Keeping the body shipshape

Healthcare has been relying on electrical systems for decades, recent advances will amplify this trend

By Morand Fachot

Treatment of patients has been greatly improving for decades, thanks to a great extent to the introduction of new medical electrical equipment and systems, and improvement on existing ones.In addition to well-established domains such as medical imagery, acoustics or ultrasonics, which have benefitted from significant advances over the years, more electrotechnologies, some very recent, are finding their way in healthcare heralding more progress in the future.

3D printed skull
This 3D-printed skull was implanted on a 22-year old woman in a life-saving operation in the Netherlands (Photo: University Medical Center Utrecht)

Continuing improvements in well-established domains

Medical imaging, used to visualize the interior of patients' bodies, is an indispensable tool that allows doctors to diagnose and treat internal illnesses and traumatic injuries, such as fractures. It benefits from continuous advances that improve its capabilities.

Medical imaging uses 5 main groups of systems, each segmented in sub-categories aimed  at reaching the right diagnosis. They are:

  • X-ray imaging uses a form of electromagnetic radiation, whose properties were discovered by German physicist Wilhelm Röntgen in 1895
  • Computed tomography (CT) relies on X-ray images that are processed by a computer to produce tomographic images or "slices" to obtain three dimensional views of internal organs
  • Ultrasound uses high frequency sound waves to produce images, viewed on a screen, of internal organs, vessels and tissues
  • Magnetic resonance imaging (MRI) uses magnetic fields produced using magnets and radio waves to generate images of the body
  • Nuclear imaging technologies are also used for tomography

These systems rely on International Standards prepared by a number of IEC Technical Committees (TCs) and Subcommittees (SCs).

The remit of IEC TC 62: Electrical equipment in medical practice, and its SCs, is to "prepare International Standards and other publications concerning electrical equipment, electrical systems and software used in healthcare and their effects on patients, operators, other persons and the environment".

The task of  IEC SC 62B: Diagnostic imaging equipment, is "to prepare international publications for safety and performance for all kind of medical diagnostic imaging equipment, such as X-ray, CT and MRI imaging equipment).

The work of IEC SC 62C: Equipment for radiotherapy, nuclear medicine and radiation dosimetry, includes the preparation of "Standards for the safety and performance of (…) nuclear medicine equipment used for imaging".

As for IEC TC 87: Ultrasonics, it prepares International Standards for equipment and systems in the domain of ultrasonics, primarily in the medical domain. In addition to imaging this includes also applications in non- and minimally-invasive therapy, like bone and ligament healing, and physiotherapy for inflammation; drug distribution to treat tumours; and cosmetic applications, such as non-invasive liposuction and therapies to improve skin tone, scars and sun-based damage. Ultrasonics is also widely used to clean medical and dental equipment.

Another well-established domain is that of acoustics. Hearing loss and impairment affect the lives of hundreds of millions in the world and have severe adverse economic and societal consequences. Hearing aids help those suffering from this disability live a nearly "normal" life. IEC TC 29: Acoustics, has prepared more than a dozen International Standards to ensure hearing aids and related equipment, such as audiometers, meet the needs of users and practitioners.

New needs, new treatments, new technologies

Many electrotechnologies, not directly related to medical applications, find their way into healthcare, either opening up new opportunities or leading to improvements in existing electrical medical equipment and systems, and to a wide variety of treatments.

One such promising technological application is medical robotics, which concerns mainly surgery. Medical robots have made laparoscopic surgery, also known as minimally-invasive surgery (MIS), even less invasive and have extended their use beyond the initial main applications of gall bladder and prostate removal, gastrointestinal and gynaecological surgery and urology. Robots are now used for more complex operations in cardiothoracic, orthopaedic and general surgery, and for internal radiation therapy.

As medical robotics is a relatively new domain, the preparation of International Standards for it is emerging as a priority.

To carry out this work IEC SC 62A: Common aspects of electrical equipment used in medical practice, formed Joint Working Group (JWG) 9 with ISO TC 184/SC 2 in June 2011. More than 80 experts are currently active in SC 62A/JWG 9, reflecting the importance of standardization for the sector.

Print those parts and those circuits

Printing prototypes and parts has been around for a while. Mostly known as 3D printing or fast prototyping, it has seen the widest range of actual applications in modern medicine, where it has been described as a game-changer. It has been used to help surgeons prepare for difficult operations, such as cardiac surgery, or the separation of conjoined twins. After gathering information using X-rays, MRI and CT scans, a specialized company prepares medical anatomical models using 3D printing to help surgeons plan and rehearse operations.

Other 3D printing medical applications include bioprinting of skin for transplant, reconstructive surgery, making customized dental implants, joint replacements and medical devices, such as hearing aids. These result in faster recovery times, better functionality and, in the case of hearing aids, smaller, custom-made devices.

Printed electronics, the printing of circuits on rigid or flexible substrates, often merged with 3D printing techniques, also offers interesting medical applications. Examples include printing wearable sensors and monitors for medical and health management applications, or the development of a customized implantable glove-like cardiac monitoring device fitted with tiny printed sensors. IEC TC 119: Printed electronics, established in 2011, develops International Standards for terminology, materials, processes, equipment, products and health/safety/environment in the field of printed electronics.

Make them small and smaller, and smaller

Nanotechnology involves manipulating properties and structures at the atomic scale, is seen as another key future technology in medicine. Nanomedecine, as it has become known, is already being used for new, more effective targeted drug delivery systems, for therapy, diagnosis or cell repair. It is expected to lead to the development of medical nanomachines that will be used in the body. Nanotechnology is in early stages of development, but IEC TC 113 has already developed International Standards for the technologies relevant to electrical and electronic products and systems in the field of nanotechnology.

More electrotechnologies in the medical environment

Many healthcare treatments rely on the use of electrical equipment and systems.

Lasers, for instance, are used in many applications that include bioprinting, ophthalmology and surgery, including brain surgery, as lasers can cut with much greater precision than any scalpel and are additionally capable of fusing tissues together. IEC TC 76: Optical radiation safety and laser equipment, develops International Standards for laser equipment used in healthcare.

Other components, like fibre optic systems and active devices are used in medical sensors. International Standards for such systems and equipment are prepared by IEC TC 86 and its SCs.

These represent a handful only of technologies and applications used in the healthcare environment. All and more rely on IEC International Standards developed by many IEC TCs and their SCs.

Gallery
3D printed skull This 3D-printed skull was implanted on a 22-year old woman in a life-saving operation in the Netherlands (Photo: University Medical Center Utrecht)
Da Vinci patient cart Patient cart - da Vinci SI Surgical System (Photo: Intuitive Surgical)
3D laser-assisted bioprinter Modulab 3D laser-assisted bioprinter to print skin (Photo: BASF)