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New device could help evade nerve damage during surgery

por John R. Fischer, Senior Reporter | August 23, 2017
Operating Room
Collimated Polarized Light imaging (CPLi)
A new, noninvasive technique could reduce the risk of nerve damage during surgery.

Researchers at the University of Amsterdam’s Academic Medical Center are studying the use of Collimated Polarized Light imaging (CPLi) to emit polarized light on nerves, which allows doctors to identify and avoid damaging them during operations, or identify if any require repairs. The findings were published in The Optical Society journal, Biomedical Optics Express.

CPLi uses a polarized beam of light that is passed over a nerve. The nerve’s unique internal structure then reflects the light in a way that is based on how the nerve fiber is oriented, compared to the orientation of the polarization of light. As the light’s polarization is rotated, the reflection appears and disappears, thus allowing the nerve to be noticed among other forms of tissue.

The collimation of the light makes the light waves parallel to one another, thereby enhancing the amount of light that the tissue reflects.

“If there is a reasonable, low cost [way] to get it in the system, and it is hands-free or no manipulation required by the surgeon, and most importantly, if it increases the probability of success (and reduces the risk of litigation), then it would likely be embraced by the medical community,” a team of scientists at The Optical Society told HCB News.

Current methods to identify nerves are limited because they do not provide real-time information, require a physical interaction with the nerve or require the administration of a fluorescent dye. CPLi allows physicians to surpass these limits and could possibly reduce risks in surgeries involving the hands and wrists which are made up of dense networks of nerves.

The technique was developed by cousins, Kenneth and Patrick Chin. Researchers at the AMC tested it on animal tissue before using it to examine 13 tissue sites in the hand of a human corpse. One surgeon used a standard form of surgical lighting to examine the hand while another used CPLi. The one using the standard correctly identified 10 nerve tissues in 13 of the cases, compared to the one using CPLi who identified nerve tissue in each case accurately.

The researchers were also successful in using the technique to identify nerve tissue during an operation to relieve wrist pain. They plan to test it during live surgeries to determine if and how optical reflection of the nerves varies among patients and under diverse conditions of surgeries.

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