In the first publication of this Value-Based Robotics series, we have analyzed several factors that constitute barriers to establishing Value-Based Robotics as a reality. One of them was that there is insufficient evidence on clinical benefits to justify an investment on robotics.
The PEMSERTER® MICRO-MATE® hand tool is a versatile hand tool weighing only 1.25 kg / 2 3/4 lbs. That can develop a squeezing force of 1,134 kg / 2,500 lbs. The kit contains one hand tool, one flat punch, seven punches and dies, one punch adapter bushing, one edge-depth guide, five fastener anvils and a. RESCUE® MicroMate has two zippered main compartments, two zippered belt pockets and a velcro flap that covers the front compartment. Complete with Glo-Flex material and zipper pull tabs. Specifications: Dimensions: 7'L x 3.5'W x 4'H; Fits up to a 48' waist. MiraMate Mini Magic – Portable Design And Easy to Use. MiraMate Mini Magic is a new portable PEMF device designed to reduce acute pain, injuries and discomfort anywhere, anytime. The Micromate ™ has redefined industry standards for functionality and ease of use. Micromate provides reliable regulatory compliance monitoring with an ISEE or DIN Triaxial Geophone and ISEE Linear Microphone. Small enough to fit in your hand, Micromate is the first monitor in the industry to provide a touch screen interface.
Interventional Systems tackles this challenge by offering a miniature robot with all the key features that make it the perfect smart assistant for image-guided surgeries, Micromate™, while at the same time decreasing the need for high initial and running costs (but that is for another blog post).
These are key points in our goal to make medical robotics the standard of care instead of the exception. Something that seems impossible, until it is not.
Better clinical outcomes
We are in the cusp of the minimally invasive surgery era, where higher accuracies and faster recovery times allow for less time spent in inpatient care. High accuracy is crucial in image-guided surgery. Inaccuracies, low diagnostic yield and incorrect initial treatments make for repeated interventions, increasing costs and pose logistic and personal burdens for the clinic and the patient, while subjecting all parties involved to further unnecessary radiation.
When compared to the state-of-the-art:
- More accurate: published studies demonstrate that Micromate™ is 50% more accurate than state-of-the-art techniques1,2,3 (patient-mounted or freehand needle guidance solutions) for percutaneous image-guided procedures, often achieving average accuracies within 1mm along the trajectory and the planned target position. This gives physicians increased confidence that their surgical plan will be successfully executed, especially for procedures that require the placement of multiple (and often perfectly parallel) needles.
- Lower complication rates: an average of around 4% of complication rates on stereotactic surgeries using Micromate™ have been described4,5,6, corresponding to a reduction of complication rates of up to 43%, comparing with the state-of-the-art7.
- As minimal as minimally invasive can be: Micromate™ provides a universal needle-guide set for percutaneous procedures and, fueled by its high accuracy, smaller incisions for stereotactic procedures can be achieved4.
- Lower radiation exposure: a physician’s exposure to radiation can be reduced by virtually up to 100%, as Micromate™ can be remotely controlled from outside the intervention room under live imaging. As for the patient, a radiation decrease of up to 84% has been documented, mostly due to the faster alignment speed, when compared to free-hand alignment techniques2,8.
A truly enabling technology
Clinical evidence shows Micromate’s irrefutable advantages in terms of accuracy, invasiveness and radiation exposure.
But patient-centric care also requires physicians to resort to three other dimensions of their skillset: technical skills (to align instruments to the surgical plan and maintain that alignment), and intellectual and clinical skills (to treat the patient and make intra-operative decisions that may impact the therapy).
We have designed Micromate™ to take over the technical skills, by performing highly accurate movements and maintaining a working channel for instrument insertion and guidance.
Due to its small form, Micromate™ fits inside the gantry or between a patient and the C-arm detector, which allows the alignment to be executed under live imaging. Potential deviations are corrected live and immediately.
This frees physicians to focus on do what they do best: treat the patient. This means not only defining the surgical plan, evaluating its condition and looking out for complications, but especially manually delivering the instrument.
Despite autonomous instrument insertion being a very recent trend for percutaneous procedures, physicians still rely on the haptic feedback while delivering instruments. It is even possible to differentiate between different tissues during instrument insertion, based on the tissue’s resistance – for example, this is used to detect when a biopsy needle enters a tumor.
