TechMed Centre Experience Pre-program Double Oration M. Rovers & J. Tamsma

Einthoven’s galvanometer represents a pivotal milestone in medical history and is considered the precursor to the modern electrocardiogram (ECG). Developed in the early 20th century by Dutch physiologist Willem Einthoven, this highly sensitive measuring instrument made it possible for the first time to accurately record the electrical activity of the human heart. Known as the string galvanometer, Einthoven’s version used a thin conductive filament placed in a magnetic field to detect minimal voltage differences and display them as waveforms. This innovation led to the introduction of the first standard ECG leads, known as Einthoven’s lead system (I, II, and III), which still form the foundation of cardiac diagnostics today. Einthoven’s galvanometer was not only a technological breakthrough but also marked the beginning of a new era in non-invasive medical diagnostics. His work was honored with the Nobel Prize in Physiology or Medicine in 1924.

Breastfeeding offers unique benefits for mother and infant, but various problems can occur. For example, many mothers are unsure if their milk production is sufficient. How can we know what and how much a baby drinks from the breast? And why do breastfeeding challenges arise? These are questions that Prof. dr. Ir. Nienke Bosschaart addresses with her team ‘Human Milk and Lactation’ at the University of Twente (TechMed Centre). We demonstrate different optical techniques that are used to study human milk and the lactating breast.

At the BMS Lab, we are dedicated to creating software that helps researchers & practitioners engage with people and understand their behavior in real-world settings.

• TIIM is our platform for interactive, participant-centered research. It enables direct communication with participants, the sending of reminders, delivery of content or stimuli, and designing adaptable studies and interventions tailored to individual needs. Whether in clinical, behavioral, or social science context, TIIM supports meaningful, long-term engagement between researchers and participants. The platform operates on secure infrastructure, compliant under NEN and ISO standards (7510/7512/7513 and ISO/IEC27001).

ScriBe is our upcoming platform for behavior analysis through multimedia. Designed for researchers working with audio and video, ScriBe allows you to transcribe, diarise, and visualise interactions, providing deeper insight into social behavior.

Health Innovation Netherlands (HI-NL) is based on the proven fact that early dialogue between innovators and relevant stakeholders improves the value and effectiveness of health innovations. By bringing all relevant innovators and stakeholders together in one place through the HI-NL Round Table service, comprehensive well-structured guidance can be provided to accelerate the introduction of innovations that directly meet end-user needs.

Heart failure remains a major cause of death worldwide, and despite decades of research, we still lack effective treatments to cure it. One of the key reasons is that traditional animal models often fail to predict how the human heart responds to new drugs. At River Biomedics, in collaboration with the University of Twente, we are developing a new approach that brings heart research closer to the human patient. We use human pluripotent stem cells to generate heart muscle cells, and from these we engineer beating heart tissues in the lab. These so-called engineered heart tissues (EHTs) closely mimic the function of the human heart and allow us to test drugs in a more reliable and predictive way. By using patient-derived stem cells, we can even create models of specific heart diseases, opening the door to personalized medicine, testing treatments on a patient’s own tissue before giving the drug to the patient. In this demonstration, I will show several of the assays we are currently working with, including technologies to assess the beating function and drug response of the tissues. These assays help us to identify potentially effective new drugs for heart disease, while also reducing the need for animal testing. This innovative platform brings together academic research and biotech development, combining the scientific expertise of the University of Twente with the application-driven approach of River Biomedics. Together, we aim to build better models of heart disease and accelerate the discovery of effective, personalized treatments for patients suffering from heart failure.

Liver cancer is one of the most common and lethal cancers in the world. To diagnose this form of cancer, a physician takes a biopsy by accurately inserting a needle in the tumor. To destroy the tumor, the physician inserts one or more ablation needles. For deep and difficult to reach tumor lesions, this procedure is performed under CT guidance. Even for skilled specialists, it is hard to reach the right spot manually based on the CT image. Sometimes several attempts are necessary to place the needle successfully. To overcome this, a needle placement robot helps the medical specialist find exactly the right angle to place the needle the first time right – to the relief of both patient and specialist.

How does a needle replacement robot work?

The starting point for developing the needle replacement robot was to retain the current workflow as closely as possible, and only to automate the steps critical for the speed and result (‘first time right’) of the procedure. The critical step is determining the angle at which the needle enters the body.

As a result, we developed a system comprising a head with a needle-guidance mechanism and an arm which secures the head in relation to the operating table with one press of a button. The head can be positioned around the patient manually. Once the system has been positioned around the patient, it accompanies the patient into the CT scanner to determine the position of the patient’s tumor in relation to the head. When determined, the system automatically steers the needle-guidance mechanism to assign it the required direction. The needle is then clamped into the guidance mechanism and inserted into the body by the doctor himself.

