In this installment of our Visionaries Q&A series, we asked Chuck Pell, TEDMED 2011 speaker, about how he’s biomechanically overhauling surgical instruments — in one case, designing the first update in 75 years — and what that means for patient recovery.
Q. The first product your company, Physcient, plans to introduce is called Assuage, a robotic rib spreader for heart and lung surgery that helps prevent common surgical complications like cracked ribs and nerve damage. It’s replacing a hand-cranked design that hasn’t changed since 1936. 1936! What has been keeping us from taking a step back and rethinking those designs? Is surgery some kind of mystical field, some kind of sacred cow?
A.We’ve left our brilliant surgeons a 1936 design that is amazingly primitive given what we know about biomechanics in 2012. Traditional surgical instruments need to catch up with doctors’ amazing talents and training. As a society, we’ve accepted for 100 years that surgical holes must be profoundly damaging and painful. Physcient respectfully disagrees! In one step, we’ve jumped 75 years into the future – the future of 2012, versus 1936. As an example, our group is the first to ever measure the forces of thoracic retraction, so we’re the first to see those signals, the first to understand them, and the first to capitalize on what they can do for patients.
Our robot senses and responds thousands of times each second, so that it can detect the subtle signs of imminent tissue damage and react many times before a human could detect anything’s amiss. This is what the military calls a force multiplier: It enhances the operator’s capabilities. We change the tool, not the procedure. The instruments should just get better so the surgeon gets to be better, so the patients can hurt less and heal faster.
Q. Have the health/medicine experiences of others in your life shaped the work you’re currently doing, and the innovations you want to see?
A. Yes! My father is gone, probably because he watched my Uncle Earl get cracked open three times. (He’s gone now, too.) Look, everybody is a patient and everybody is pre-operative. And we’re becoming more aware that these surgeries are way more painful than everyone first admits.
The common source of damage appears to be the basic assumptions embodied in the sometimes centuries-old design of the instruments. The results? When patients talk to each other in confidence, they say, “I feel like I’ve been hit by a truck.” Or, “Next time, I’d rather just die.” It doesn’t have to be that way.
When you wake up alive after an operation and the surgeon asks, “How are you doing?” the polite thing to say is, “Thank you for saving my life.” No one says what my Uncle Earl told me, “I feel so bad I want to grab the surgeon with my bare hands.” He was alive, but he was upset at how bad he felt for some time. I was so shocked, that statement stuck with me.
As soon as people find out that major surgery doesn’t have to cause such pain, they won’t sit still for the old way of doing things. They’ll want a better way. I would. So, I design instruments like I’m going to have surgery next week. We’ll shoot for the moon: Surgery should be as pleasant as we can make it, before, during, and after. The fear of waking during painful major surgery should become a thing of the past.
Q. Where are you with Assuage? When will it be clinically available?
A. Assuage should be available within 18 months of closing our current round.
–Interviewed by Stacy Lu
Please stop by tomorrow for part two of our interview with Chuck Pell. Click here to watch his TEDMED 2011 talk.