Medical Innovations for 2013: WLS Leads the List!

November 9, 2012

The Top 10 Medical Innovations for 2013:  WLS Leads the List!

After more than 110 Cleveland Clinic experts nominated 150 emerging technologies to compete for the top 10 breakthrough device and therapy innovations for 2013, the top 10 list has been revealed and weight loss surgery is in the forefront.  The list includes medical applications for mobile devices and advanced data technologies that will have an important impact on improving the care of patients in this next year.  The list was selected by a panel of Cleveland Clinic physicians and scientists who were asked, “What innovations are “game changers” in your field?” The nominated innovations were required to meet the following criteria:

* The innovation must have a significant clinical impact and offer significant patient benefit as well as high user-related functionality that improves health care delivery.
* Innovations must have a high probability of success.
* The innovation must be on the market sometime in 2013.
* The innovation must have significant human interest in its application or benefits, and must have the ability to visualize human impact.

The Top 10 Medical Innovations for 2013 are:

1. Bariatric Surgery for Control of Diabetes

Instead of as a last resort, diabetes experts now believe that weight-loss surgery should be offered much earlier as a treatment option for patients with poorly controlled diabetes.  A recent study published in the New England Journal of Medicine revealed that not only does weight loss surgery help many to lower their blood pressure and cholesterol, patients who had the surgery were more likely to be free of diabetes or have reduced their dependence on diabetes medications. Could weight loss surgery be a cure for Type 2 diabetes? Time will tell!

2. Neuromodulation Device for Cluster and Migraine Headaches

Over 50 million people suffer from headaches severe enough for them to need to consult a doctor.  The most painful of headaches are cluster headaches, which affect about three of every thousand adults in the United States.  Cluster headaches are almost always only on one side of the head and come without warning often lasting for days. weeks, and even months.  There is no known cause or effective treatment for this type of headache.

According to the National Headache Foundation, migraine headaches affect approximately 28 million adults in the United States and cause debilitating pain that can last for hours or days.

Behind the bridge of the nose, we have a nerve bundle called the sphenopalatine ganglion (SPG).  Over the years, the SPG bundle has been a target for the relief of severe headaches and medical experts have found that applying lidocaine and other medications offers a temporary relief.  But now, American researchers have invented a patient-controlled stimulator for the SPG nerve bundle. The neurostimulator, which is implantable and the size of an almond, is placed through a minimally invasive surgical incision in the upper gum above the second molar, where it is held in place. The implant has a lead tip that is placed at the SPG nerve bundle on the side of the face where headache pain is usually experienced by the patient. When a patient feels a headache coming on, a remote control device is placed on the cheek and it delivers an on-demand stimulation to the SPG, blocking the headache pain in about five to ten minutes.

Currently, Neuromodulation Therapy is available in Europe and is proving to have excellent results with pain relief in about 68 % of patients.  At this time, the FDA has granted investigational use of the neurostimulation system for cluster headaches for use in the United States.

3. Mass Spectrometry for Bacterial Identification

Even with advanced medical technology, the identification of bacteria growing in cultures can still take days or weeks.   A technique called matrix assisted laser desorption/ionization, or MALDI,  developed in 2002, improved mass spectrometry to make growing and testing bacteria more rapid.  Now, with MALDI -TOF (time of flight) clinical microbiology laboratories worldwide are implementing new mass spectrometry technology which provides rapid organism identification that happens to be more accurate and less expensive than current biochemical methods.  Rapid organism identification is an important technique because it allows clinicians to prescribe the most appropriate treatment sooner by identifying bacteria in minutes which is a major advance in treating infections.

