damage to a major artery

Damage to pelvic nerves

Complications caused by the carbon dioxide used during the procedure, e.g. gas bubbles entering blood system

Serious allergic reaction to the general anesthetic
Further surgery is usually required to treat these major complications
MORBIDITY
GETTING
BIGGER
AND BIGGER...
I
I
2010
36%
Roux-en-Y
(Gastric Bypass)
Adjustable Gastric Band
52 years old
Age:
_____________
BMI index:
47
_____
Pre-existing conditions:
High blood pressure (151/95)
Type II Diabetes
____________________________
Male
Sex:
_________
Laparoscopic Sleeve Gastrectomy
Scheduled for:
________________________________
2
2
1
LRYGB
LSG
LAGB
Day
Days
Days
I
Sleeve gastrectomy
7-12K $
9-17K $
10-18K $
CRITERIA:

BMI>40

BMI>35 + severe comorbidity

Failure of non-invasive methods: "Last Resort"
Minor complications 1-2 cases per 100)

MANDATORY TESTS:

ECG

Blood tests

Ultrasound

X-ray

Colonoscopy
BARIATRIC SURGERY

General anesthesia

Pneumatic boot or compression socks

Shaving of operation area

About 2 hour operation time

two to three hospitalization days

Mild pain during first week

New stomach capacity about one cup


One to two weeks to normal function

Strictly liquid diet during at first


Weight loss during first month:
5-15
Kg

During first and second year:
2-4
kg a month


Routine Checkups with Dietitian and Psychologist
*Covered by national health insurance
APPROVED BY:

Psychologist

Dietitian

Cardiologist

only liquid the day before & fast from night before surgery

Hospital admission

Meeting with an Anaesthetist

Blood test

I.V.

Antibiotics & Anticoagulants
PRE-OP
SURGERY
_ _ _
_ _ _
_ _ _
_ _ _
_ _ _
____________________________
NEW KID ON THE BLOCK
GROWING PEOPLE...
...GROWING MARKET
27.03.2013
Surgeons:
ISRAEL:

6-7K
Dr. Bshara, Dr. Abud
__________________________________
Procedures annualy
65%
65%
45%
After one year
_ _ _
Advantages
Disadvantages
Feasibility
Flipped axis
No tactile feedback
Poor depth perception
Limited range of motion

In 2011 - Laparoscopy devices market was worth USD 6,968.0 million.


By 2018 - Expected to reach USD 13,152.9 million.
North America holds the highest market share and is expected to retain its lead position in terms of revenue till 2018
Increasing availability of skilled surgeons

Growing demand for minimally invasive surgeries

Increasing acceptance of Laparoscopic procedures
Factors driving the market:
FUTURE OPPORTUNITIES:
Pediatric laparoscopy
Technological
advancements
THE MARKET
EARLY LAPAROSCOPIC SURGERY
Reduced pain
Quicker surgery
Shorter recovery time
Reduced hemorrhaging
Less post-operative scarring
Reduced wound complications
Reduced exposure to outer environment
First laparoscopic procedure in dogs
First laparoscopic operation in humans
Robotic arm designed to hold the laparoscope camera and instruments.
First video-laparoscopic cholecystectomy.
First ever live broadcast of laparoscopic surgery via the Internet was performed.
1902
1910
1996
1994
1987
Laparoscopic procedures in the operating room under sterile conditions.
1980
The first solid state camera introduced :
start of 'video-laparoscopy'.
1982
Needle Driver
Tools!
Surgical Mesh
Suction
Clip applicators (single staple)
Illuminator
RAMBAM
HOSPITAL
LAPAROSCOPE
TROCAR
CANNULA
ENDOLINEAR STAPLES
INSUFFOLATOR
Bowel Grasper
Scissors
Endocoagulator (usually bipolar)
ADAPTED for LAPAROSOCPY
Retractors (active/passive)
AND MORE
Laparo-[laprō]-prefix meaning
"abdomen or abdominal wall"

Hernia repair

Bleeding stomach ulcer repair

Female sterilization treatment

Treatment of ectopic pregnancy

Treatment of fibroids
1.Diagnosis
Uses

Pelvic inflammatory disease (PID)

Endometriosis

Ectopic pregnancy

Female infertility

Ovarian cyst

Unexplained pelvic or abdominal pain
Cancer:
Pancreatic, Ovarian, Bileduct, Gallbladder
2.Treatment

Appendectomy (removal of the Appendix)

Gallbladder removal

Hysterectomy (removal of the womb)

Oncologic surgery (tumor removal)

A number of Bariatric (weight loss) procedures, including Sleeve Gastrectomy
OMENTUM
Major complications (1 in every 1,000)
A LOOK TO THE FUTURE
The Challenge
To overcome traditional Laparascopic challenges of:
miniaturization
maneuverability
access
Types of Advancements
Technologies
Techniques
CAMERAS
SCOPES
ROBOTICS
NOTES
SILS
Future Predictions
Short run
Long run
Advanced flexible laparoscopy at the forefront of everyday surgeries
Mobile platforms
Robots cheaper and more accessible
UNMET NEEDS
ff
OUTLINE
RAMBAM HOSPITAL & GENERAL SURGERY
History & Statistics
Block Diagram
General Surgery definition
Department outline
Laparoscopic Surgery
Definition
Uses
Complications
History
Advantages & Disadvantages
Market
Tools
Obesity
Definition & Classifications
Mortality & Morbidity
Growth of Problem
Bariatric Surgery
General Workflow
Pros & Cons
Different types
Market statistics
Sleeve Gastrectomy
Patient Data
Surgery in Detail
Summary + Unmet Needs
Future
Advancments
Technologies
Techniques
Summary

QUESTIONS ?
What you've seen today
What we've seen before
What we think.
How much fun we had

SUMMARY

Incisions:

Minimizing Entries

Closure Issues (Hernias)
Big Market
The Prize

First Entry

Leaks

Re-usability

Residual Staples

Obstructions
Full transcript