Taylor Wilson, Univeristy of Utah
SALT LAKE CITY — For the first time, surgeons at the University of Utah's Clinical Neurosciences Center have used a novel new tool that cuts then cauterizes with no collateral damage to adjoining tissue.
Neurosurgeon Joel MacDonald, who has worked with the inventor of the Ferromagnetic Wand almost from the beginning, recently used it on the first human, in this case a patient needing spinal surgery.
"These are areas in the body where you need a lot of precision and a lot of dexterity. You don't want a lot of heat spreading into untoward directions," he said.
Unlike current electrosurgical tools, the wand uses a paper clip-like tip coated with a special alloy that creates a magnetic field. Inventor Dr. Kim Manwaring says the alloy is so thin that it flashes into a pure heat. It directly hits the target, instantly heating or cooling at the surgeon's command. No electricity passes through the body as it cauterizes while it cuts. And since there's no deep absorption as with other tools or even lasers — surrounding tissue is not burned or damaged.
Manwaring first envisioned this new kind of surgical device in his garage. David McNally, who now heads up the company manufacturing the wand, says "I met Dr. Manwaring there where he showed me a ham radio with a small piece of wire. He showed me how he could heat that piece of wire, and we talked about the potential for a new kind of technology."
Manwaring contacted an engineer in Philadelphia via the Internet after he discovered reports on an alloy used by NASA. Samples were sent and eventually the ferromagnetic material was coated around the tip of the small incising tool.
"To my surprise, it worked as I could have hoped for under the best of circumstances," Manwaring said. "It would heat instantly and cool extremely fast."
From that garage to a basement, to what is now Domain Surgical, the wand has kept its roots in Utah.
Now with FDA approval, it's being used on the first human patients.
Manwaring describes "the ideal combination is an incision that is pure searing or sealing of the margin with no bleeding and yet right beneath that sear is perfectly viable, healthy tissue."
The wand potentially could lower overall risks to the patient. Less time in surgery and less scarring could promote faster healing and recovery.
MacDonald says the device could prove extremely useful in brain surgery since it does not pass electricity through that sensitive tissue, which already uses electrical impulses to function.
Manwaring says the wand sort of takes on a personality of its own. Though it has no drag or the need to push or pull as with a conventional cold blade scalpel, it still feels compatible in the hands of the surgeon.
"It's an intuitive instrument. I can pick it up and quickly proceed with surgery and feel entirely comfortable," he said. "The instrument also has a feedback loop. It automatically senses if the instrument is being keyed in the air before you touch the tissue or when you're barely touching the tissue or if you decide to deeply insert the tip while making the incision."
The wand easily cuts like a scalpel or with a simple change to a tip with a larger loop, it can scoop out tumors. In the case of removing unwanted tissue, the device even uses flash heating to self-clean.
"The surgeon is there to solve a problem and leave the least evidence that he was ever there," Manwaring said, describing the "key goal" of the wand.
Surgeons like MacDonald say they're optimistic. They like the tool's feel and versatility and its potential for all kinds of applications in the operating room.
Over the next three months, neurosurgeons will use the wand at other major hospitals including Johns Hopkins, Stanford, Columbia and Duke.
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