System Bits: Jan. 8

Measure twice, cut once
University of Texas Southwestern Medical Center researchers are working with a robotic device that can perform laparoscopic surgery through a single incision, an operation that typically requires five or six small incisions. The device is called the SP Robot, developed by Intuitive Surgical. It features four arms that go into the body through a 1-inch incision. UT Southwestern was the first institution in Texas to use the robotic device, which can be employed for prostate surgery and other procedures. Dr. Jeffrey Cadeddu, professor of urology and radiology at the medical university in Dallas, said of the technology, “Every hole you create in a patient has a risk associated with it. Every incision means increased pain, increased risk of hitting a blood vessel.” Dr. Cadeddu made an incision of about 1 inch above the patient’s belly button, then “docked” the robot’s four surgical instruments inside the abdomen, while adding a fifth instrument, controlled by a magnet outside the abdomen. The prostrate procedure took about three hours and was successful, with the patient able to return to work a week later. “We expect this to be the start of a cascade of improved surgical procedures with fewer incisions, meaning less pain and fewer complications for patients,” said Dr. Cadeddu.

Credit: Paul Masih Das, University of Pennsylvania

Easier manufacturing of porous 2D membranes
University of Pennsylvania researchers in the Department of Physics & Astronomy are advancing the utilization of nanoscale materials, showing how the manufacturing of porous 2D materials can be done on an industrial scale. These membranes can have thicknesses ranging from one or two atoms, up to about 10 atoms thick. While the membranes may not be suitable for electronics, they are strong and versatile for other uses. “This additional robustness can be used for applications like desalination or gas transport,” says Priyanka Thiruraman, a graduate student. The lab run by Marija Drndić, the Fay R. and Eugene L. Langberg Professor of Physics, grows the membranes on sheets of molybdenum foil, heating them to 800 degrees C, in a chamber with sulfur vapor. Acid etching is employed to add atomic-scale holes in the membranes. A scanning transmission electron microscope was then used to take images of the membranes at the atomic scale, producing a nanotopography of the materials. “This level of structure, where we can see the individual atoms of these multilayer molybdenum disulfide membranes, hasn’t been seen in the related literature before,” says Drndić.

Preventing, treating osteoporosis
The Lady Davis Institute for Medical Research at the Sir Mortimer B. Davis Jewish General Hospital in Montreal, Quebec, has identified 518 genome-wide loci, 301 of which are newly discovered, that are now compiled in an atlas of genetic factors associated with estimated bone mineral density (BMD), a clinically relevant factor in diagnosing osteoporosis. This work could go a long way in preventing osteoporosis, or effectively treating the condition, which often leads to fractures. “Our findings represent significant progress in highlighting drug development opportunities,” says Dr. Brent Richards, the lead investigator, a geneticist at the LDI’s Centre for Clinical Epidemiology, who treats patients with osteoporosis in his practice at the JGH. “This set of genetic changes that influence BMD provides drug targets that are likely to be helpful for osteoporotic fracture prevention.” Osteoporosis presents a progressive reduction of bone strength, sometimes resulting in fractures, which can be highly harmful to the elderly, to the possibility of death. “We currently have few treatment options,” said Dr. Richards, a Professor of Medicine, Human Genetics, and Epidemiology and Biostatistics at McGill University, “and many patients who are at high risk of fractures do not take current medications because of fear of side effects. Notwithstanding that, it is always better to prevent than to treat. We can prescribe injectables that build bone, but they are prohibitively expensive. We have medications that prevent loss of bone, but they must be taken on a strict schedule. As a result, the number of people who should be treated, but are not, is high. Therefore, we believe that we will have greater success in getting patients to follow a treatment regimen when it can be simplified.”