Micromate™’s disposable needle guides have been designed to hold instruments with a user-adjustable gripping force, allowing to find an optimal compromise between play-free guidance while keeping the much-needed haptic feeling.
Finally, the instrument can be inserted under live imaging as well, which brings additional, real-time information to help physicians deliver the instruments to the desired target location.
Micromate™ is not meant to replace the physician, it’s meant to enable their skills while providing assistance (as a stable third hand) on the most difficult step of the workflow, without requiring significant adaptations.
Sources:
[1] Dorfer, C., Minchev, G., Czech, T., Stefanits, H., Feucht, M., Pataraia, E., … & Wolfsberger, S. (2017). A novel miniature robotic device for frameless implantation of depth electrodes in refractory epilepsy. Journal of neurosurgery, 126(5), 1622-1628.
Micromaterials Inc
[2] Workflow for CT-guided robot assisted needle placement, Gernot Kronreif, Martin Kornfeld, Martin Fürst, Wolfgang Ptacek, Michael Vogele [@Hamlyn Symposium]
[3] Czerny, C., Eichler, K., Croissant, Y., Schulz, B., Kronreif, G., Schmidt, R., … & Zangos, S. (2015). Combining C-arm CT with a new remote operated positioning and guidance system for guidance of minimally invasive spine interventions. Journal of NeuroInterventional Surgery, 7(4), 303-308.
[4] Minchev, G., Kronreif, G., Ptacek, W., Dorfer, C., Micko, A., Maschke, S., … & Wolfsberger, S. (2019). A novel robot-guided minimally invasive technique for brain tumor biopsies. Journal of Neurosurgery, 132(1), 150-158.
[5] Legnani, F. G., Franzini, A., Mattei, L., Saladino, A., Casali, C., Prada, F., … & Wolfsberger, S. (2019). Image-Guided Biopsy of Intracranial Lesions with a Small Robotic Device (iSYS1): A Prospective, Exploratory Pilot Study. Operative Neurosurgery, 17(4), 403-412.
[6] Minchev, G., Kronreif, G., Martínez-Moreno, M., Dorfer, C., Micko, A., Mert, A., … & Wolfsberger, S. (2017). A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot. Journal of neurosurgery, 126(3), 985-996.
[7] Formenko A, Serletis D. Robotic stereotaxy in cranial neurosurgery: a qualitative systematic review. Neurosurgery. 2018;83(4):642-650.
Micromate
[8] Kroes, M. W., Busser, W. M., Fütterer, J. J., Arntz, M. J., Janssen, C. M., Hoogeveen, Y. L., … & Kool, L. J. S. (2013). Assessment of needle guidance devices for their potential to reduce fluoroscopy time and operator hand dose during C-Arm Cone-Beam computed tomography–guided needle interventions. Journal of Vascular and Interventional Radiology, 24(6), 901-906.
Overview
Micrometer To Meter
Micromate Reader
Key Features
- USB 2.0 with Host and Device support
- USB support for memory sticks, and Instantel compatible field printer, modem and GPS devices,
- Large, high resolution, color graphics touch screen. Easy to read and navigate menu structure
- Context Sensitive Icons: Icons are only shown if they are relevant to what you are doing
- Short Cut Icons: Fast, one touch access to the most commonly used features
- Context Sensitive Help at your fingertips
- Integrated Keypad: Large 10-key interface with dedicated function keys
- Supports Instantel’s Auto Call Home for remote automated data reporting/transmission
- Monitor Scheduler: Assign different setup files, scheduled self checks, scheduled Auto Call Home times and when to start and stop monitoring
- Small enough to be hand-held
- Rugged and reliable: Field rugged and durable design with a fully sealed top panel, non–corrosive connectors, and sealed electronics to enhance water resistance
- Optional protective boot and faceplate
- Storage capacity for 1,000 events (additional capacity optional)
- Optional printer for immediate infield printing of reports
- 10 day battery life (standard), 15 days (optional)
DATA SHEET
Micromate Limited
View PDF Datasheet below. Some browsers do not support this function, you can Download Here.