Medical imaging techniques and surgical navigation systems are the special area of expertise of Dr. Rainer Graumann (59), a physicist whose inventions make surgeons’ work easier. One example is a method for the navigation of surgical instruments during bone operations: Although the patient is scanned only once, the surgeon receives constantly updated images showing the changing positions of his or her instruments.

Graumann always has something in the pipeline when it comes to ideas for inventions in the field of imaging methods and navigation. He has worked at Siemens Healthcare in Erlangen, Germany, for 28 years, is always in contact with surgeons, and is more than happy to observe surgical procedures in person. “That enables me to see for myself what the surgeons really need,” he says. After all, just because something is technically doable doesn’t mean it will offer benefits in everyday surgical practice. Graumann knows all of the imaging methods inside and out — including classic X-rays, computed tomography, positron emission tomography, sonography, and magnetic resonance tomography — and he has come up with inventions for many of the technologies. Thanks to this wealth of experience in many areas, Graumann’s inventions are very practice-oriented.

This is also true of a surgical navigation method that Graumann registered as an invention about 11 years ago and which today is the standard for minimally invasive skeletal operations, particularly on the spine. The previously used, conventional process is laborious and time-consuming: The image of the patient in 2D or 3D, which has been prepared in advance, must first be brought into correlation by the surgeon, who locates and measures marker points in the image and correlates them with the corresponding points in the area to be operated on — a process called “registration.” A disadvantage of the previously used process is that the marker point locations can often be inaccurately determined or become shifted if the patient moves.

Graumann searched for a way to more quickly and precisely correlate the coordinates in the area to be operated on with those in the patient image. The result is that the patient image is no longer created prior to the operation, but rather during surgery. The scanning instrument, a C-bow X-ray device, comes with a factory-installed reference coordinates system, which requires no adjustments. All that is needed is for the patient to be positioned so that the center of the area to be operated on is exactly at the center of the imaging device. This distance therefore becomes a known quantity that never changes. Now, the reference points of the instruments and of the C-bow X-ray device are captured during surgery with a stereo camera, and this data is used to generate the patient image, which indicates the current position of the instruments during the operation. This technology is used for the most part in bone surgery because the position of body tissue shifts position too easily, in which case the coordinates wouldn’t remain constant. The navigation system enables the surgeons above all to correctly position implants, artificial joints and screws, and it can also be used in neurosurgery, and operations on the mouth, jaw, and face. 

Back in his student days in Hamburg, Graumann never dreamed that he would one day specialize in medical technology. At the time he was studying theoretical high-energy physics and astrophysics, which are still his hobbies today. After receiving his doctorate, Graumann conducted basic research for some time at the Deutsches Elektronen-Synchrotron (DESY) in Hamburg, before moving in 1982 to Siemens Healthcare, where Graumann is now the Principal Key Expert in basic development. “I find it very gratifying that my work offers concrete benefits for the doctors and, of course, for patients,” he says. As a guest instructor at the Technische Universität München, Graumann gives regularly scheduled lectures on healthcare imaging and surgical navigation. The list of his innovations is impressive: Graumann has registered 238 inventions, which so far have led to 82 individual patents in 155 patent families.

A strong sense of “creative curiosity,” according to Graumann, is a prerequisite for his research work — as is extensive, continually updated specialist expertise. So in his free time he also likes to read medical journals. His only hobby that has nothing to do with his profession is tennis. And with his five children now grown to adulthood, he also finds more time for it — “whenever my wife doesn’t need me to work in the garden”.

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