New Technologies: Safer Diagnosis, Enhanced Patient Care

July 01, 2016

Lurie Children’s is a leader in researching and using new technologies to diagnose and treat children safely, bringing 21st-century expertise to enhance clinical care and surgery. From a simple handheld scanner to the most advanced robotic surgery system, patients benefit from the safest and least invasive treatments.

White light replaces radiation

In a creative new twist on existing technology, a handheld scanner—similar to the barcode reader at a store checkout—uses white light instead of radiation to safely and reliably capture the upper body anatomy of children with chest deformities.

The approach piloted by pediatric surgeons at Lurie Children’s, offers a more convenient and less expensive alternative to traditional CT scans to measure and monitor the degree and severity of chest deformities. Preliminary findings from research conducted through the Stanley Manne Children’s Research Institute of Lurie Children’s show that the radiation-free scanner can reliably capture the abnormal chest shape in detailed, 3-D format among children with sunken chest, or pectus excavatum, a common upper body defect occurring in one of 300 to 400 children. The approach allows clinicians to track changes in shape, depth and volume as the child ages or as a result of surgery. The white-light scanning protocol is available to Lurie Children’s patients with chest defects as part of an ongoing clinical trial.

First, do no harm

“As physicians, our first obligation is to do no harm so we sought a new way to reliably and accurately capture the architecture of the chest wall without radiation,” says study lead investigator Marleta Reynolds, MD, Surgeon-in-Chief at Lurie Children’s and the Lydia J. Frederickson Professor in Pediatric Surgery. “Even technology that’s been around for years can be harnessed in novel ways to make the practice of pediatric surgery simpler and safer.”

For patients like high school freshman Alan Bruner, diagnosed with sunken chest at age five, the innovation is welcome. “Alan has had so many tests over the years, as did his older sister, who also has pectus excavatum,” says his mother Jill. “I’m happy to know an alternative that doesn’t involve radiation will soon be available for all the kids who have this condition.”

Complex procedures, tiny incisions

Just as young patients with chest deformities benefit from safer imaging, patients treated by physicians in the Division of Urology can benefit from leading-edge technology provided by the newest robotic surgery system, the daVinci Xi Surgical System. As one of the nation’s highest-volume minimally invasive urological surgery programs, Lurie Children’s is a referral center for the most complex procedures, with almost 500 robotically assisted surgeries completed over the last 10 years. The newest version of the system brought enhancements that allow surgeons to perform highly complex procedures through tiny incisions, resulting in less pain, a lower risk of infection and less scarring.

How it works

The robot-assisted minimally invasive approach allows the surgeon to operate with three or four interactive robotic arms while sitting in a nearby video console with hand controls, like a very sophisticated video game. The system translates the surgeon’s hand movements to the robotic instruments. The instruments can move in a tiny surgical area with more precision and greater range of motion than the human wrist.

One of the robot’s arms holds a camera that is lowered through a small incision and lets the surgeon see inside the body in 3D images. The system provides up to 10X magnification, allowing the surgeon to see small structures more clearly than in open surgery, a real advantage when operating on a six-month-old baby.

“With this new system I can offer minimally invasive surgery to children who might otherwise have had no choice but an open surgery approach,” says  pediatric urologist Emilie Johnson, MD. What does she like best about the new system?

  • “The 3D-HD visualization in the console—the picture is excellent”
  • “It has very slim arms, which allow great freedom of movement even with very small patients“
  • “The 10X magnification”
  • “Everyone in the operating room can see what’s happening on auxiliary screens”

Focus on outcomes data

Responding to the dearth of solid outcomes data for robotic surgery, Dr. Johnson is leading a multi-institution collaborative study that focuses on the technical factors that lead to the best outcomes for robotic ureteral reimplantation, one of the most complex surgeries performed by pediatric urologists.

“There’s surprisingly little consensus on the best way to do procedures,” she notes. “Does Surgeon A use this suture here and that suture there? Does Surgeon B cauterize this way or that way? What are the differences, and can we identify technical choices surgeons are making that are associated with a difference in complications or outcomes?”

Dr. Johnson and her research collaborators want to optimize the technical aspects of robotic surgery to achieve the best possible results. Still, she is the first to say that the reason to choose Lurie Children’s for urologic surgery is that the team provides excellent care regardless of the surgical approach. 

“This is a wonderful tool we can offer to the children we care for and it allows us to perform complex procedures in a minimally invasive way. But if the robot broke, we would still take great care of kids.”

Dr. Johnson’s research is supported by the Children’s Research Fund.

This article originally appeared in the Spring 2016 issue of Heroes magazine.