In early December, New Hyde Park, N.Y.-based Northwell Health became the first system in New York state to offer the Teligen spine surgical system, in a procedure led by Daniel Sciubba, MD, senior vice president of neurosurgery at Northwell and co-executive director of the Northwell Spine Institute based in New Hyde Park, N.Y.
The system allows spine surgeons to better view the spine during advanced and minimally invasive procedures.
The Teligen system, which earned FDA clearance in 2022, was developed by DePuy Synthes and consists of a tower with a 4K high-definition screen monitor and a tiny disposable camera that is attached to a flexible wire and inserted into the surgical site of the patient.
Dr. Sciubba told Becker's the firsthand benefits of using the Teligen system, and how he expects spine care to improve over the next five to 10 years through improved technology and navigation.
Question: What benefits does the Teligen spine surgical system offer patients?
Dr. Daniel Sciubba: So, the system is basically a very small fiberoptic camera that can be used to look down corridors in a way that most spine surgeons have not used before. To compare it, there are endoscopes in the belly and in the brain, but the endoscopes are usually rigid like a long tube that doesn't bend. The reason that works in the belly is because it can move around the liver and the other organs. The brain is soft enough that it can move around it. But the spine is so rigid that you can't move it and you can't move nerves in the spinal cord or things will be hurt.
The key is this is a flexible scope that can fit down small corridors. What this allows us to do is maneuver through smaller incisions. It's a big benefit to minimally invasive procedures because we don't have to gain a big access point to see certain pathology and targets.
That's for standard operations and smaller operations. In very large operations, we sometimes can't get the whole tumor through one approach. In spine, it might be a spine operation and then a chest operation because we can't see what we can't see from the back. What is happening is not only does it make small operations really small, but it takes big operations and lets us get it all done from the back. One operation instead of two. It's letting us see things we couldn't see because it's a flexible image that can now be snaked or fished or moved around structures we couldn't see.
Q: Does Northwell plan to expand its use of Teligen, or add any new tech you can talk about?
DS: I think the first use of Teligen at Northwell has been by me in the sense that I do these very complex spine tumor surgeries and it's making my big surgeries smaller. What it's going to be expanded to is using it for many surgeries. Some bread-and-butter surgeries so patients can have shorter stays and faster healing. Instead of a traditional operation, now we can make those smaller. Those are the common surgeries that we do hundreds of a day. Now we can do minimally invasive degenerative surgeries, and more.
In the times I've used it, we've used it with other forms of technology, such as navigation, monitoring, so that we have more dials on our dashboard. We can see more with our camera, we can see more with our navigation, and we have monitoring that's gotten more advanced so we're looking at signals with higher fidelity. Radar, navigation and visualization is all better. When those three things happen, operations are safer, more efficient and faster. Things can move more quickly and we probably are more precise if we have three different ways of managing a target.
Q: Is there anything else you want to elaborate on?
DS: I'd say that spine is one of the most exciting areas currently and will continue to be more exciting. In other words, we're just beginning to see our inflection point. There was an age of implants, there was an age of understanding how to reconstruct and image spine, what we're going to see now is really improving people's functions. Meeting patients where they are and getting personalized health. We're really just delving into the next generation. Anyone who is down on spine, I'd remind them we are just hitting our stride. The next five to 10 years will be the best time ever.