Making Surgery Smarter and Safer

Winter 2016

Making Surgery Smarter and SaferFor years, Google has been hard at work on a smart car that promises to eliminate human error through technology, stemming both fender benders and deadly accidents without drivers needing to consciously act. It’s high time that surgeons had a similar system, says Jin Kang, the Jacob Suter Jammer Professor of Electrical Engineering and director of the Photonics and Optoelectronics Lab.

Many surgical procedures require extremely precise hand movements, particularly the microsurgeries common in the fields of ophthalmology, neurosurgery, dermatology, and reconstructive surgery. If surgeons make a cut that’s off by just a fraction of a millimeter, consequences for the patient—a severed key blood vessel or nerve, for example—could be disastrous.

That’s why Kang and his colleagues are developing a suite of smart tools to help surgeons achieve the best results without even thinking about it, a project partially funded by hotel magnate Bill Marriott. Marriott credits his retina physician, JHU’s Peter Gehlbach, with saving his eyesight, and he decided to support the researchers’ work after treatment.

The tools, developed in a collaboration between the Whiting School of Engineering, Johns Hopkins’ Department of Neurosurgery and the Wilmer Eye Institute, rely on optical coherence tomography (OCT), a technology akin to ultrasound that uses light instead, creating an incredibly high-resolution image due to light’s ultrahigh frequency. Because OCT probes can be very small, about 100 microns, they can be attached to the tools surgeons commonly use, such as scalpels, forceps, or syringes.

The new smart tools, which include a miniature, high-speed linear motor, can be programmed to automatically guide the tool toward targets of interest—a structure that needs to receive a precise injection for gene therapy, for example—or steer it away from a structure that would be dangerous to disturb. Their system is accurate down to 5 microns, precise enough for even the most delicate procedures.

“By making surgical tools smarter,” says Kang, “we can make surgeries safer for patients.”