What were our challenges?

Firstly, the system architecture based on the current medical workflow was a challenge. It needed to minimize the barriers to being used by the doctor, both literally and figuratively. A second challenge was the design factor. The entire system, including arm and head, needed to fit in the (tight) space between the patient and the CT scanner’s ring. However, the biggest hurdle was CT compatibility. The bulk of the system would enter the scanner’s X-ray field but should not disrupt the imaging. That meant that the usual materials like steel, copper and titanium were not an option. We worked with several suppliers including Ceratec (ceramics) and Futura Composites to develop alternatives. Varieties of materials were used in the components, such as composites (for rigid construction parts and flexible elements), ceramics (for highly stressed precision parts and ball bearings), Dyneema fibers (for rotating cable drives), carbon nanotubes (for power wires and switches) and plastic optic fibers (to read out encoder positions remotely). These solutions imparted high rigidity to the construction, minimizing any transmission play. The result is a system which can guide the needle correctly and precisely, with a margin of error of less than 2 mm at a depth of 25 cm. This means the patient suffers only minimal tissue damage, the medical team can complete the procedure more quickly (and thus more economically), and the doctor remains ‘in control’.

Our role in developing this system

We developed the needle placement system in close collaboration with medical specialists from the Erasmus Medical Center Rotterdam and the University Medical Center Groningen (UMCG). Besides development, we also conducted the clinical study to validate the system. The study included 28 patients at the University Medical Center Groningen (UMCG). The robot-supported method proved to have clear advantages over the manual approach, one prominent advantage being the milder impact on the patient.

Principles of Technical Medicine is a movement working to better visualise Technical Medicine, how it came into being, and, most importantly, its place in and contribution to the medical world. It adds to the established knowledge and expertise already present in medicine. We want to describe the principles of the discipline and practices now emerging in several Dutch clinical settings.

With an extensive group of contributors, we are in a creative process. The first step is a website, which we will present on May 22. Visit us and stay informed about the latest updates!

Cardiovascular modelling is increasingly recognized as a valuable tool for the development and testing of medical devices. Cardiovascular simulators can function as "virtual patients," enabling the evaluation of safety and efficacy for new therapies while offering a promising alternative to animal testing and clinical trials.

In this presentation, we showcase the simulators developed by our group and demonstrate their application in evaluating a range of medical devices[1], [2], [3]. Our simulation techniques span a broad spectrum—from purely in silico to in vitro approaches, and from 0D to 1D to 3D models[4]. These techniques are combined ad hoc depending on the specific therapy under investigation. Higher-order models are employed for anatomical regions directly impacted by the device, while lower-order models represent the rest of the cardiopulmonary system. This modular strategy reduces computational demands, making it feasible to generate numerous test scenarios or patient profiles—comparable in scale to large clinical trials.

A clear example of this approach is the testing of venoarterial extracorporeal membrane oxygenation (VA-ECMO), a therapy implanted between the vena cava to the arterial system. Since key questions regarding the safety and efficacy of the therapy relate to the arterial region, we developed a setup using a 3D aortic phantom, in which the VA-ECMO is cannulated in a clinically realistic manner. The phantom is physiologically actuated with realistic pressure and flow profiles, generated in real time by an in silico patient model that interacts dynamically with the phantom.

This hybrid in silico–in vitro approach, combining computational simulation with a 3D physical phantom, provides a high-fidelity test bench. It enables the assessment of VA-ECMO effects both at the systemic level—via the in silico patient simulator—and locally—within the aortic phantom. Building on this example, we are developing additional test benches targeting other anatomical sites, to support the evaluation of different cardiac and vascular medical devices.

The Biomedical Device Design and Production lab (BDDP) focuses on generating knowledge and expertise to cover the entire trajectory from a clinical need to clinical evaluation of a biomedical device, including innovative designs, manufacturing, verification of Medical Device Regulation demands and circularity. Within this exhibition we display the wide variety of problems that we work on using various methodologies. E.g. musculoskeletal modelling of the aging knee joint, derivation of design requirements for ALS patients, gaining fundamental knowledge on bone-sawing interaction and various medical devices to assist patients in activities of daily living.

Pelvic floor problems such as pelvic organ prolapse, urinary and fecal incontinence or pain during intercourse occur in up to 40% of women aged 40 and over. There are different types of treatments such as pelvic physiotherapy, pessaries (rings) or surgery. Each type of treatment has its own advantages and limitations. Limitations in improvement of therapy might be becaused due to our lack of understanding the pelvic floor. Majority of the research that is done focuses on questionnaires or on imaging made with the patient in a lying position. At the University of Twente we have access to a tiltable MRI, with which we perform various translational and clinical studies to better understand pelvic floor problems and then improve them. During the tour we will show you how the scanner works, how big the anatomical differences between standing and lying are for this population and what our future plans are.

