At the time that it was invented, in 15th Century, The Laterna Magica – or Magic Lantern – was a revelation. In basic terms: it is a slide projector, with a simple light source, such as candle that projects hand-painted slides onto a screen. It may sound incredibly simple by today’s standards, but the Laterna Magica reinvented the way people saw the world.

The remarkable history of this innovation is highlighted as part of an exhibition on the history of projection at AV Stumpfl Museum, in Austria. Reinhold Stumpfl, the owner and founder of Canon partner, AV Stumpfl, and an avid collector, asked his friend, Dr. Scheucher, a recognized expert in visual storytelling, to curate the exhibition.

“There’s a connecting line beginning from the early times of mankind, right through to today where powerful images in projections are used by powerful people to shock and influence.” Dr Andreas Scheucher, curator of the AV Stumpfl Museum.

“The idea of telling stories with pictures is as old as humanity itself ” – Reinhold Stumpfl, owner and founder of Canon partner AV Stumpfl.


16th Century

During the reformation in Europe in the 16th Century, the Catholic Church dominated in matters of morality and law, until the Protestants challenged their dogma.

“The Jesuits were very important for the Roman Catholic Church, as they were multimedia people,” explained Dr Andreas Scheucher, curator of the AV Stumpfl Museum. “They founded a special form of spiritual theater and used the Magic Lantern. The first projected images were images of the devil.”

“Jesuits travelled widely using the Laterna Magica to spread church propaganda, and to show that if you were not a good Catholic, you would go to Hell. From the middle ages, right through to today, powerful images have been used in projections to shock and influence.” said Dr. Scheucher.

This was probably the first use of broadcast images for the purposes of propaganda. As wealth moved from the hands of the church and aristocracy and into the hands of merchants, so did the use of the Laterna Magica.

18th Century

During the French Revolution (1789-1799), stage magician, Étienne- Gaspard Robert, discovered how to project from two Magic Lanterns mounted on rails and used this to entertain Parisian people, who were shaken by riots. He performed terrifying shows of supernatural spectacles called ‘Phantasmagoria’.

19th Century

In the middle ages, an oil lamp was used with the projecting apparatus, but the oxy-hydrogen lamp was invented in the 19th Century. Hydrogen and oxygen were mixed, creating a high temperature in a chemical reaction so that a limestone began to glow with a very white light. This ‘limelight’ was about 6,000-8,000 lumen, which is brighter than average car headlights of today, this was at a time that most people had seen was the light of a yellow oil lamp.

Astonishing images from around the world were meticulously hand-transferred onto glass slides in crisp, beautiful detail, and the “limelight” then allowed them to fill huge screens with news, discoveries and catastrophes, such as erupting volcanoes.
By the Victorian industrial revolution, its popularity peaked, and thousands of people descended upon the Royal Albert Hall in London, UK, to see these projection shows. The apparatus used were big projectors with three lenses, dissolve units and limelight. It was the cinema projector of the 19th Century. The slides are unique, feature many colors and every slide is an artwork.


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Hybrid Interventional suites offer so many benefits in the clinical environment for specialists, patients and management that they are often on the development wish-list of many hospitals. And hybrid interventional techniques are part of a highly skilled expertise that will only advance in the future. Canon Medical’s Infinix-i Hybrid + is a market leading interventional system that offers outstanding performance in a wide variety of clinical scenarios.

In September 2018, the Bichat-Claude Bernard Hospital, in Paris, France, installed a hybrid operating room (OR) that features Canon Medical’s flagship, Infinix-i Hybrid, which has enabled the Hospital to significantly enhance its interventional capabilities. With the new suite, it has now emerged as one of Europe’s centers of excellence in interventional cardiovascular techniques.

With the Infinix-i Hybrid + the hospital can now boast about being one of Europe’s centers of excellence.”- Dr Jean-Michel Juliard, Interventional Cardiologist

With the Infinix-i Hybrid + room, we now have a suitable tool for all our medical and surgical specialists.” – Dr Quentin Pellenc, Vascular Surgeon


Core technology

The Infinix-i Hybrid + has a unique, double, ceiling mounted sliding C-arm and dedicated surgical Maquet Magnus table. These features enable the system to provide ultra- fast whole-body 3D coverage, free head access and a unique lateral C-arm stroke for better ergonomics, improved productivity and the highest quality 3D images from head-to-toe. The system also has many dose reduction tools – live zoom, spot fluoroscopy, Dose Tracking System (DTS) fluoro-roadmap, which are essential during complex aortic repair or mesenteric stenting, which can only be achieved using lateral views.

