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Remote Telepresence Surgery

This important report from Canada presents 22 telerobotic general surgery laparoscopy cases performed by two surgeons over a distance of 400 kilometers; from a teaching hospital in Hamilton, Ontario to a community hospital in rural Northern Ontario.

No intraoperative complications occurred and all post operative recovery was uneventful with minimal telecommunication challenges. However, while Anvari has shown this to be feasible and patients with appropriate education are highly receptive to ARTS (Assisted Robotic Telepresence Surgery) there are considerable limitations. The presently available clinical robots are not capable of telepresence remote operation across a network. The sheer size, weight and cost of the Intuitive daVinci Robot makes it unsuitable for remote regions and small communities. The cost of establishing the telecommunication lines with the required quality of service may also be prohibitive if not already in place, as it is in Canada. There is also the cost of training the remote surgeon and operating room team in the use of the robot technology and having an IT person available for technical support at the community site. However, the potential for "on the job" training of surgeons in new techniques and the development of user friendly robotic systems may provide important surgical interventions in remote locations in the future. This is truly the surgery of the future!

Reference
Surg Endosc. 21(4): 537-41, April 2007
M. Anvari.

Reported by Elspeth M. McDougall, MD, a Contributing Editor with UroToday.

Fats Encapsulated With Fiber May Lead to Tasty Low-Calorie Foods

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LOW-FAT FOODS, OBESITY, DIET, FATS, OILS

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Researchers have found that surrounding fats with layers of dietary fiber prevents the fat from being digested, which could lead to low-calorie foods with all the appeal of the real thing.

Newswise — Low-fat foods are often disappointing to consumers since removing the fat changes the desirable taste, texture and aroma of the original product. Now, a team of researchers at the University of Massachusetts Amherst are developing a new technology that could lead to low-calorie foods that taste like the real thing.

“Our goal is to keep the fat in the food, but stop it from being digested by surrounding it with layers of dietary fiber,” says Julian McClements, UMass Amherst professor of food science. “Foods produced with these encapsulated fats should have the same qualities as conventional high-fat foods.” The research team includes McClements and UMass Amherst food science professors Eric Decker and Yeonhwa Park.

To make the encapsulated fats, small oil droplets are formed by mixing oil, water and a surfactant in a process similar to making salad dressing. The surfactant coats the droplets and keeps them separate from the water until fiber is added to the mix in the final step. Controlling the electrical charges of the surfactant and the fiber molecules allows the oil to attract the fiber like a magnet. Droplets are usually coated with two to three layers of fiber, and other substances such as proteins can be incorporated to hold the fiber layers together or to provide additional benefits.

The process is suitable for encapsulating a wide range of fats and oils, everything from orange oil to olive oil, and uses fiber obtained from apples, oranges, seaweed or shellfish. All the ingredients are food-grade, so this technology requires no FDA approval to use. Encapsulated fats can be used in emulsion-based foods such as beverages, sauces, desserts, yoghurt and salad dressings. They remain stable in acidic foods and during freezing, thawing and cooking, and can also handle large amounts of salt.

How much of the fat can be digested is controlled by the number of layers and the types of fiber used. The team is currently experimenting with ways to chemically link the fiber layers to enhance their ability to stay intact around the fat droplets.

Layers of fiber could also be used to encapsulate vitamins and antioxidants, enabling them to survive a trip through the stomach and be released in the small intestine for absorption by the body, and this process could allow ingredients with proven health benefits but unpleasant taste, like Omega-3 fatty acids, to be included in a wide variety of foods.

Future research by the team will focus on customizing the layers of fiber to respond to different environments, and testing to determine whether this method can be used as a delivery system for therapeutic drugs that can dissolve in fats. “It should be possible to develop coatings that release drugs at specific sites within the human body,” says McClements.

McClements and Decker are currently seeking a patent, and the technology is available for licensing and research collaboration. Interested parties can contact the UMass Amherst Office of Commercial Ventures and Intellectual Property at http://www.umass.edu/research/cvip/index.html.

 
 
 
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