Stryker’s New Automated Image-Guided Therapy Tool Propels Sector Competition

August 04, 2023 - Last month, Stryker commercially launched the first fully autonomous surgical guidance system for cranial and spinal surgery applications. The product utilizes a proprietary FP8000 camera that navigates four times faster than Medtronic’s StealthStation and 16 times faster than Globus Medical’s ExcelsiusGPS.

Using imaging data from Stryker’s Airo TruCT, surgeons can now view two- and three-dimensional planning for cranial or spinal procedures, including details like screw placement, catheter placement, and updated alignment based on patient orientation. The device was successfully tested in one operating room and has already been rolled out to five university hospitals for further use.

Q Guidance utilizes dual PCs to download images before a procedure and generate a three-dimensional map of a patient’s brain or spinal cord. The system’s distinct advantages are its automated proprietary camera, approval for pediatric spinal procedures, and compatibility with multiple imaging modalities, including fMRI, CT, MR, and PET, which can provide surgical guidance faster than competitors.

The active/passive optical tracking supported by Stryker’s software algorithms can assign predetermined reference points to the surgical field, assisting surgeons by identifying objects of interest and instrument pathways. Before the advent of autonomous capabilities, surgeons would manually conduct and plan these processes.

"In my opinion, Stryker's Q Guidance System with Cranial Guidance Software could be the new gold standard for image-guided neurosurgical navigation," said Dr. Melvin Field, a Q Guidance System user and medical director for the Minimally Invasive Brain Surgery program at AdventHealth. "Cranial procedures are extremely delicate, and outcomes may go beyond physical health, potentially altering your patient's appearance or personality. The system offers advanced planning and guidance capabilities, giving me greater confidence to perform these complex surgeries."

Stryker’s autonomous system also enables collaboration inside and outside the sterile field. The capability can reduce staff movement between operating and control rooms and ultimately help reduce the time needed for surgery. By cutting down on planning time, surgeons can complete more daily operations.

New technology like the Q Guidance System improves upon X-ray fluoroscopy by providing better image quality and autonomous capabilities like segmentation, skull stripping, and visual tractography with brain fiber bundles. Additonal engineering innovations are quickly transforming the surgical platforms available to patients.

Image-Guided Market

Artificial intelligence (AI) and augmented reality (AR) are already making their way into the image-guided therapy industry. HOLO Portal, a guidance system created by Surgalign, features AI planning tools that automate some tasks, including implant sizing and trajectory selection. While these capabilities are similar to the ones offered by Q Guidance, HOLO also includes an AR terminal for viewing for enhanced visualization and reduced time spent in the operating room.

Further development of image-guided therapy will likely involve a few key innovations. To alleviate the administration burden associated with procedures, more systems will eventually include AI that can complete complex tasks quickly. Surgeons will also be aided by AR that can superimpose imagery onto the surgical field and reduce the need for a monitor in the operating room. X-rays will also be replaced by photorealistic ultrasound and magnetic resonance (MR), which can provide an improved three-dimensional image of physiological structures.

Most large medical device manufacturers now offer their own version of an image-guided therapy system that includes some of these features.

• Meditech’s comparable system is the StealthStation S8 navigation system and StealthViz applications. Meditech differentiates itself with software that allows a practitioner to fuse images from multiple modalities, including ultrasound and MR, to create traversable 3D structures.
• GE Healthcare makes the Allia IGS 7, which supports an array of coronary interventions and allows surgeons to use AR guidance in planning. The Allia is marketed as a tool that can expedite surgical procedures with its wide-bore C-arms that will enable additional clinician engagement with the patient and user interfaces. 
• Phillips sells the Azurion image-guided therapy system, similar to GE’s technology, and includes an AR feature that works in tandem with Microsoft’s HoloLens. According to Phllips’ data, the system reduces procedure time by 17% on average. Recently, Phillips also announced a new C-arm line to support additional flexibility in the operating room.

Further advancements in the image-guided market will continue to make minimally invasive surgery more accessible and safer, allowing surgeons to employ devices in additional patient populations.