The Histology Automation Revolution Is Coming!
It is easier to change the specification to fit the program than vice versa.-Alan Perlis
The Histology Automation Revolution is coming! the Histology Automation Revolution is coming!
For the past ten years, we in the field have been told to watch for the technology rider to gallop to our labs and announce that new automation is here. The rider has come to our labs several times, but it seems to me he is at a slow walk and the lamp of true technology change has not yet been lit. I do not think we will wait much longer.
I know what you are saying to yourself, hasn’t he seen all the new instruments that we can buy?! There are automated slide stainer/cover-slipper combos and rapid and microwave tissue processors, technology is all around us. Yeah, but those are only the advance guard and I see “upgrades” to many of the same old processes and instrument platforms. When will the army of innovative automation arrive to truly reduce the workflow bottlenecks and create a giant leap in quality? Sure technicians can walk away from existing processes at many steps and we can use management tools to clean up, but we are fighting the battle with old technology. I say it is time to consider creating a new process, it’s time for a new method!
There are four major bottleneck in the existing Histotechnology process and they are not being adequately addressed by automation; grossing of tissues, embedding blocks, cutting slides and now a rapid decline in trained technical staff. To date there is only one automation advance that has tackled one of the bottlenecks - embedding blocks, and that is the AutoTEC automated embedding instrument. This advance is met with push back because people are resistant to change.
To help address the increasing workload, I say we need a revolutionary change in tissue sampling, such as one that recently came to Cytology or has been used for many years in Flow Cytometry. We need a new sample collection process that will allow for true standardization and automation of the diagnostic biopsy and continue to provide the Pathologists “cells” to stain and attach antibodies and probes.
Histotechnicians/Histotechnologists need time to redirect their efforts to add value to the existing process and help produce new diagnostic tools for our Pathologist partners and results for our patients.
I continue to look for the new technology rider and a bright signal for change. What have you seen or what are you waiting for?
Just went out to CA last month for Sakura training on the VIP 6 and got to look at the “dream lab” Sakura just set up.
Very cool! At that lab they have the Automatic Embedding system. What they do to get proper orientation at the time of grossing is they’ve developed special cassettes that have, for lack of a better word, baskets. They have a biopsy cassette basket, a basket that could be used for tubular structures (ie vas deferens), they have a basket for larger specimens (uterus etc) and baskets that have rows for breast bx and prostate bx.
The whole idea is to maintain orientation all the way through the process. The tissues are oriented in these cassette baskets at the time of grossing. They are loaded onto the processor, then loaded into the auto embedding center. Never having to re orient the samples.
Then the baskets are embedded directly into the paraffin wax and are sectioned. You section right through the basket. It is made of a special type of plastic that is “sectionable.” It is a really cool idea and process to watch.
I brought home some samples of the baskets so I could try them here in our lab even though we don’t have the auto embedding station. We sectioned through a couple of the different basket varieties and got good results.
I’d contact my Sakura rep for some samples so you could try to section with the basket and see if it works for you.
We don’t have the volume that would necessitate an auto embedder b/c we are a research lab - but if we could justify it I’d love to have it.
I am certinly glad that you were able to see and embrace the Sakura technology. Tissue sample selection and orientation, at the Grossing bench, is an important first step onto the automation revolution road. What do you see ahead on the road that will transform the Anatomic Pathology and Histology Lab?