A group of researchers from University of Florida (UF) recently demonstrated the feasibility of using Intuitive's da Vinci robot for performing a complex nerve block placement procedure from a remote location. The investigational trial, results for which have been published in Anesthesia & Analgesia's September issue, was performed with a phantom ultrasound.
Although the reality of using the da Vinci for anesthesia procedures is still years away, the implications of such an application could be significant. The excitement mainly surrounds the prospect of using the robot to perform complex anesthesia procedures from a remote location. Teleanesthesia--as it's referred to--may help solve the problem of the shortage of anesthesiologists across the country. An anesthesiologist at a large urban hospital, for example, can administer anesthesia to a patient at a small rural hospital miles away without having to be at the patient's bedside.
U of Florida Indicates Potential Application for Robots in Anesthesia
Following a tumultuous year for radiation therapy and radiology, in which The New York Times and other major news media sources reported on incidents of long-term patient radiation overexposure, California state legislators moved last week to enforce radiation regulations and improve reporting protocol to prevent further overexposures on the state-level.
Last fall, the California Department of Public Health and general public learned that approximately 260 patients at Cedars Sinai Medical Center had been exposed to radiation dosages up to eight times higher than normal while undergoing CT scans across an 18-month period, implicating both scanner operators and vendors. California was particularly hard hit in subsequent national reports on radiation overexposure; other centers in the state, including USC Medical Center; Mad River Community Hospital; Glendale Adventist Medical Center; Providence St. Joseph Medical Center; and Bakersfield Memorial Hospital, among others, were identified as having made similar mistakes.
CA State Legislature Passes Bill to Protect Against CT Radiation Overexposure
Last week CareFusion announced the US commercial launch of its AVAmax Vertebral Balloon, bringing a direct competitor to the kyphoplasty market. Until now, Kyphon products (acquired by Medtronic in 2007) have been the only real player in this fairly lucrative market. Last year, roughly 400,000 surgical procedures were performed worldwide to treat vertebral compression fractures, resulting in a market of over $1 billion.
Similar to vertebroplasty, kyphoplasty treats vertebral compression fractures by injecting bone cement into a patient's collapsed vertebrae. Unlike vertebroplasty, however, kyphoplasty is able to restore vertebral height through the use of a balloon that inflates to raise the collapsed vertebrae. While many are attracted to this value proposition, the added cost of the procedure is often a major concern for hospitals. Kyphoplasty can easily add several thousand dollars of additional cost relative to vertebroplasty. Further challenging the financial picture for these procedures, the vendor market has been extremely limited and provides little downward pressure on prices.
The new product by CareFusion looks to differentiate itself in several ways, not the least of which is price. The company's press release claims the product and its components cost up to '40 percent less than similar kyphoplasty products on the market today.' In addition, CareFusion's balloon integrates into the AVAmax Advanced Vertebral Augmentation System, which has the added flexibility of being able to perform both vertebroplasty and kyphoplasty. Initial reports on the technology have been positive. During it's limited release period, 300 case studies were completed, with eight in ten physicians expressing a strong inclination to switch to AVAmax products.
A new product in this market will clearly be a welcome addition, and with even more in the pipeline, the market for kyphoplasty could be very different in the near future. All the same, it's unlikely that cost will come down to make this financially competitive with vertebroplasty, but as these cases continue to migrate outpatient where a separate (and higher) reimbursement for kyphoplasty is provided, better margins may be in the cards.
New Kyphoplasty Device Introduces Competition to a Single Vendor Market