Company to develop lung surgery technique using imaging, AR

A technique that uses real-time imaging combined with augmented reality to remove early stage lung tumors and other lesions has taken another step closer to broader use.

Navigation Sciences, a Brookline, Mass.-based company, is licensing rights to develop for commercialization the combined use of technologies, having received exclusive rights from Brigham and Women’s Hospital to further develop the approach.

The technology, called image guided video-assisted thoracoscopic surgery (iVATS), is intended to provide real-time navigation to precisely locate and excise tumors. Navigation Sciences and Brigham and Women’s executives say the approach has shown potential to improve surgical outcomes, increase operating room efficiency and surgical precision.

iVATS uses an active fiducial marker for localizing the tumor, along with augmented reality software to enable real-time, enhanced visualization and guidance and an integrated surgical cutting device. The technology is used in conjunction with a multi-modal, minimally invasive procedure that includes imaging and a proprietary navigation algorithm for placement of fiducials, as well as tracking of the surgical tools and site in real time to precisely obtain an adequate margin.

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The use of the approach is believed to be beneficial for patients who have early indications of tumors or soft-tissue lesions. If diseases can be treated early in their progressions, the chances for survival increase significantly; however, it’s difficult for surgeons to perform these procedures non-invasively and in a way that ensures that all problematic tissue is removed, as well as ensuring that appropriate margins of healthy tissue around diseased cells are excised.

That’s where iVATS technology is intended to help clinicians, says Alan Lucas, co-founder and CEO of Navigation Sciences.

“iVATS technology is designed (to achieve) the precise localization and removal of lesions with optimal surgical margins, while preserving lung function and sparing unaffected tissue,” Lucas says. “Current approaches in lung cancer surgery either remove a small section around the tumor, preserving lung function, but increasing recurrence risk, or an entire lobe, which lowers recurrence risk at the expense of diminished lung function.”

More effective screening techniques are enabling clinicians to identify diseased lung tissue earlier. There are more than 450,000 soft tissue surgeries per year in the U.S., including lung, breast, liver, thyroid and brain, for which minimally invasive, image-guided surgery has potential to provide significant benefit to patients.

With lung cancer, for example, the number of early stage patient diagnoses is expected to increase because of early screening; but insufficient distance between the tumor and the margin of the resection has been shown over time to be associated with recurrence and death. In breast cancer, lack of precision in localizing tumors and excision with appropriate surgical margins, is a significant contributor to repeat surgeries in the approximately 25 percent of women who undergo lumpectomies.

The iVATS technology was first profiled in 2015 in a test by its creators, Raphael Bueno, MD, chief of thoracic surgery at Brigham and Women’s Hospital and Professor of Surgery at Harvard Medical School, and Jayender Jagadeesan, PhD, research assistant at the hospital assistant professor of radiology at Harvard Medical School. Their clinical trial with 23 cancer positive patients found no significant complications from surgeries, and all nodules were fully resected with negative margins. The study also demonstrated the technology integrates with surgical workflow.

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