Medical Device Daily Executive Editor

Society of Thoracic Surgery Annual Meeting

FORT LAUDERDALE, Florida — Roaming the exhibit floor during the annual meeting and exhibition of the Society of Thoracic Surgery (Chicago), held last week, isn't exactly a soothing walk in the park.

About every fourth booth or exhibit features a video of something rather traumatic: one showing what looks like various slices of sushi being pulled together with wires and metal prongs poking around (a valve surgery); another of a huge gash through a thick layer of adipose and bone, the bone cut and spread (a sternotomy, preparatory to a CABG procedure); over there, just a picture of something reddish, variegated and pulsating hopefully, a portion of heart. And some of these are even offered up in 3-D.

This, of course, is what thoracic surgeons do working with the bone, fat, muscles and vessels of the chest, doing the unbelievable (and a tad stomach-churnning to someone who just writes about these procedures).

Sprinkled amongst the videos are booths displaying the tools of the trade, and looking a bit like instruments of torture.

But explained and demonstrated by the exhibitors, such instruments make sense of all this, turning the torturous less so (or, sometimes, more-so).

Exhibiting one of these is Stephen Blinn, executive VP of Suturtec (North Chelmsford, Massachusetts), who says, with assurance, "We're the only new thing here."

He brandishes an instrument, holding it, and looking a bit, like a badminton racquet handle, spouting from it a probe with a semi-circular sort of thing at the end.

He first runs for Medical Device Daily the company's video to show what is difficult to do without this instrument a cracked sternum, via sternotomy, with the surgeon having finished the procedure and then closing the sternum.

In the video, a surgeon punches holes in each side of the sternum bones in order to place suture wires, the wires then used to pull the sternum bones back together.

The considerable effort to do just two of these hole-punching-and-threading procedures takes more than a minute. To do the necessary series of these would take, say, at least 10 minutes.

Blinn then turns to a model of a cracked sternum, using the Suturtec instrument to punch the holes and pluck the threads through in, what? maybe just four or five seconds each.

The company received FDA clearance for the device a couple of years ago, along with a variety of other quick-suturing products, and it is introducing the first in a proposed larger family at the STS meeting, targeting cardio as the most profitable application.

Blinn said the STS event was good for the company. "We've had 130 leads," he said, during just the first day of the exhibit.

After the cracked sternum is put back together and the patient sewn up, follow-on rehabilitation may be the really difficult part for the patient if he or she has to do something simple, say, like coughing or the basic follow-on respiratory therapy. A cough or any other exertion can damage, even open the wound, with frequent potential for infection and other post-operative complications.

The standard (but hardly gold-standard) method for stabilizing the thoracic cage, and healing, has been to provide the patient a pillow or a stuffed toy animal for support during cough or deep breathing.

Improving on this extremely low-tech approach is the Heart Hugger, a sternum support device that was being shown at the meeting by General Cardiac Technology (Los Gatos, California).

Placed harness-like around the upper body, the Heart Hugger features two handgrips over the chest that the patient grasps and squeezes together when coughing or doing anything else requiring exertion. Its purpose is to support the rib cage and maintain incision closure and sternum union, thus avoiding invasion of bacteria while reducing the pain that such simple activities can cause during rehab.

A company representative said that the device is currently in use in some 230 heart hospitals and gets rave reviews from those providing rehab services to these patients.

General Cardiac was also exhibiting its much lower tech device for women who have gone through heart surgery: The Surgi Support Vest —"vest" being a somewhat euphemistic term for what was essentially a large-size halter-top, offering an alternative to a standard bra with a variety of adjustable features. The adjustments enable better fit as post-op dressings are changed and made smaller or simply for larger-breasted women.

On the other side of the hall, one of the higher-tech exhibits provided the MDD reporter with an even closer look at some of the videos he was still trying to get use to.

Viking Systems (Westborough, Massachusetts) was featuring its surgical camera systems. The systems come in a variety of formats, from small cameras placed on the ends of endoscopes for heart procedures, and the company more recently moving into High Definition. The endoscopic views are then placed on monitors giving the necessary sharp close-ups for the surgical team.

Viking's primary offering at STS, however, was a giant step forward in cardiac visualization: 3-D.

The 3-D look at the heart or valves is accomplished by means of a virtual reality-type headset, and an eyepiece of each eye providing the binocular vision needed to produce the third dimension.

The benefit, a Viking representative told MDD, is similar to the comparison between regular TV and HD, the cost of the 3-D system ranging from $60,000 (basic) to $130,000 (complete with bells and whistles).

Nearby, Intuitive (Sunnyvale, California) was offering its own 3-D view of da Vinci system, its product videos being watched by attendees wearing the type of glasses they use to pass out for 3-D movie watching.

Giving a more high-tech approach to a middle-tech concept the water bed was Kimberly Clark (Dallas), exhibiting its surgical back warming system.

The company's representative credited the well-known Bear Hugger as a device for surgical warming, but said that device does not reach the back during a cardio procedure.

Kimberly Clark's device is essentially a pad, thick enough to contain small inner channels that become filled with warm circulating water.