4. Drugs for Advanced Prostate Cancer

Prostate cancer is the second leading cause of death in men.  Currently, the withdrawal of androgens such as testosterone is the standard of care for metastatic prostate cancer. Although this androgen deprivation therapy, or ADT, can result in long-term remissions of metastatic prostate cancer, the cancer soon becomes resistant to this therapy and continues to advance.  For 2013, new medications are showing that innovative approaches to treatment can be successful in halting the progress of prostate cancer.  Five new drugs have been approved for advanced prostate cancer in the past two years: sipuleucel-T, denosumab, abiraterone, cabazitaxel, and enzalutamide. A sixth, radium-223 dichloride, is expected to be approved later this year.  Prostate cancer researchers believe that these drugs, and others coming, will eventually help make advanced prostate cancer a chronic disease that's successfully managed with a routine of daily medication,  and lifestyle changes.

5. Hand-held Optical Scan for Melanoma

As the most common cancer in the United States, skin cancer affects millions each year. One in five Americans will develop this cancer in their lifetime.  The annual costs for treating skin cancer in the United States is over $3 billion.  Now there is a new FDA-approved handheld office device for dermatologists that can help in the identification of skin lesions that have characteristics of melanoma.  The device uses imaging technology created by the military for guided missile navigation and is placed on the skin over the suspect lesion. Lights of 10 specific wavelengths are shined on the skin, and the computerized system quickly visualizes the micro-vessel structure of the lesion just below the skin's surface. The device then uses sophisticated step-by-step caclulations that objectively analyze the lesion.  In a clinical trial of 1,300 patients the device detected 98% of the melanomas.

6. Femtosecond Laser Cataract Surgery

Approximately 75% of people over age 60 have some sign of cataracts which results in the cloudiness of lenses in the eye.  Cataract removal surgery,  which is done freehand with a surgical blade, helps to improve vision in more than 95% of cases if the eye is normal except for the cataract.  Now, cataract surgery has been improved with the introduction of femtosecond laser technology, a device already being used successfully in ophthalmology, particularly for LASIK surgery.

The femtosecond laser, which pulses one quadrillionth of a second, is a FDA-approved bladeless cataract procedure and is revolutionizing surgery by allowing surgeons to make smaller, more precise incisions. It also requires less energy time inside the eye, causes less inflammation, and offers more stability when implanting a new lens.

7. Ex Vivo Lung Perfusion

According to the Cleveland Clinic report, almost 400,000 Americans die of lung diseases every year, and over 35 million are living with chronic lung disease.  Technological advances are allowing for successful lung transplants but unfortunately, donor lung shortages are a limiting factor in the number of lung transplants that can be performed each year.   Due to the lung's vulnerability to complications that arise before and after donor brain deaths,  lungs are currently harvested from only 15 percent of donors.

But help is in our midst!  Experts believe that a new approach called ex vivo, an outside the body "lung washing," will allow up to 40 percent of previously rejected donor lungs to now be suitable for transplantation.  This new pioneering procedure has already resulted in many successful lung transplants.

8. Modular Devices for Treating Complex Aneurysms

Aortic aneurysms are the 13th leading cause of death in the United States, with over 15,000 fatalities each year.  As many as 20 to 40% of people with aortic aneurysms are not suitable for the grafts that are currently marketed and they are not candidates for the more demanding open surgical repair procedure.   However, a new fenestrated stent graft system recently approved for trials in the U.S. is allowing surgeons to now treat patients with these more complex aneurysms.  The new modular device helps to offer a significant reduction in morbidity and ICU stay and is life-saving for previously untreated high-risk patients.

9.  Digital Breast Tomosynthesis (DBT)

Second only to lung cancer, breast cancer takes countless lives each year.  Due to increased mammogram screenings and technological advances, the breast cancer death rates have actually declined by 20% in the last decade.  However the mammogram has limitations because it relies on a two-dimensional x-ray image and the female breast is three-dimensional.  Approved by the FDA in 2011, now breast tomosynthesisor 3D mammography can be performed along with the conventional mammogram to provide a more accurate view of the breast.  3D mammography also reduces the need for repeated additional testing following a routine exam.

 -Photo courtesy of RDECom 

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