Integrated Microwave Amplifiers for Electrosurgical Applications

Modern surgical techniques, while extremely successful in curing life threatening diseases, can involve large volumes of tissue removal and possibly blood loss, with impacts upon recovery times, risk of infection and, in the longer term, quality of life. Radio frequency and microwave energy can be and is used in surgical systems to treat a vast range of medical conditions, such as benign and cancerous lesions, heart, liver and eye conditions and obesity (microwave assisted liposuction), with beneficial effects including tissue removal, heating, blood clotting and drying. Cancers of the lung, bowel, breast and prostate accounted for almost half (46%) of all cancer deaths in the UK in 2012 and more than 1 in 3 people will be diagnosed with some form of cancer during their lifetime. However, many clinical applications currently remain unrealised, prohibited by technology that addresses the requirements for power generation and application to the treatment site in a separate manner, greatly limiting overall functionality. Existing systems have proven the capabilities of microwaves; now is the time to realise their full potential in surgery.

Accordingly, the proposed research is targeted towards optimising surgery to achieve high precision, minimally invasive surgery using targeted, non-ionising microwave and mm-wave energy. Revolutionising treatments for cancer and other diseases, efficacy will ultimately be improved and the side effects or disruption encountered with existing radiotherapy, chemotherapy or surgery reduced. Performed via an antenna, or applicator, keyhole laparoscopic or endoscopic surgery can be performed with minimal risk to the patient. However, the microwave power source is currently over specified to overcome system losses to the treatment site inside the body. Less than 25% of the applied microwave energy reaches the treatment site; the rest wastefully and potentially dangerously dissipated in the cable as heat over traversed regions of the body not targeted for treatment. The opportunity exists to greatly reduce the cost and size of the source.

With the advent of high power density microwave semiconductor devices, clinical effects are achievable much more effectively and efficiently by transforming the system architecture and housing the microwave power source at the point of demand - inside the treatment applicator. Low cost commercial devices are capable of providing the required power levels, with chip dimensions of 0.85 x 1.1 mm to provide an incredibly compact solution. In collaboration with the Christie and Creo Medical, microwave developments will target technology that has undergone preclinical studies for bowel conditions. Applicator integration will deliver an operational concept demonstrator for representative tissue model testing. Manufacturing challenges must be solved to integrate the electronics together with complex antenna structures and future manufacturing technologies, such as 3D printing, will be exploited to produce cost effective applicators. The project will enable a clinically driven trajectory of microwave system developments towards compact applicators that will enable confirmation of diagnosis, energy dose calculation, highly controlled and targeted treatment, efficacy assessment and safe exit to prevent seeding, all in a single minimally invasive intervention procedure. It is envisaged that a range of clinical procedures could be enabled in an outpatient environment or within the patient's home that would otherwise have occurred within an operating theatre.

Building upon Manchester's aims to be a leading centre for healthcare business and innovation, the research will result in a pipeline of electrosurgical technology outputs for an enhanced treatment portfolio, to provide better patient outcomes for UK and international healthcare providers. Through cross-disciplinary approaches, more efficient treatments from diagnosis to recovery will address global health issues for international markets with reduced procedure costs and risk of infection. Therapeutic patient specific interventions of the future will benefit the health, quality of life and life expectancy of society worldwide. Reduced infrastructure may ultimately be required and the need for a hospital bound recovery period removed, with treatment provided at specialist centres that also provide networks of support services under remodelled healthcare provision, contributing towards the NHS ambition to achieve 2% to 3% net efficiency gains each year for the rest of the decade.

Operational pilots, supported by the £15m a year NHS England programme "commissioning through evaluation", will generate evidence on the real financial and operational impact of innovations on services, with accelerated adoption of cost effective medtech innovation. Increased energy efficiency will bring environmental gains over worldwide volumes. Outputs from the world class, university led, collaborative efforts will contribute to growth of the UK and global electrosurgery market, estimated to reach in the region of $4 billion by 2019, at CAGR of 5.9% from 2014 to 2019. Inward investment will be attracted by the partnerships effected through the Healthcare Technologies of the future in a Manchester Cluster.

UK business opportunities for new electrosurgical products and enabling entry into the healthcare space will be fostered through this collaborative project with Creo Medical and Filtronic Broadband. Future secondments from industry into the University of Manchester will enable the bi-directional translation of technological and clinical knowledge, ideas and concepts. Engagement with identified international electrosurgical equipment manufacturers and healthcare providers will increase awareness of international markets and opportunities and inform good practice techniques.

Healthcare public policy development to align future priorities with developing capabilities will be facilitated by the Policy@Manchester initiative, which mobilises knowledge in research and teaching to influence and inform public policy as part of the University of Manchester social responsibility mission. Engagement with regulators will help shape regulation in line with future medical device technology developments.