At the TechMed Academy, we train healthcare professionals and technological developers to become adaptive experts—individuals who can act effectively even in unforeseen and untrained situations. In this demo, we showcase how we achieve this in close co-creation with our target group, with a strong focus on practical application. Discover how our education prepares professionals for the complex realities of healthcare and technology.

Machine perfused ex-vivo organs offer an excellent experimental platform, e.g., for studying organ physiology and conducting pre-clinical trials, such as drug delivery studies. One key challenge in machine perfusion is the accurate assessment of organ condition during perfusion. Among the available imaging modalities for this purpose, contrast enhanced ultrasound (CEUS) is a highly flexible and real-time option, providing visualization of tissue perfusion using ultrasound contrast microbubbles.

In this demonstration, conducted in the hybrid operating room, we present the use of CEUS in an ex-vivo machine perfused pig liver that is retrieved from a local slaughterhouse. The liver is perfused using the LiverTwin perfusion platform developed at the University of Twente. In the perfused liver, ultrasound contrast microbubbles (Sonovue, Bracco, Geneva, Switzerland) are injected and a 9L4 ultrasound probe, connected to the Acuson S2000 ultrasound system (Siemens Healthineers, Erlangen, Germany), is used to visualize the microbubble presence. By moving the ultrasound probe, poorly perfused regions, which may indicate the onset of ischemia, can be identified in real-time.

This demonstration aims to highlight the unique capabilities of contrast-enhanced ultrasound for the visualization of perfusion, providing insights into its application for pre-clinical studies and translational medicine.

Eating is more than the consumption of food. Eating is often a social activity. We sit together with friends, family, colleagues and fellow students, to connect, share and celebrate aspects of life. Sticking to a personal diet plan can be challenging in these situations. The social uncomfortableness that is associated with having a different diet than the rest of the group greatly contributes to this. Additionally, it is well known that we unconsciously influence each other while we eat. Not just in the type of food that we choose, but also the quantity of the food that we consume, and even the speed with which we consume the food is affected by our eating partners.

The interactive dining table is created to open up the concept of healthy eating in a social context: where individual table members feel supported in their individual diet plans, yet still experience a positive group setting. The table is embedded with 199 load cells and 8358 LEDs, located below the tabletop surface. The table can use artificial intelligence to detect weight shifts over the course of a meal, identify individual bite sizes and classify interactions between table members and food items. Simultaneously, the LEDs can be used to provide real-time feedback about eating behavior, give perspective regarding food choices, or alter the ambience of the dining experience as a whole. Light interactions can change over time and between settings, depending on the composition of the table members or the type of meal that is consumed.

This demo will showcase groundbreaking wireless technologies that could revolutionize the future of minimally invasive medical procedures. Visitors will see how microrobots can navigate wirelessly through the brain's blood vessels for precise surgical interventions; how a video capsule endoscope can be steered inside the body using an external magnetic field for targeted imaging; and how wireless magnetic screws can be actuated through soft tissue and viscoelastic materials, offering new possibilities for surgery without traditional incisions.

You have a brilliant idea for a Health Technology Innovation. How can you progress this idea to life? Who can help you to identify opportunities and risks with regards to (clinical) practice, quality and regulatory, (clinical) evidence strategy, business development, and implementation? And how can you prioritize and finance strategic innovation and implementation activities? Together with partners in our ecosystem, the University of Twente is establishing Local and Regional Roundtables to support researchers and innovators with advice and services to take the next steps towards societal impact and sustainable health(care) for all. Will you help us to initiate a culture shift, in which an early, iterative and interdisciplinary approach towards Health Technology Innovation becomes fun and feasible? Today we play the HealthTech Innovation Game!

The Zorg Innovatie Plein is a regional initiative committed to maintaining accessible and high-quality care for people with chronic conditions in Twente and neighbouring regions such as Salland. Through close collaboration between healthcare professionals, researchers, technology developers, and individuals living with chronic illnesses, the initiative focuses on innovations that truly make a difference in practice.

The urgency is clear: the number of people with chronic diseases is rising, health disparities are increasing, and the shortage of healthcare personnel is growing. The Zorg Innovatie Plein addresses these challenges by connecting technology, healthcare, and research. Innovations are not only developed here, but also selected based on actual care needs, tested in real-world settings, and refined through a learning-by-doing approach.

The initial focus is on conditions that place the greatest strain on the region—such as diabetes, cardiovascular diseases, osteoarthritis, and dementia—but the initiative is designed to be scalable to any health-related challenge. The Zorg Innovatie Plein serves as a dynamic hub where ideas, knowledge, and experience converge—driven by one mission: ensuring sustainable, accessible healthcare for everyone in Twente.