By Jana Soeldner Danger
City & Shore 20th Anniversary Issue
Medicine has made big strides in the past 20 years – here are three notable examples:
Twenty years ago, cardiac-valve repair and replacement required breaking the sternum, opening the chest and temporarily stopping the heart. In the early 2000s, Dr. Joseph Lamelas, chief of cardiac surgery at the University of Miami Health System, pictured above, pioneered the Miami Method, a minimally invasive technique that requires just a four- or five-centimeter incision between the ribs. He also developed instruments and exposure devices that allow him to work through the tiny incision. “We’re able to apply the technique to many different pathologies of the heart,” he says. “The procedure allows quicker recovery and allows the patient to return to a normal lifestyle much more quickly than conventional surgery.”
Two decades ago, fewer than 50 percent of cancer patients were cured. Today, the cure rate is more than 60 percent, says Dr. Luis Raez, medical director and chief scientific officer, Memorial Cancer Institute, pictured above. “The other 40 percent have significantly prolonged and better quality of life,” he says. Two groups of drugs, immunotherapy and targeted therapy, help some patients. “Twenty years ago, chemotherapy was all we had,” Dr. Raez says. Immunotherapy enhances the patient’s own immune system, so it recognizes cancer cells, goes after them and and kills them. “We release the brakes on the immune system, so it’s free to become stronger,” he says. Targeted therapy is used when gene mutations that cause specific cancers are identified, and medications specific to each gene are found that shut down the gene’s pathway so it cannot reproduce. “We can do oral therapy, with very few side effects,” Dr. Raez says. Another development allows identification of genes through a blood test instead of a biopsy. “It’s very exciting to see progress that can save many more lives and with very good quality of life,” he says.
X-ray vision is no longer science fiction. An augmented reality headset provides virtual X-ray vision to help with spinal surgery, says Dr. Jonathan Hyde, an orthopaedic surgeon at Aventura Hospital and Medical Center, pictured above. The AR system uses CAT scan images delivered to the software to create a 3D hologram of the patient’s anatomy. The hologram is then reflected onto the physician’s display headset, correlating directly with what he is doing with his surgical tools. Unlike some other imaging systems, it allows the doctor to focus directly on the patient rather than on a screen displaying the patient’s anatomy. He can virtually see through the patient, so he knows exactly where to implant rods and screws. It significantly reduces the number of images that need to be taken during the surgery, thereby reducing the amount of radiation delivered. “I can look at the hologram and bring different structures into view,” Dr. Hyde says. “As I change my position, I change my view of the hologram. I can see one section of the CAT scan in the corner of my left eye, and another in my right eye. The hologram tells me exactly where the anatomy is. It gives us X-ray vision without radiation. It takes surgery to another level.”
All photos courtesy.