Smarter medical instruments for minimally invasive surgery

Catheters are becoming smarter and helping enable faster and safer medical procedures. These advancements, which are already benefiting patients and doctors, are likely to accelerate in the coming years.

Catheters are used in minimally invasive interventional procedures, accessing the therapy site through a small incision into the blood vessels, allowing physicians to avoid highly invasive surgical procedures such as open-heart surgery. Minimally invasive interventional procedures typically take less time than traditional surgical procedures and are far less traumatic, often being carried out under conscious sedation. They result in significantly reduced patient pain and discomfort, as well as hospitalization and rehabilitation time.

Engineers have been working on ways to further reduce the impact of catheters by making them smaller and smarter, adding capabilities to send and receive signals, data, or energy to and from one end of the catheter to the other. These innovations could expand the use of minimally invasive procedures and meaningfully improve outcomes for countless future patients.

Adding targeted capabilities to a catheter can provide powerful benefits for doctors and their patients. Embedding imaging sensors in the tip of a device could allow a physician to monitor a procedure in real time, increasing its effectiveness while also reducing reliance on more invasive methods. For example, increased resolution of ultrasound devices could enable physicians to target ablation procedures more accurately, reducing potential need for follow-up procedures.

Catheters must be small and nimble enough to navigate a patient’s anatomy, so real estate on the device is at a premium. That means the inherent challenge of making catheters smarter is a matter of integrating sensors, cabling, and connectors into a very tight space. That requires creative engineering to build sensors that are small enough to fit in catheter shafts, as well as connections and fine wires that allow those sensors to transmit and receive signals. For example, TE Connectivity’s IntraSense catheter pressure sensor is less than a quarter of a millimeter wide and one tenth of a millimeter thick and includes pre-attached leads, simplifying assembly and connection within a catheter device.

As effective as these innovations can be, the pace of their development has remained relatively slow. New devices that improve the efficacy of a specific procedure typically require engineers to customize them from the ground up. A more flexible, platform-based approach to device manufacturing could unlock new possibilities to get better tools into the hands of more physicians more quickly to help more patients.

Speeding up innovation requires a more flexible approach to complex sensor and electronics integration. TE Connectivity has been hard at work in this area, developing versatile components such as the VERSIO™ connector, which gives designers space for 208 contacts in a connector suitable for up to 1,000 mating cycles with catheters. In isolation, these efforts will only take the industry so far, however. Close collaborations among component and device manufacturers will be necessary to consolidate technology that provides complementary functions on common point solutions.

For example, a well-designed family of mass-produced, customizable silicon chips could give component manufacturers a standardized solution they could more easily and quickly customize with the electronics device manufacturers and physicians require.

TE engineering teams work closely with our customers’ engineers during the development process to clarify requirements and risks, and to work through solutions quickly and collaboratively. We also have extensive prototyping and testing capabilities to allow for fast evaluation of catheter options early in the design cycle to speed optimization. As flexible platforms become more robust and innovation cycles shorten, the possibilities before us will become greater and greater.

The keys to the future of sensor-based smart catheters are safety and cost. Single-use catheters improve safety by eliminating concerns around cross-contamination, while allowing for lower-cost construction, as they don’t need to withstand multiple procedures or harsh sterilization. Higher-cost components and reusable devices are justified by benefit to the patient, physician, or overall functionality of a device. Therefore, the innovations most likely to drive change will be those that produce a substantial improvement in performance and patient safety.

These sorts of advances could include wireless data transmission through micro-antennae that will enable faster and safer interventional procedures by providing real-time data to inform and guide the physician. Temperature data, fluid pressure information, and the amount of force being applied at the catheter tip will offer critical feedback that can guide physicians during procedures. Tactile sensors and enhanced image sensors will provide the information needed to assist in robotically assisted procedures by reproducing the sense of touch physicians experience while holding and manipulating a device today.

Many believe that enabling remote procedures will improve safety for both patients and physicians. Physicians would be able to work in better ergonomic conditions outside of the x-ray field surrounding the patient. Improved imaging would enable physicians to see what they are doing while minimizing or eliminating the use of X-ray fluoroscopy and contrast media, resulting in a better patient experience.

New materials that include softer, more flexible polymers or alloys could allow for assisted or autonomous navigation, potentially improving patient safety and giving physicians access to parts of the body that have historically been difficult to reach. As we work to develop more flexible platforms for these devices, these innovations will happen more quickly, bringing substantial changes to the way doctors and patients experience interventional procedures today.

In the not-too-distant future, physicians may wear a virtual reality or augmented reality headset, giving a detailed catheter tip point of view as they navigate the anatomy and carry out a procedure from a robotic interface console, assisted by navigational and procedural algorithms translating hand and finger motions into device or tool actions at the therapy site. Looking forward even more, devices could be self-propelled or auto-navigating, supported by hydraulic motion systems and other novel technologies, improving access and reducing trauma. These devices will likely require a high level of sensing and control – possibly even some level of autonomy.

We are eagerly creating the future of medical technology and are actively working to make it a reality with our work in sensor miniaturization, material science, and other areas to create safer and more effective catheters that are truly smart.