The annual Congress of the Association of periOperative Registered Nurses (AORN) offers what I think is the best peek at the latest developments in surgical technology. Here, I'll review some of the new products on display at this year's 50th Congress in Chicago.

Infection control
The QuantIM 16 countertop vacuum steam sterilizer from SciCan is well suited for small, single-specialty ASCs or for point-of-use processing in larger ASCs. It features a 16-liter round sterilization chamber that can accommodate three 8"x11"x1" wrapped or open instrument cassettes; you can opt for a printer for quality assurance documentation. This little sterilizer features something usually only found in its full-sized cousins: closed-door vacuum drying - so no more "cracking the door" to get the wrapped packs to dry.

The Reliance Synergy Washer Disinfector from Steris looks very much like the 444. But this new pass-through unit packs a larger chamber into the same footprint as similar washer disinfectors, uses half the utilities that similar devices do, and features cycle times of less than 30 minutes.

To easily transport contaminated instruments out of and through sterile areas while you are soaking them, check out the Instru-Bin soiled instrument transport box from Ruhof. This 15"x27"x8" transparent box has a plastic mesh basket inside. It is covered by a snap-down lid.

Architectural equipment
The OR light and service boom market is a mature one, but manufacturers are still significantly, if mostly incrementally, improving their products.

Berchtold's new D650 OR light has a 26-inch lamphead that produces up to 140,000 lux of illumination. What I like most is the halogen/xenon bulb: It costs only about $40 and lasts 1,000 hours. A secondary bulb is energized when the primary bulb burns out. The company also makes the smaller D550, which produces 100,000 lux from its 22-inch lamphead. Both are great lights on great suspensions.

Berchtold also showed the Teletom 700 series OR service boom, released in October. This boom handles up to 350 pounds of equipment and is said to articulate and brake better than previous models.

Burton's new Genie Plus OR light emits 130,000 lux from its 22-inch lamphead. Its four 50-watt halogen bulbs provide 2,000 hours of service. There is no reserve-bulb circuitry, but the lamphead's multiple bulbs mean this is not a problem. The Genie Plus's suspension system compares with those of OR lights costing much more and, at $13,000, is lots of OR light for the money.

Steris's high-end Harmony 500 light, which we reported on in this space last year, offers a 130,000 lux lamp and comes video enabled as its standard configuration. This means the lamphead, suspension arm and intensity control come pre-wired to accept a video camera in the light handle. The liquid crystal display, software-driven intensity control has video connectors on its underside ready to plug and play. The surgeon can also dim the lamp using buttons on the lamphead. The light is designed to be upgraded in the field with minimum OR down time.

Trumpf introduced its OR light, the TL702HX, which is supposed to give 160,000 lux; the xenon bulbs claim a 5,000-hour life. The lamphead has an automatic halogen bulb as a back-up.

Pending FDA 510(k) approval is Getinge's new Axcel light. The lampheads are shaped like three-sided stars, which Getinge reps say will allow multiple lampheads to be nested together in an overlapping fashion to avoid "head shadows." These lights are set to cost half of what typical OR lights cost ($8,000-9,000 instead of $18,000-20,000) and are supposed to be easy to install due to their light weight.

Imaging
As with all things electronic, diagnostic and procedural imaging technologies are becoming more digital and are getting smaller, faster and better.

Smaller is often better due to staffing, space and exposure of patient and staff to ionizing radiation. The new Premier Encore extremity-imaging unit from Fluoroscan, a leading manufacturer of mini C-arms, offers more image-storage options, including either a 2,000- or 4,000-image hard drive, 3.5-inch floppy diskette drive and CD-R/CD-RW drive. The device is also networkable, with a 10/100 base-T Ethernet connection.

The Vista full-sized C-arm from Instrumentarium Imaging Ziehm features a small footprint but provides a 30-inch opening in the C. The unit is very quiet, delivers excellent images and emits a low amount of radiation. The unit comes standard with last-image hold, digital image rotation and reversal, patient dose recording and half-dose mode. Special software allows the device to achieve the lowest possible X-ray dose by optimizing the image for the given body region. The Large Patient Diameter Key feature optimizes images on patients with "large diameters."

Patient surfaces
You can adjust the height of Berchtold's new OR table, the Operon B810, from 28 to 48 inches. Other premium features include gel padding, a radiolucent carbon fiber tabletop that is claimed to be 10 times stronger than other composites, and a full-length X-ray cassette channel. It's rated for 600 pounds.

Skytron's new model 1700 Outpatient Surgical Table incorporates many of the same features as the company's higher-end tables, including 180-degree top rotation for C-arm accessibility and for clearing the base when a surgeon is operating while seated. Yet it costs only $21,000. The table is also rated for 600 pounds.

Trumpf's new Titan bariatric Surgical Table has a 1,000-pound capacity in all articulations and a fully radiolucent sliding top. It is controlled with an infrared remote, just like your TV. An optional wall control is offered. For pain management, the company has the Jupiter Pain Management Table, which features a floating carbon fiber top.

Other equipment and instruments
A remarkable new electrosurgery system from ERBE, called the VIO System, can expand as your needs change. For instance, you can buy the base unit, then add argon plasma coagulation later. You will also be able to update electrosurgical waveforms via software instead of what I call the "dumpster upgrade": You buy the new one and throw the old one away. Erbe offers a line of bipolar instruments that work with the device's "plug-and-play" digital instrument recognition technology, but if you don't like them, that's OK. You can use another vendor's high-frequency bipolar ligation forceps with the machine; all you need to do is download the appropriate software.

Surgeons can use ERBE's new hydro-dissection system, the Helix Hydro-Jet, for precise, selective tissue dissection. While this device is intended for liver and kidney surgery, it has been approved for abdominal laparoscopic procedures, including laparoscopic prostatectomy, laparoscopic partial nephrectomy and total mesorectal excision.

Linvatec introduced new color-coded attachments for its Hall Powerpro II modular handpiece driver drill system. Also introduced were new reamer attachments that are geared for additional torque with a 5:1 gear ratio; the standard 3:1 ratio reamer is still available. Linvatec continues its venerable line of Hall power tools and today's attachments will work with the older pneumatic driven handpieces and the newer electric and battery handpieces.

Nellcor Mac-Fast adhesive forehead pulse oximetry sensor is said to be faster and more accurate than all other ear, nose or forehead sensors. The single-use device is for patients under 40 kilograms.

Pedigo's new foot-operated pneumatic height adjustable stool offers hands-free adjustment. The 14-inch diameter round padded seat adjusts from 19 to 24 inches and is available with or without a backrest. It is also competitively priced at around $200.