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New microscopic technology could revolutionize UMHS surgeries

(February 17, 2016) — The University of Michigan Health System has recently acquired Synaptive Medical’s BrightMatter technology, a device that fuses high-definition intraoperative visualization and surgical guidance to transform the way surgeons operate.

Currently, when surgeons want to view something in high detail they use a microscopic eyepiece. The field of view provided by this microscope is incredibly small and requires the surgeon to frequently move around while working. The surgeon is able to project two-dimensional images onto a screen for others in the operating room to see, but the surgeon her or himself cannot see that image. UMHS neurosurgeon Oren Sagher said the new device aims to change that.

“The BrightMatter device parts from that,” Sagher said. “The surgeon is now seeing the same high detail over a larger area and is able to see it on a large screen in front of them rather than having to look into a microscope.”

The device also allows all those in the operating room to see exactly what the surgeon is seeing. Sagher said he believes this will greatly improve communication and teaching capabilities in the operating room.

“Now everybody knows exactly what the surgeon is seeing and doing and the scrub can anticipate what the surgeon needs and (this) really greatly improves the workflow in the operating room,” he said.

What sets this device apart from current technology is that it combines more advanced visualization technology with surgical guidance, Sagher added. Currently, surgeons take digital images of a patient’s brain, for example, and reconstruct them into three-dimensions. A computer in the operating room then guides the surgeon’s hand where to go according to this three-dimensional model. This technology has existed for more than 20 years but lives completely separately from the microscope used previously — this new device will combine them.

“If a surgeon was operating under a microscope, they cannot use the guidance system very easily, in fact sometimes not at all,” Sagher said. “With the Synaptive device, BrightMatter, not only can you do that, but it actually is integrated into the device. They are actually able to guide your view and your path exactly the way you have planned it based on the patient’s preoperative imaging.”

The device itself is a robot. The visualization camera hangs above the head of the surgeon and slightly in front of them in order to not get in their way. The surgeon is able to give the robot verbal commands to change paths and trajectories.

“It is just short of the ability of the robot to actually do the operation,” Sagher said. “It essentially allows the surgeon to just get to that limit where the surgeon is operating but being aided by the robot.”

The BrightMatter device is currently being used at a handful of hospitals across the country, including Henry Ford Hospital in Detroit. Karin Muraszko, chair of neurosurgery at the University, said while the BrightMatter device is costly, the University thinks it is a worthwhile investment.

“It’s a significant outlay of funds and a hospital has to feel that they have got the need for that kind of technology,” Muraszko said. “We view ourselves, and I think appropriately so, as a place that leads in cutting edge technologies. I think that, like everything, it is going to require a learning curve, but we have invested a fair amount of effort and time to access its feasible and usefulness in our own practice before we made the commitment to bring this system to Michigan.”

Both Sagher and Muraszko said they believe the University will uniquely implement of this technology due to the prominent brain tumor program the University has, as well as how they will be able to integrate the BrightMatter technology with a visualization instrument that another UMHS neurosurgeon, Daniel Orringer, has developed. Orringer has created a visualization instrument called stimulated Raman spectroscopy, which allows for the visualization of actual cells. This offers the potential to be able to differentiate between tumor cells and normal cells in the operating room.

“We can take a real breakthrough and make it a truly monumental breakthrough, leveraging what our in-house talents are here with Dr. Orringer’s SRS microscope,” Sagher said.