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 The hand-held device, called Chimaera, could revolutionize the
delivery of miniaturized neurostimulators to specific nerves, and
give many more patients access to pioneering new pain management
technology.
Different regions of the brain are known to be linked to areas of
perception, such as pain. Neurostimulation involves applying an
electric impulses to nerves to alter brain activity in a specific
area.
"Pain is simply a series of electrical signals as transmitted
through the nervous system, whether that's pain from a broken leg or
pain from a headache. So by putting an electrical signal directly
into target nerves - in a known way, you need to understand the
waveforms to put into that nerve - you're able to lessen, override
or deliver particular signals which influences how your brain is
experiencing things," explained Simon Karger from technology
developers Cambridge Consultants.
The main challenge with neurostimulation procedures is safely
accessing the correct nerve - which might be deep in the face or
behind an eye-socket - and implanting the device without
complications for the patient.
Chimaera is designed to make implanting neuromodulators to nerves
much easier by integrating surgical, sensing and implant delivery
functions in one intelligent device. It uses preoperative CT
(computerized tomography) scan data to create a 3D X-ray image of
the patient, enabling surgeons to identify critical structures, such
as nerves and blood vessels. This combines with the intraoperative
data from Chimaera's sensing technology to guide the surgeon to the
precise location of a procedure, helping to ensure the surgical
device stays on a predetermined safe pathway.
The real-time data generation is designed to be used in conjunction
with optical wearable technology, such as Google glass. This means a
surgeon can literally 'see' exactly where they are within the body
at any point during an operation. Once the target nerve has been
reached the sensors also let the surgeon know, and the implant can
then be deployed down the device.
Karger said their aim was to figure out how neuromodulators -
measuring less than a centimeter in length - could be implanted as
simply and quickly as possible. Chimaera, he said, could allow
doctors around the world perform a procedure that can currently only
be carried out by a handful of people.
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"With Chimaera, what we've done is we've combined smart sensing
technology, pre-operative planning, we've taken small implant
form-factors; and we've combined both implant delivery with surgical
tool to provide a completely connected, unified surgical system that
has the potential to take a surgery that maybe only four or five
people in the world can carry out today and make it accessible to a
broad cross-section of general surgeons. By doing that we make it
accessible to a much, much broader patient population," he said.
The developers said that while most of today's surgical tools are
largely passive, offering surgeons little feedback, Chimaera opens
the door to a new generation of neurostimulation implant procedures.
It could, they say, enable more surgeons to carry out complex
operations at lower risk and with better results for patients.
While it may be some time before a device like Chimaera is in
surgeons' hands, Karger said it could pave the way for wireless pain
management for patients using, for example, their mobile phone:
"Imagine a migraine sufferer who literally as they feel the onset of
their migraine, can reach for their cell phone and dial-down the
pain. That is a life-changing therapy for that patient. And
crucially what it does is it changes that patient from a patient
into a consumer; they don't need to feel like a patient anymore."
Developers Cambridge Consultants say Chimaera is the equivalent of a
'concept car' that demonstrates their vision for the next generation
of surgery. They say that all of the technologies that are used in
Chimaera currently exist, and they are now looking for partners to
lead a product development cycle to turn it into a medical device
ready for market.
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