Wearable offers a simple path for fluorescence-guided surgeries

Fluorescence-guided surgery has become a new standard of care for certain types of tumor resection. It involves a patient ingesting a substance before surgery that metabolizes and fluoresces under blue light, allowing the surgeon to isolate the tumor and remove it. Until recently, this type of procedure required a microscope to help the surgeon visualize the fluorescence.

The microscope, although often called the gold standard, has some drawbacks. The first is that repositioning the device for different views is time consuming and can lengthen surgical procedures and therefore result in unnecessary exposure to anesthesia for the patient. Another is the cost of the microscope itself.

“The operating microscope with the fluorescent housing costs about half a million dollars,” said John Walsh, vice president of Designs for Vision, in an interview with DM+DI. “It limits the availability of blue light procedures to academic medical centers and even within those academic medical centers they may have one, maybe two of these types of microscopes,” he continued.

Designs for Vision aims to eliminate these issues with its Reveal fluorescence-guided surgery system. Reveal is a wearable, wearable system that includes the company’s flagship tribeam HDi, which combines three high-definition imaging LEDs that allow the surgeon to choose between two excitation settings and white light. Reveal also includes a wireless Bluetooth foot pedal to control light settings, two rechargeable power packs that can be combined for 10 hours of run time, and goggles with 2.5x or 3.5x magnification. Improved viewing is achieved by filtering emissions in the magnification and optics of the goggle lenses calibrated for the HDi headlight.

Reveal can be worn 18-20 inches from the surgical field, compared to the 13 inches needed for the microscope, which means a more comfortable experience for the surgeon. Walsh received feedback from early adopters who mentioned that because Reveal is portable and doesn’t need to be repositioned for a different view, sometimes 30-40 minutes can be saved on procedures. The system sells for $7,500 to $8,500, making it much more affordable, even for community medical centers.

Image courtesy of Designs for VisionDesigns For Vision Reveal FGS System.jpg

Reveal’s Tribeam HDi headlight uses three high-definition imaging LEDs.

In The Evolution of 5-Aminolevulinic Acid Fluorescence Visualization: Time for a Headlamp/Loupe Combination, researchers found that there was no difference between what fluoresced under a Zeiss microscope and what fluoresced under the Reveal system. . “That’s by far the best possible results for us, because you didn’t want different fabrics to be exciting,” Walsh said. “And in an interesting corollary, however, they found that Reveal would fluoresce almost 10 times brighter than the microscope, so it was easier to visualize the fluorescence.”

Walsh explained that the microscope uses beams to split the light path to cameras, monitors, or a different or separate set of eyepieces. “The Reveal is much simpler,” he said. “Only the emission filter built into the glasses is the only optical path that needs to be transmitted. So it’s not that we’re providing more light or doing something different, it’s just a simpler path.

Designs for Vision launched Reveal in May 2021, and it’s currently available in the US, Europe, and Canada.