Electronic Drilling System Keeps Orthopedic Procedures on Target

Orthopedic procedures require accurate positioning of a thin metallic wire to guide the positioning of a fixating screw, often the surgical procedure is hampered.

Hip fracture fixation is performed on 258,000 patients; spinal fusion accounts for 350,000 persons every year in the United States alone. As the population ages, the number of these surgical procedures will continue to grow.

Common orthopedic procedures, such as hip and pelvic fracture surgery as well as spinal fusion, require the accurate positioning of a thin metallic wire to guide the positioning of a fixating screw. However, the surgical procedure is often hampered by deflection, bending and even breakage of the guide-wire, which then requires repair while complicating and prolonging the recovery of patients.

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‘BendGuide, an opto-electronic drilling system, monitors and detects minute changes in guide-wire trajectory during an orthopedic surgery.’

"This is a significant challenge", said Prof. Meir Liebergall, head of the Department of Orthopedic Surgery at Hadassah Medical Center, "as complications in guide-wire positioning could lead to revision surgeries and increase hospitalization time and cost."

To address this challenge, Prof. Liebergall partnered with a multidisciplinary team of medical doctors, along with engineering and business students, from The Hebrew University's BioDesign: Medical Innovation program. They identified a solution: by creating a system that provides real-time indication of deflection or bending of the guide-wire, the surgeon will be able to adjust the procedure before damage occurs.

The team developed BendGuide, an opto-electronic drilling system that monitors and detects minute changes in guide-wire trajectory during surgery. It allows surgeons to correct drilling trajectories during the procedure itself. The system eliminates guide-wire bending or breakage and significantly reduces operation time and enhances safety.

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"This is an elegant technological solution to a complex problem," said Prof. Yaakov Nahmias, director of The Hebrew University's Alexander Grass Center for Bioengineering and the BioDesign program. "The group model and proof-of-concept experiments showed they could detect even miniscule changes in guide-wire trajectory."

BendGuide uses a fiber bundle with a reflecting laser beam that enables detection of small deflections in wire trajectory. At a fully-aligned state, the beam power hits the center of the detector array. When deflected, mirror misalignment causes the power to spread differentially across the fiber bundle.

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The market for computer-aided navigation systems for surgery is growing fast. The potential market is estimated at $500 million annually in the United States alone. BendGuide aims to become an integral part of this market, which is expected to grow further with the aging population.

The interdisciplinary team which developed BendGuide included Prof. Giora Weisz, M.D., Chairman of the cardiology department at Shaare Zedek Medical Center in Jerusalem; Hadar Shor, an MBA student at the Hebrew University's Jerusalem School of Business Administration and a fund manager for Israel's Ministry of Economics; and Kuti Uliel and Michal Zimerman, graduate students at the Alexander Grass Center for Bioengineering.

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BioDesign: Medical Innovation is a multi-disciplinary, team-based approach to medical innovation, created by the Hebrew University of Jerusalem and its affiliated Hadassah Medical Center. Sponsored by Boston Scientific and the Terumo Medical Corporation, the program takes outstanding medical fellows, bioengineering and business graduate students, and tutors them in the science and practice of bringing a medical innovation to the market.

The program is directed by Prof. Yaakov Nahmias, director of the Alexander Grass Center for Bioengineering at the Hebrew University of Jerusalem, and Prof. Chaim Lotan, director of the Heart Institute at Hadassah Medical Center.

The innovations produced by the Biodesign program participants are commercialized by Yissum, the technology transfer company of the Hebrew University of Jerusalem, and Hadasit, the technology transfer company of the Hadassah Medical Center.

Source-Eurekalert