How Warming Tech from the Automotive World Can Help in Robotic Surgery

By Matt Phillion

As we emerge from a bitter winter in many parts of the country, things like heated seats and steering wheels have become the sort of amenities we’ve come to expect to combat the cold when we drive—often in a way that’s quicker and more effective than the car’s cabin heater. But what if that same technology could have a place in surgical suites to improve patient safety and patient comfort?

Gentherm Medical, a division of Gentherm, a developer of innovative thermal management and pneumatic comfort technologies best known for partnering with auto makers, has designed a new product that combines air-free patient warming with a securement technology to help keep patients from slipping during procedures using tilt.

The idea initially came from a meeting at a trade show and a conversation about improving patient safety during robotic surgery, explains Steve Fletcher, Senior Vice President and General Manager of Gentherm Medical. A medical device company approached Gentherm about developing some sort of pad that could both warm the patient and secure them during a procedure in one solution.

“Gentherm has a long history of keeping people warm and cooling them down, and when you look at robotic surgery and how much real estate is actually really there on the patient, it can be a challenge,” says Fletcher. “The patient is usually in various degrees of tilt, and then you have a robot that needs adequate space to operate effectively. A great deal of heat escapes the patient during surgery because of exposure to a cold operating room and other factors, which means clinicians are faced with a tough choice about whether it’s more important to keep the patient warm or keep them secured.”

The real estate factor begs the question of where do you put a warming device in this situation?

“That’s the key here and where we come in. We have a unique opportunity here,” says Fletcher. “We have the technology to do this and to help clinicians solve two problems with one product.”

Leveraging what already works

The concept is very similar to the technology in use in cars, Fletcher explains.

“There are a few ways to heat a car seat—one being metal wire, such as copper, sewn onto a carrier material for example. We chose a carbon fiber technology for robotic surgery. Our Astopad® technology has been on the market for 20 years and is a reusable product using this carbon fiber tech,” he says.

This is placed between two layers of foam with a high coefficient of friction that keeps the patient secure.

Gentherm’s medical team understands the standards required for medical devices, and the product also needed to be designed in a way that could handle the necessary clinical requirements to ensure ultimate patient safety, Fletcher explains.

“Patient safety is always number one, so we take the carbon fiber technology and design it in a way that, for example, if any blood or fluid from the surgery are absorbed by the foam, the heating element will still operate safely,” he says.

They also wanted to make sure there was very good heat transfer to the patient, Fletcher goes on. “When you have a person being operated on, there is a lot of heat loss,” he says. “When designing the pad, we had to answer questions like how much heat transfer is safe versus how much energy is needed to maintain the patient’s temperature.

Empowering staff to keep patients safer

Staff are able to adjust the temperature without it interfering with their other processes, Fletcher explains.

“The beauty is it fits in with their current workflow,” he says.

The team brought in nurses and clinicians to get feedback and ensure that, from a staffing standpoint, this doesn’t become something that interrupts or complicates their processes.

“Their biggest concerns were always about patient safety and making sure the flow wasn’t disrupted,” Fletcher says.

The robotics component brings some unique challenges to the proverbial table, he adds.

“When you think about securing a patient, the nurses still adjust the patient prior to surgery, so it’s important to think about not just making sure they stay on that pad. Some existing pads have a memory foam feel that isn’t conducive to adjusting the patient on the fly,” Fletcher says. “The staff needs to be able to make adjustments as the robot comes down. This new material allows for easier movement of patients to better streamline workflow and increase positive patient outcomes.”

In speaking with nurses and other staff, the team has been able to identify and address improvements ahead of time. For example, in talking with those nurses the topic of being able to x-ray the patient came up in conversation. Will the heating technology interfere with that in any way?

“We quickly looked at our tech and pivoted to using the carbon fiber heating element so you can x-ray it without artifacts. It’s radiolucent,” says Fletcher. “There’s nothing like being able to talk to the customer and identify these kinds of improvements.”

While someone outside of the industry may pause at the idea of a convergence of automobile technology and operating room application, expertise in keeping people warm is a transferrable skill, Fletcher notes.

“It’s all about thermal heat transfer. We have a group of thermophysiologists, academics who completely understand heat transfer and the science behind how to warm or cool someone,” he says. “We have a lot of expertise, and while on the automotive side, it’s about keeping people comfortable, on the medical side, it’s about how you affect outcomes for the better.”

The technology is currently going through FDA approval and Fletcher expects clearance in the first half of the year, but the feedback from staff who have seen it work has been positive so far.

“We’re hitting an absolute need, and it’s timed with a growth in robot surgery,” he says. “It doesn’t interrupt the workflow, and if you don’t keep that patient warm, which is the standard of care, you’ve got a high risk of infection and blood loss. At the end of the day, anything you can do to help keep patients safe and let them leave the hospital sooner is important.”

Fletcher points out that numerous studies have shown that being able to leave the hospital sooner benefits the patient and lowers certain risks. That’s one of the major selling points for robotic surgeries, that they can be minimally invasive and help patients get out of the hospital quicker.

“We want to be part of that story,” he says. “We know change in any healthcare setting is not easy. It’s hard to get buy-in. It’s also challenging in that we’re known as an automotive company but not many people know us as a medical device company. But we’ve had products out there for years that have been benefitting patients in medical facilities around the globe, so it’s a matter of getting that story across.”

The current standard of care using forced air for patient warming has drawbacks Fletcher hopes this technology can help alleviate. Forced-air blowers are noisy and involve a lot of air movement, he points out, and this offers a chance to lessen both of these factors.

“When patients are brought into the operating room, they’re often scared and complain of the cold,” says Fletcher. “When forced air is used for warming, they don’t turn the unit on until after the patient is asleep. With our technology, you can pre-warm the pad immediately after setup which means you can transfer your awake patient over to a warm surface, hopefully easing anxiety and warming them at the same time.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.