Andrew N. Goldberg, MD, MSCE
Professor and Director, Division of Rhinology and Sinus Surgery
Department of Otolaryngology – Head and Neck Surgery, University of California, San Francisco
The first line in a recent article published in News-Medical.net (“Infection Control by Sterilizing Medical Connectors & Equipment”) says it all:
“The importance of sterilizing medical connectors and equipment is impossible to overstate.”
The article makes clear the potential for infection: 48 million surgical procedures performed in the United States in 2009 translating to hundreds of millions of opportunities for patient infection: https://www.news-medical.net/whitepaper/20181005/Infection-Control-by-Sterilizing-Medical-Connectors-Equipment.aspx
I am always on the lookout for new technologies…specifically new technologies that can have an impact on my practice and the practice of others. And I found one in Silicon Valley that addresses part of the medical device market that few of us pay attention to – the connector.
Where the Connector is Challenged – High-bandwidth Video Streaming
With the advent of endoscopic and laparoscopic surgery, and continuous advancements in imaging technology, surgeons have never had more valuable tools at their fingertips. But like any computing system, image-guided surgical treatments rely upon the integrity of the connection – in this case, the visual image transmitted from inside the patient to the central console. The requirements are stringent: high-resolution, next-to-zero latency, signal integrity, and most importantly, reliability of the connection. And connectivity is only going to become even more challenged, as Google/Johnson & Johnson’s new joint venture, Verb Surgical, works on what it is calling its digital surgery program, generally understood to be looking at combining advanced imaging, instrumentation and robotics, with AI, machine learning, and advancements in connectivity.
It’s the Little Things that Count – the Lowly Connector
But in this whirlwind of technical advancements, we sometimes forget how critical some of the simplest components are. Take the connector – that fundamental and mechanical structure that connects two devices together with the sole purpose of transmitting data from source to destination. In the case of robotic surgery, that data is not only mission critical, but it is also transmitting higher and higher bandwidth as camera and sensor technology continue to advance. Without that connection, we have no image, and without an image, we have no robotic surgery.
Yet connectors in robotic surgery still rely upon age-old technology, mechanical constructs that mate metal with metal, to form a connection. Certainly, medical device connectors are housed in medical-grade plastics and engineered specifically for medical environments, but even so, the fundamental connector design is one that hasn’t changed in decades.
Standard medical device connectors are typically housed
in medical-specific plastic, but rely upon traditional metal-to-metal
contact for connectivity – an mechanical structure that is
challenged on multiple fronts in medical applications
Sterilization of Medical Connectors Has Become a Liability
Similar to any other industry, technical requirements for medical device connectors have increased, while the overall size of the connector continues to decrease. This puts pressure on connector manufacturers to engineer a sustainable and reliable solution that can withstand the intense sterilization requirements of any hospital device. But connector design is coming to a breaking point. Metal pins are not capable of transmitting high-bandwidth signals, and connectors designed for high-bandwidth are fragile and cannot withstand the high-temperature and pressure of standard autoclaving. Of course, there are alternatives to sterilizing connectors – CIDEX for example. But even so, caustic cleansers such as CIDEX can easily damage the high-bandwidth-capable connectors. And special chemical sterilization takes time and expertise.
Contactless Connectivity – Revolutionizing the Connector
Like every facet of technology, there are those who are rethinking the basics. California-based Keyssa has spent years of R&D to reinvent the connector…and what they have developed has clear applications in the OR and ICU. Keyssa has developed a solid-state connector, which means that a semiconductor, embedded in one device behind plastic or some other material, connects automatically with a companion device, also embedded behind material, when you bring these two devices together. No plugs…no receptacles…no crevices where infectious agents can thrive, no mechanical connection that can wear and tear over time leading to fatigue….and failure.
Keyssa’s solid-state connector is 3mm x 3mm, capable of
6 Gigabits per second (HD Video) and can be embedded
behind any type of plastic
I Know I’m Just Scratching the Surface
When I first saw Keyssa technology, I instantly thought of the intersection of high-resolution and robotic surgery. After all, each Keyssa semiconductor is capable of 6 gigabits per second, which alone is enough for high-definition video transmission. I thought of the reliability and time savings in sterilizing connectors. I encourage my colleagues in the medical device industry to take a look at Keyssa and think about the myriad of ways this advanced tech might improve device functionality.…in the ICU?…MRIs where metal is a huge issue? I’m sure there are a wide range of use cases for the technology in medical devices.
Keyssa has reinvented the way we think about device-to-device connectivity, and in so doing, has allowed manufacturers to rethink the way devices are designed.
About Andrew Goldberg:
Andrew N. Goldberg, MD, MSCE, is Vice Chairman and the Roger Boles, MD Endowed Chair in Otolaryngology Education in the Department of Otolaryngology – Head and Neck Surgery (OHNS) at the University of California, San Francisco. He is the Director of the Division of Rhinology and Sinus Surgery and specializes in endoscopic surgery of the sinuses and relates structures, minimally invasive skull base surgery, and surgery for snoring and sleep apnea. He received his medical degree from Boston University, and completed an internship in general surgery at the Los Angeles County-Harbor/UCLA Medical Center. Dr. Goldberg completed his residency at the University of Pittsburgh, School of Medicine Eye and Ear Hospital, followed by a fellowship in Clinical Epidemiology of Cancer from the National Cancer Institute, through the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania. He also completed a Master’s Degree in Clinical Epidemiology at the University of Pennsylvania.
Dr. Goldberg consults with a number of small technology-focused companies whose technology intersects with the medical industry. Dr. Goldberg is an Advisor to Keyssa.
Below are links to more information on the topic of medical connectors:
- Infection Control by Sterilizing Medical Connectors & Equipment
- Connectors in Medical Robotics (2015 article but provides a list of market leaders)
- What Does the Future Hold for Robotic Surgery? (recent article – September 2018)
- Cable Assemblies in the Operating Room (important only because identifies market analyst at Bishop & Associates)
Articles on the resolution/importance of video to surgery (these are case studies)
- Robotic Surgery Center Creates Broadcast Quality Video with Extron Matrix Switching and Fiber Technology (Extron is a leader in A/V switching technology – this is more of a case study but highlights the importance of HD quality images)
- SurgTrak: Affordable Motion Tracking & Video Capture for the Da Vinci Surgical Robot (another case study)