The Health News – 6 May 2016

Overview:
• A robotic machine called the Smart Tissue Autonomous Robot (STAR), has succeeded at stitching two segments of a pig’s bowel together, an advance for the tricky field of soft tissue surgery, according to the report in the journal Science Translational Medicine.

• There were significant failings in the obstetric care provided to three babies who died soon after being born at a rural Victorian hospital, the state’s coroner has found. The babies’ deaths were only reported to the coroner in 2015, after a cluster of stillbirths and newborn deaths at the hospital were identified by Victoria’s Consultative Council of Obstetric and Paedeatric Mortality and
Morbidity (CCOPMM).

• For the first time, scientists have kept human embryos alive in the laboratory for six days beyond the point at which it would normally implant into the uterus. Two separate groups of scientists report in Nature and Nature Cell Biology their successful development of human embryos in a petri dish for up to 13 days after fertilisation.

News on Health Professional Radio. Today is the  5th of May 2016. Read by Rebecca Foster. Health News

http://www.abc.net.au/news/2016-05-05/robot-successfully-conducts-soft-tissue-surgery/7386032

A robotic machine has succeeded at stitching two segments of a pig’s bowel together, an advance for the tricky field of soft tissue surgery, researchers said on Wednesday.

The machine, called the Smart Tissue Autonomous Robot (STAR), does not replace the need for a skilled surgeon, but acts as a tool to improve the accuracy of stitching, according to the report in the journal Science Translational Medicine.

The study showed STAR outperformed expert surgeons and a well-known robotic surgery tool already on the market, called the da Vinci robot, which is held in the surgeon’s hand and used to perform surgeries such as hysterectomies through a few small incisions.

Until now, robotic surgeries have largely relied on the expertise of the surgeon and outcomes have varied according the doctor’s skill, researchers said.

Soft tissue is particularly complicated because it is malleable and moveable.

But being able to improve on such surgeries “could potentially reduce complications and improve the safety and efficacy of soft tissue surgeries, about 45 million of which are performed in the US each year,” according to the study led by doctors at the Children’s National Health System in Washington, DC and Johns Hopkins University in Baltimore, Maryland.

Researchers stressed surgeons were keeping a close eye on the machine as it worked, and it could be quickly stopped if any errors occurred.

The STAR system is likely years away from widespread use. Researchers expect there will be a need for clinical trials to assess its safety in humans before it can [be] approved by regulators.

http://www.abc.net.au/news/2016-05-05/bacchus-marsh-baby-deaths-case-coroner-releases-findings/7385182

There were significant failings in the obstetric care provided to three babies who died soon after being born at a rural Victorian hospital, the state’s coroner has found.

The three baby girls were each born at the Bacchus Marsh maternity unit of the Djerriwarrh Health Service in 2013, but died 24 hours, seven days and 16 days after their births.

Each child, the coroner noted, was their parents’ first.

The babies’ deaths were only reported to the coroner in 2015, after a cluster of stillbirths and newborn deaths at the hospital were identified by Victoria’s Consultative Council of Obstetric and Paedeatric Mortality and Morbidity (CCOPMM).

Obstetrics Professor Euan Wallace was recruited by the state’s Department of Health and Human Services to examine the cluster, and found seven deaths between 2013 and 2014 could have been avoided.

As the Coroner’s Court has no jurisdiction over stillbirths, only the three newborn deaths were investigated.

In each case, the coroner found significant clinical errors were made in the care of the child during the labour and birth.

She described the handling of care in each case as “sub-optimal”, with the misinterpretation of the CTG, or foetal heart monitoring system, a feature common to each.

The hospital itself has acknowledged its own failings in the report.

In a statement, the hospital said it had implemented all of the recommendations made by Professor Wallace in his report, and that “while we can never change the past, the staff and leadership… is working hard to ensure we meet the current and future needs of our local community” [they said].

http://www.abc.net.au/news/2016-05-05/human-embryos-grown-in-the-lab-up-to-14-days/7384002

For the first time, scientists have kept human embryos alive in the laboratory for six days beyond the point at which it would normally implant into the uterus.

Two separate groups of scientists … report in Nature and Nature Cell Biology their successful development of human embryos in a petri dish for up to 13 days after fertilisation.

The research teams said the advance shines a light into an unexplored period of early embryonic development.

Meanwhile others said the development could open up discussion about the ’14-day rule’; a globally-agreed developmental cut-off beyond which scientific research is not permitted on human embryos.

Human embryos normally implant into the wall of the uterus seven days after fertilisation.

Dr Marta Shahbazi, lead author of the Nature Cell Biology paper, said until now, human embryos had only been sustained in the laboratory for up to nine days after fertilisation.

The ability to observe embryonic development in the laboratory offers a unique opportunity not only to learn how the embryo develops in this period, but to understand why pregnancies fail at this critical junction in development, she said.

Using an approach tested in mouse embryos, the researchers cultured the embryos in a medium that did not actually contain any maternal cells or tissues.

“The key here was that we basically let the embryos develop on their own, without providing any kind of maternal tissues or maternal interaction,” Dr Shahbazi said.

Professor Patrick Tam, the deputy director and head of the Embryology Unit at the Children’s Medical Research Institute, said the study was a “major step forward in understanding a period of human development that has never been understood properly before”.