“Robotic surgery is much more than a new technology”
The recent surge of innovations in endoscopy, minimally-invasive surgery and surgical robotic applications are helping to democratize healthcare in fast-paced steps. In this interview, Tony Cappabianca, Business Development Medical, Principal at SCHOTT North America, shares his views on the role of robotic surgery in advancing healthcare, how high-class illumination benefits surgical outcomes, and his own motivation for working in this market.
Why is robotic surgery a promising market?
Robotic surgery is one of the most exciting areas in medicine today with impressive annual growth rates of 20% to 25% expected for the years to come. But honestly, it’s not just about the business case, it’s really about the patients and how we can improve their lives.
Robotic surgery is a complement to traditional and minimally invasive surgery as it incorporates new technologies. Robotics is about bringing digitalization into medicine and surgery, which means capturing a lot of data and turning it into information to assist the surgeon which ultimately will benefit the patient. So ultimately, the question is: Can we find a way to democratize medicine? Can we make it available to everyone around the globe?
Which innovations for the robotic surgery market is SCHOTT focusing on in its current technology projects?
SCHOTT has always been a leader in fiber optic illumination, especially in minimally invasive surgery, that is, in endoscopy itself, operating in the visible spectrum. But it goes beyond that. Technologies today incorporate near IR wavelengths for fluorescence imaging used to distinguish between healthy and potentially cancerous tissue. Additionally, spectroscopic techniques that are able to identify blood flow in real time play an incredibly important role for surgeons, impacting surgical outcomes as they receive all the information at once. That is one of the big advantages of what is being incorporated into robotic surgery today.
Why is illumination so important for robotic surgery applications and what value does SCHOTT add?
Illumination is at the heart of any vision system. When working with endoscopes, it’s critical to have as much light entering the patient as possible. It is usually not noticed until there is a bad design. So, we always encourage designers to think about lighting early on, and really incorporate it into their critical design parameters for the overall vision system.
Besides, medical applications have different requirements. That is why we spent a lot of time in developing our specialized lead-free PURAVIS® fiber series, which are specifically designed for medical applications, and often times for the kinds of procedures associated with robotic surgery.
Which features and benefits do SCHOTT PURAVIS® glass optical fibers (GOF) offer to robotic surgery applications?
Different from traditional endoscopy, robotic surgery applications often cover long distances. So the main concern is that the amount of light travelling from a remote light source finds its way directly into the patient where it is as bright and white as possible.
Our “GOF85” fibers are specifically designed for long lengths. For remote light sources of 20 feet or more away, our fibers are formulated to offer both a high transmission as well as a strong color temperature. You don’t want that light to be yellow since the goal is to transport as much bright white light to the patient as possible.
We always want to look at lighting as a system defined by more than just a single component. We care about the light travelling down the flexible cable coupled to the light source, but we also care about how efficiently that energy is coupled into the fibers located inside the endoscope. Our internal endoscope fibers are “wide angled” to accommodate today’s sensor technology – our “GOF120” fibers which illuminate a 120° field of view. Ultimately, by combining different fibers within one system, we can optimize the amount of light travelling from the source all the way into the patient.
Which development is SCHOTT working on to improve the illumination quality of robotic surgery?
SCHOTT is working on several new developments. It always begins with a strong foundation, which are our lead-free PURAVIS® fibers. Their capabilities allow us to achieve certain performance levels, but there are other processes further optimizing output performance to meet the demands specifically around robotic surgery.
In the operating room, a remote, high-powered light source can be a significant distance away, meaning that a lot of energy needs to be introduced into the light guide. Here, we work with hot fusion technology, which uses temperature and pressure to fuse the fibers together, thus eliminating traditional methods of epoxying bundles of fibers together into the end fitting. This fused end termination enables the launching of much higher power levels into the light guide.
In addition, we‘ve developed a new process to help couple as much of that energy from the light guide directly into the smaller light bundle located inside the scope, and ultimately reaching the patient. Our newest technology – a form of advanced fusion – allows us to fuse and taper the larger light guide bundle to improve coupling efficiency to the smaller light bundle within the scope. For example, a five-millimeter fiber optic flexible light guide can be tapered down to match the two-millimeter bundle inside a scope.
On a more personal note: what fascinates you about robotic surgery?
I’m very fortunate to be part of an industry that has an impact on the world around us. Our work should never be taken for granted, which can often happen as a component supplier. Sometimes we can miss the bigger picture of what we are involved in, and miss seeing the influence our PURAVIS® fibers and light guides really have – or whatever new technologies we’re talking about. It is actually helping surgeons do their job better and that literally means saving lives.
I like the concept of democratizing medicine. It’s an exciting time to realize that we have the ability and the technology to share all this information. And that translates to surgeons helping other surgeons by sharing intelligence regarding new techniques and surgical experiences. Sometimes, you get to sit back and think “wow, what we are doing is helping to save someone’s life” – and it could be someone close to us one day or even ourselves.
Text: Dr. Haike Frank, SCHOTT Lighting and Imaging