Medical Engineering

Aristidis Schnelzer

2019 - Ongoing

Technological development is advancing at a rapid pace. In the field of medicine, it is producing increasingly futuristic-looking technologies:

Bionic prostheses that can be controlled by nerve impulses, robots that restore the mobility of stroke patients, 3D printers that print organic tissue ...

What forms does this development take and what is the added value for those affected?

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  • Navient, a cranial navigation system from Claronav. The system offers greater safety when taking biopsies and during tumour resection (removal of tumours). With the appropriate software and access to MRT and CT data of the patient, surgical interventions can be planned preoperatively.

  • The active two-arm exoskeleton, developed by the German Research Center for Artificial Intelligence, serves to optimize upper body rehabilitation. A previously recorded movement can be executed as often as desired. The movement can be triggered by EEG or EMG. The exoskeleton also has a mirror mode. Here, the affected arm can be controlled by the healthy arm.

  • Da Vinci Xi surgical system produced by Intuitive surgical. The surgeries are mostly minimal invasive, that means there is only a small cut through which all the instruments find access to the inner organs. The robot is controlled remotely by a surgeon via the surgeon console. Through the console the surgeon sees a very detailed tenfold magnified 3D image of the surgical area. Additionally the robot compensates accidental movements like trembling of the surgeon. The Da Vinci robot is primarily used for urological surgeries.

  • As part of the KUKA Innovation Award, researchers from the University of Zagreb developed an interactive robotic system to support neurosurgeons in the preparation phase of surgery. The system is based on the LBR Med robotic arm developed by KUKA. With various attachments, this robot serves as an assistant in the fields of bone surgery, ultrasonic diagnostics, minimally invasive surgery and many more. Germany. 2019.

  • CMF System, a cranioplasty system developed by Madison Ortho. Cranioplasty is used for defects of the cranial bone. These can be caused by disease or external force. Based on CT data, patient-specific implants can be produced, which are fixed in place during the operation using the plates and screws shown above.

  • International Neuroscience Institute in Hanover. The architecture of the building is inspired by the human brain.

  • The holomedical application Virtual Surgery Intelligence (VSI) makes it possible to augment the real world with holograms. Images from medical imaging procedures (CT, MRI, etc.) can be displayed three-dimensional in mixed reality glasses. These anatomical images can be merged with the patient with millimeter accuracy, allowing pathologies to be located more quickly and treated more precisely. It is also possible to synchronize the hologram views between different glasses. This allows the operation to be discussed with patients in advance. In addition, other doctors can be remotely consulted for complicated procedures.

  • View through Hololens.

  • Research project at the Institute of Mechatronic Systems at the Leibniz University Hanover. The aim of the project is to optimize the "image-to-physical" registration of bone tissue. Images that were created preoperatively by computer tomography are to be registered together with images that were created intraoperatively by endoscope images. In medicine, image registration is defined as the combined presentation of different images, created by different imaging methods (e.g. computer tomography, ultrasound, endoscopy), in one image. The analysis of the thereby generated multimodal "merged" image provides more information, as more data is recorded by different imaging methods. The critical point of registration is the linking of the often very different images.

  • Optogenetics allows the targeted stimulation of nerve cells of animals by light. The stimulation of nerve cells by light is more precise and immediate than stimulation through electrical impulses or drugs. Optical filters are used to obtain fluorescence images of living cells. Their specific properties allow only certain spectral colors of light to pass through, which can be detected by a photodetector or a camera. On fluorescence images the smallest structures of the cell are visible.

  • Experimental setup for the further development of optogenetic methods. Optogenetics allows the targeted stimulation of nerve cells of animals by light. The stimulation of nerve cells by light is more precise and immediate than stimulation through electrical impulses or drugs. A blue light-emitting diode can be used to illuminate heart cells, that have previously been made sensitive to light, in a Petri dish. When the manipulated heart cells are illuminated with blue light, they contract in response.

  • Acoustically dead room. This is used to simulate certain sound situations in order to advance research related to the auditory system.

  • Cochlear implant. This device enables deaf people to hear again. It consists of an external and an internal implanted part. The external part detects sounds and converts them into digital signals which are then transmitted to the internal part. The auditory nerve is then stimulated via electrodes so that patients can perceive corresponding sounds again. In Germany more than 30,000 people now wear such an implant.

  • Patient wearing a cochlear implant.

  • Operating table for small animals. These are implanted with small devices to make their hearing more resistant to noise. Afterwards it is tested whether their hearing actually behaves differently than in animals that have not undergone the operation.

  • Rat with implanted optical cochlear implant (oCI). In contrast to the electrical cochlear implant (eCI), which has been used in medical practice for decades, the auditory nerves in the optical cochlear implant are not stimulated by electrical impulses but by light signals. Since the cochlea is naturally filled with a fluid, auditory nerves can be stimulated much more precisely by light than by electrical impulses. However, human cells do not normally respond to light, so optogenetic methods are currently being used to find ways of making them light-active. It is expected that human clinical trials can be conducted for the optical cochlear implant from 2025.

  • The M6 Cyberknife system combines precision robotics, image localization system and breath compensation to treat tumors. It therefore offers a special form of radiotherapy for the treatment of tumors. Radiosurgical treatment can be used for tumors that, for example, have clear boundaries and do not exceed a certain size. If these criteria are met, Cyberknife technology, which is very gentle for patients, can be used as an alternative to surgical operations or radiation therapies lasting several weeks. The treatment is non-invasive, does not cause any pain and only takes between 20 and 60 minutes. The integrated image localization system detects minimal movements of the patient during radiation and adjusts the positioning of the robotic arm. In this way, movements of the tumor, caused for example by breathing, can be compensated for.

  • Bio X Bio 3D printer produced by Cellink. The printer can print with organic three-dimensional forms, such as organs. So far the organs are not implantable, because scientists are not able to print a functional blood vessel system. Also at the moment the process of printing takes too long, so that cells die while printing.

  • Dynamic Arm, a prosthetic upper arm developed by Otto Bock. The prosthesis, which is powered by an electric motor, is connected by electrodes to the intact muscles at the amputation site and can thus be controlled by nerve signals from the patient. The hand prosthesis can also be changed. The hand prosthesis VINCENTevolution 3 from Vincent Systems is shown here. With 6 integrated motors, each finger can be moved independently.

  • Hand prosthesis made of silicone developed by Otto Bock. This prosthesis serves as a replacement for finger and partial hand amputations. The prostheses are custom-made and realistically replicate missing limbs.