Medical miracles – Surgery for diabetes and new migraine relief lead list of Top 10 Medical Innovations for 2013

Each year, Cleveland Clinic announces its list of Top 10 Medical Innovations that will have a major impact on improving patient care within the next year. The 2013 list is made up of devices, including a handheld optical scan for melanoma; drugs; diagnostic tests, such as 3D mammography; and a government program that financially rewards patients for improving their health.

The Top 10 Medical Innovations for 2013 are:

Exercise and diet alone are not effective for treating severe obesity or Type 2 diabetes. Once a person reaches 100 pounds or more above his or her ideal weight, losing the weight and keeping it off for many years almost never happens.

While the medications we have for diabetes are good, about half of the people who take them are not able to control their disease. This can often lead to heart attack, blindness, stroke and kidney failure.

Surgery for obesity, often called bariatric surgery, shrinks the stomach into a small pouch and rearranges the digestive tract so that food enters the small intestine at a later point than usual.

Over the years, many doctors performing weight-loss operations found that the surgical procedure would rid patients of Type 2 diabetes, oftentimes before the patient left the hospital.

Many diabetes experts now believe that weight-loss surgery should be offered much earlier as a reasonable treatment option for patients with poorly controlled diabetes—and not as a last resort.

The sphenopalatine ganglion (SPG) nerve bundle—located behind the bridge of the nose—has been a specific target for the treatment of severe headache pain for many years.

Researchers have invented an on-demand patient-controlled stimulator for the SPG nerve bundle. This miniaturized implantable neurostimulator, the size of an almond, is placed through a minimally invasive surgical incision in the upper gum above the second molar. The lead tip of the implant is placed at the SPG nerve bundle on the side of the face where headache pain is typically experienced by the patient. Whenever a patient feels a headache coming on, a remote control device is placed on the cheek and it delivers as-needed stimulation to the SPG, blocking the headache pain in about five to 10 minutes.

Even in this age of advanced medical technology, identification of bacteria growing in culture can still require days or weeks.

However, clinical microbiology laboratories throughout the world are now implementing new mass spectrometry technology to provide rapid organism identification that is more accurate and less expensive than current biochemical methods.

Using one of the two MALDI-TOF mass spectrometry systems currently available in the United States provides more accurate identification of bacteria in minutes—rather than days.

In the past two years, five new drugs have been approved for advanced prostate cancer. A sixth is expected to be approved later this year.

Significant progress has been made in treating advanced prostate cancer, not only by greatly increasing patient survival, but also by halting the progress of this disease.

Many in the prostate cancer research community now believe that these drugs, and others coming from the prostate cancer therapeutic pipeline, will one day help make advanced prostate cancer a chronic disease that’s successfully managed with a routine of daily medication, lifestyle modification and regular checkups.

A new FDA-approved handheld office device assists dermatologists in identifying skin lesions that have characteristics of melanoma.

Without cutting the skin, the device—which uses imaging technology created by the military for guided missile navigation—is placed on the skin over the mole. Special lights of 10 specific wavelengths are shined on the skin, and the computerized system rapidly visualizes the micro-vessel structure of the lesion just below the skin’s surface.

In less than a minute, an assessment of the skin lesion is given and the dermatologist can then decide on possible next steps.

Unlike a surgical blade that cuts, a femtosecond laser separates tissue by ablating and cleaving it. The novel FDA-approved bladeless cataract procedure is now revolutionizing surgery by making it more predictable and accurate, 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.

A femtosecond is one quadrillionth of a second. This is the super-fast amount of time that numerous laser pulses of near infrared light are used by a surgeon in this new cataract procedure. The femtosecond laser helps make a perfect circular hole in the lens capsule, splits the lens into sections, and then softens and breaks up the cataract. The device has already been used successfully in ophthalmology, particularly for LASIK surgery.

Experts believe that as many as 40% of previously rejected donor lungs may now be suitable for transplantation thanks to a new approach called ex vivo—outside the body—lung perfusion. This novel “lung washing” procedure can reverse lung injury in many donor organs deemed unsuitable and allow for transplantation.

In this new pioneering procedure, the damaged lungs are removed from a donor, placed in a bubble-like transparent chamber, and connected to a cardiopulmonary pump and a ventilator.

Over a four- to six-hour period, the lungs are then repaired and assessed. Special proprietary fluids are forced through the blood vessels and nutrients are used to re-nourish the lungs as they inflate and deflate as oxygen is pumped through. When necessary, targeted medications are introduced to clear infections. Once determined as being viable, they are ready for immediate transplantation.

Unfortunately, as many as 20%-40% of people with aortic aneurysms have anatomies that are not suitable for the grafts that are currently marketed, nor are they candidates for the more demanding open surgical repair procedure.

However, thanks to a new innovative fenestrated stent graft system, surgeons can now treat patients with these complex aneurysms without having to take detailed measurements and then wait for weeks, sometimes months, for the customized endografts to be delivered.

The new modular stent graft system offers a significant reduction in morbidity and ICU stay, but, more importantly, it allows an application of life-saving technology to high-risk patients who never could have been treated for their aneurysms.

Tomosynthesis, or 3D mammography, is a diagnostic technology that was approved by the FDA in 2011. Breast tomosynthesis does not currently replace traditional two-dimensional mammography testing, but is performed along with the conventional mammogram to provide a more accurate view of the breast.

During the tomosynthesis portion of the exam, the X-ray arm of the machine makes a quick arc over the breast, taking dozens of images at a number of angles. Later combined to make a 3D rendering of the entire breast, the images can be viewed by a radiologist at a computer workstation to check areas of concern. What 3D technology offers doctors and mammography technicians is a much greater opportunity to discover small cancer cells obscured by surrounding tissue that may not be visible on standard mammograms.

The bipartisan Medicare Better Health Rewards Program Act of 2012 has been presented to Congress as a way to improve health care and control costs for Medicare participants. The goal of the program is to encourage people to take a more active role in their well being by developing and maintaining healthy habits.

The Better Health Rewards Program is part of a growing wellness revolution in American health care that is designed to give everyone achievable health goals and a detailed plan to reach them, as well as financial incentives to keep motivated and follow through with the various health strategies.

The three-year program uses the annual wellness visits Medicare already subsidizes to determine and measure improvements in six key areas of health. In the first year, people will be assessed and then work with their doctor to develop a plan to bring their indicators into a healthier range. Progress will be measured during subsequent wellness visits in years two and three.

By saving the Medicare program money, participants in the Better Health Rewards program will be given up to $400 after checkups in the program’s second and third years. All of these monetary incentives will come entirely from savings generated by seniors becoming healthy and utilizing fewer health care services.

For videos of the Top 10 and other multimedia content, visit toptenmedicalinnovations.com.