“We really appreciate the ergonomics of the room. The C-arm can be positioned in a multitude of angles, allowing combined approaches from femoral and upper body access during the same surgery. Furthermore, image quality is excellent, and the digital zoom is very useful for complex procedures, such as fenestrated and branched stent grafts,” said Dr Quentin Pellenc, Vascular Surgeon at the Hospital.
“The system enables us to perform all the structural interventional cardiology interventions, some of which we used to perform in a catheter lab, in a dedicated environment for cardiologists and anesthesiologists. The room is also an OR for simultaneous intervention of cardiologists and cardiac surgeons in some complex procedures,” remarked Dr Jean-Michel Juliard, Interventional Cardiologist at the Hospital.

Unique capabilities

With the extensive capabilities of the Hybrid OR, the team at the Hospital have also been able to create some facilities for new clinical possibilities, such as a digestive stroke center in collaboration with the Gastroenterology and Digestive Surgery Departments. “This very specific activity is quite unique in France and is particularly adapted to the use of a hybrid room, such as the one provided by Canon Medical,” added Dr Pellenc.

The new facility has enabled the skilled specialist team at the Bichat-Claude Hospital to advance their expertise and emerge as pioneers in European cardiolovascular intervention.

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Having worked for Canon Medical Systems in logistics for many years, Johan Vochteloo, took on management of the European demo equipment. Johan gained a unique insight into the demo equipment’s lifecycle that laid the foundation for a brand-new project, Secondlife, which was officially launched in 2009 and has since become a successful venture that has provided affordable, refurbished, top quality Canon Medical systems.

“We had a huge warehouse, full of outstanding demo equipment,” said Johan. “Part of it could be sold, the rest was returned to the European Head Office. I remember wondering what to do with all this excellent equipment that hasn’t been sold yet?”

Dynamic maintenance environment

Refurbishing medical equipment demands a lot of work with many strict regulations and legal aspects, which can change over time. In addition, the equipment hardware and software used in demos, of course is continually changing.

“I have developed a sort of ‘Bible’, in which every piece of equipment that qualifies as refurbished equipment is defined. We had to write refurbishment manuals for each type of equipment we were using, and also prep the equipment itself,“ said Johan. “The task of writing and updating manuals can seem endless. We almost have to write our manuals over and over again.”

Custom built facilities

Secondlife has a new facility in Zoetermeer, which contains several areas dedicated to each step of the process. It has an inbound area were the dismantled materials will be received and checked on completeness, and damages. A cleaning and disinfection area were all units will be cleaned and disinfected before it is handed over to the engineers. There are two CT refurbishment booths and one multi-modality booths, in which CT’s and larger X-Ray models can be worked on, including interventional ceiling mounted systems. The multi-modality booth can also be used for trainings and to receive customers to inspect their new system. The facility is a dedicated area that enables three systems to be serviced simultaneously and provides every engineer with his or her own work facility. When the systems are ready they are moved to the outbound area, where each system is packed and crated for shipment and the necessary paperwork is added.

Expanded team

With considerable expansion of facilities and Secondlife operations, Canon Medical’s Secondlife team has required a much bigger team. It now comprises of two CT engineers, three Ultrasound engineers, two mechanical engineers, two account managers and one trade desk coordinator to properly refurbish its equipment fleet across Europe.

TLC

“What began from a crowded warehouse full of demo equipment with potential, but requiring tender loving care that only our skilled engineers can give it, has grown into a successful and thriving subsidiary business. Secondlife equipment sells everywhere across Europe,” added Johan.

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The burden of cardiovascular disease (CVD) is set to increase drastically over the next decades and it is already the most common cause of death in Europe. Canon Medical now provides hemodynamic monitoring solutions in combination with imaging. This has been made possible through the recent acquisition of Fysicon.

Unique integration of sophisticated products

Information Technology (IT) connects everything inside the majority of modern hospitals. Fysicon’s sophisticated products add greater IT connectivity and workflow management, as well as security.

Monitoring cardiac conditions

It’s most well-known product is QMAPP – a hemodynamic monitoring system. QMAPP completes Canon Medical’s Alphenix cardiovascular X-ray system as a complete system for the cardiac lab. This can be an ideal, effective, affordable and efficient combination for small hospitals.

