Enormous know-how, instinct and a steady hand are among the most important qualities of a good surgeon. However, even the best physician may accidentally score a blood vessel or healthy tissue during an operation. In the future, this risk will be minimized – thanks to cutting-edge software developed by the University of Bern. What may appear as the screenplay for a futuristic medical drama could soon become reality in hospitals: During an operation, the system measures the positions of the surgical instruments and connects them with a three-dimensional simulation of the organ and its vascular systems. Similar to a GPS, this system allows surgeons to carry out intended treatment steps accurately thanks to improved spatial orientation.
The software was developed by the Institute for Surgical Technology and Biomechanics (ISTB) of the University of Bern in cooperation with the university hospital for visceral and graft surgery of the Inselspital (university hospital) Bern, originally for liver surgery. However, extending it to other organs is conceivable. The “GPS for liver surgery” is exemplary for how future-oriented research achievements assert themselves on the market and lead to sustainable cooperation with industrial partners.
It is no coincidence that the University of Bern is holding a strong position precisely in the field of medical technology. The canton of Bern has been pursuing a cluster strategy for more than ten years. With 227 members and the university and technical college as partners, the medical technology sector represents one of those networks.
In this way, the canton and local alma mater remain faithful to their roots. For, medical technology has a long tradition in the canton of Bern: Already in the 17th century, the famous “medicus and chirurgus” of Bern, Wilhelm Fabry (Hildanus), shaped a sample of the curved knife for a special eye operation. And whenever the Nobel laureate-to-be Theodor Kocher (1841–1917) stepped to the operating table, he would resort to instruments designed by himself and made in Bern.
Accurate as clockwork
The list of innovative physicians who have continuously thrived to improve medical devices continues into the present – and there were always industrial partners involved in the development process. What is more: Thanks to the legacy of the clock industry along the southern Jura, the canton of Bern has the indispensable know-how in the precision handwork required for medical technology. Certainly one of the most defining figures was the orthopaedist Maurice E. Müller, who was a professor and hospital chief between 1963 and 1980. Already starting in 1958, he and Robert Mathys designed and developed instruments for orthopaedic operations, from 1967 in his own firm, Protek, and in cooperation with Sulzer, the “artificial hip joint”. Maurice E. Müller’s legacy is being maintained at the University of Bern.
The actual medical technology showcase at the University of Bern is the “Artorg Center for Biomedical Engineering Research”. The university founded it in order to promote interdisciplinary cooperation between the fields of education, research and development, innovations and start-ups in the area of organ support technology. The “GPS for liver surgery” mentioned at the start was developed at one of the Artorg Center’s institutes.
The combination of modern imaging techniques and latest findings of anatomical research is one of the centre’s areas of specialization.
This is further demonstrated by a novel technology, which was also developed at the Artorg Center and which enables a hip joint replacement surgeon to position the socket inexpensively according to a map.
The third dimension
This technology was also developed at the ISTB of the University of Bern, patent pending. For the first time, the developed algorithms allow an exact three-dimensional (3D) reconstruction of the geometry of the human hip based on a conventional, two-dimensional radiograph, which is already required for the diagnosis of the hip condition. The additional three-dimensional data is generated mathematically from extensive empirical values – rendering expensive computer-tomographic 3D imaging (CT/MRI) and complex navigation systems unnecessary during surgery. Natural gravity is used as the angle reference. Two simple circular levels assist the orthopaedist in controlling the socket insertion. This gives the technology the potential to be utilized in the developing world. In order to market the technology, the ISTB and the Swiss Ortho Clinics are founding the start-up company OrthoCompass.
The University of Bern has long been very dedicated to and cooperating with the Inselkliniken (university hospitals) university hospitals to research medical technology. The Artorg initiative is expected to further enhance this aspect. The fact that this dedication is worthwhile is demonstrated not least by the positive echo from the medical technology companies settled in the canton of Bern to the research accomplishments of the university: In 2009, the two aforementioned examples were distinguished with an innovation prize (first and second place) from Ypsomed, the injection manufacturer of Burgdorf.
Prof. Dr. Urs Würgler is Rector of the University of Bern. He studied mathematics, physics and philosophy and obtained a doctorate in 1969. In 1975, he habilitated in mathematics after several years of research work in Heidelberg. From 1991 to 1993, he was dean of the philosophy and natural sciences faculty, from 1994 to 2000, managing director of the mathematical institute. From 1996, he was deputy rector of the University of Bern.