Managing advanced cardiac diagnostic tools

Information on stents, balloons, devices, valves and any implants are stored on QMAPP, and can be sent to registries. Fysicon has also developed the EVOCS web application – an image and document sharing system, which transmits images from one hospital to another over a secure Internet connection. With EVOCS, the risk of losing or damaging the images disappears, transfer process is expedited, and the data anonymized. DataLinQ is another Fysicon workflow management system used to facilitate a paperless pacemaker clinic and make pacemaker follow-ups more efficient and less costly. Usually, pacemakers are implanted in the cardiac catheter lab. Fysicon facilitates an IT solution where all the data from the pacemaker is directly fed into the database for easy reference. With DataLinQ Remote Device Management it is also possible to integrate data from remote device systems into DataLinQ Cardiac Rhythm Management.

Wider potential

Many medical institutions are realizing the wider implications of the advanced capabilities of the combination, such as in diagnosis and subsequent treatment of stroke. Time is critical in brain injury and stroke management, and EVOCS can help make a difference. It can save time when a patient CT information is sent to the neurovascular reference center, to enable the neurosurgeon to get the data as soon as possible and trigger the appropriate chain of actions.

Early diagnosis

The combination of Alphenix and QMAPP can help detect CVD at an early stage, before any complications, such as stroke, arise. Other modalities, such as oncology, can also be used to help in the early diagnosis of CVD.
“Offering single modalities alone isn’t usually enough to meet our customers’ needs. It’s important to think across the clinical pillar, because we can offer a holistic approach, for example, a complete cardiac solution. You can’t do everything with one device and that’s why you need to use the whole portfolio,”

Security

Cybersecurity is an essential consideration in all IT systems, especially when the systems are exposed to the internet. Data acquired on all Fysicon solutions is encrypted. The security measures that it uses are approved by the US Department of Defense.

Continuous improvement

“We are continuously looking for opportunities to make the current workflow more efficient, by combining additional modalities, and improving integration and usability.” – Eric van Antwerpen, Chief Commercial Officer at Fysicon.

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Providing cutting edge medical imaging technology goes way beyond selling equipment: it is also about supporting customers through a diversity of scenarios. Canon Medical Systems aims to provide the best service and highest levels of support. It incorporates an holistic approach to service that not only includes the highest level of technical support on a practical level, but also through the creation of tangible benefits from dynamic partnership.

“It’s our job to let physicians focus on patients, by happily taking away the burden of maintaining the equipment. We do everything in our power to keep customers happy.” – Rob de Jong, European Service Director.


Canon Medical Systems Service offer has been shaped and is managed by Rob de Jong, European Service Director, and Afshin Hamzei, Senior Service Manager. Service is provided through a network of 49 companies covering 52 countries, which combine Canon Medical Group companies, as well as Canon Medical partners. The relationship with these partners goes way beyond dealership, It’s a partnership that works closely together to deliver the best possible customer service experience.

Key issues in service for our customers include:

Maintenance

Maintaining medical equipment requires special care and highly trained service professionals. Canon Medical draws on its wide-ranging skills to deliver the best possible service. Handling the delivery of approximately 25,000 service parts each year in 52 countries, meeting cross border challenges in many cases, Canon Medical almost always delivers the parts onsite at expected date.

Aging

One of the main challenges in servicing medical imaging devices is that equipment is aging. Many systems currently used by various medical institutions in Europe are older than 10 years and some are obsolete. Financial pressures can often necessitate the use of old systems, which can be potentially more vulnerable to cyberattacks.

Cyber security

The number of cyberattacks has increased tremendously over the past few years. Canon Medical uses whitelist antivirus as standard on its equipment, which is more secure than traditional antivirus. By continuously working with software developers, cybersecurity strategies are constantly improving. And there is a global effort to raise awareness of cybersecurity and better protect systems.

Remote solutions

Remote technology offers new opportunities that expand the boundaries of service.
Canon Medical has a dedicated Product Security incident Response Team (PSIRT) in Japan that communicates with all relevant global organizations in this field. PSIRT observes, assesses and offers solutions if any threat appears on its radar.
In Europe, the initiative is relayed by Canon Medical’s Cyber Security Incident Response Team (CIRT), which reports potential risks in each country, before they reach international level, to PSIRT.

Its remote service system, Innervision, which issues automatically created alerts to prevent down time. Alerts are generated and send to the engineers in charge, to determine which course of action to take.

In addition, there is a growing trend towards predictive service in healthcare, as any ‘break and fix’ approach is becoming obsolete.

Canon Medical’s advanced service offer and capabilities have helped set new standards in the whole imaging and diagnostics equipment industry.

“Customers prefer to know in advance what is going to happen with their equipment. That can have a positive effect on both cost and downtime. They can plan what they will need to spend to keep their equipment up and running. This is the biggest change we will see in the near future.” – Afshin Hamzei, Senior Service Manager.


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