Surgery Enters A Third Era of Innovation
The history of surgical innovation is described by incredible advancements that have dramatically improved patients’ lives.
In the first era, surgery transitioned from open techniques using large incisions to less invasive approaches. This trend started in the 1980’s when surgeons started putting cameras and small instruments into the abdomen to remove diseased gall bladders and now even includes heart valve replacements delivered through catheters that are snaked through arteries from the groin all the way to the heart. Incredible technology.
I saw this impact first hand when working at Kyphon in the 2000’s, where we trained orthopedic and neurosurgeons to use x-rays to guide instruments into the spine using small incisions instead of making large muscle dissections so they could see the anatomy with their own eyes.
A second era of innovation began as the engineers at Intuitive Surgical created robots to increase the capability of surgeons during minimally invasive procedures. Surgical robotics revolutionized abdominal surgery, gaining initial traction first in certain urology, then progressing through gynecology, general surgery and thoracic surgeries in the coming decades.
I was again fortunate to witness robotic technology improve endoscopic procedures at Auris. The Monarch system was developed to improve lung cancer treatment, with designs on urology and other endoscopic procedures in the future.
We are entering the third era of significant surgical innovation as data products begin to proliferate the operating room. This revolution holds incredible promise to deliver patient improvements that are not just about surgical tools, but improve the entire operating environment.
A broader impact
During the first two eras, technologies brought to surgery were typically designed to solve specific problems with one technique or one type of patient. Despite the benefits of minimally invasive surgery, many procedures are still done open due to the procedure specific nature of technology and procedure development. The same is true for robotics, as different robotic systems are used for abdominal surgery, orthopedic surgery, spine surgery, neurosurgery, and so on. This is why less than 5% of surgeries are performed with the benefit of robotics.
In the digital era, we can do better
So how do you have a broader impact? First, the technology must be easy to use, and require no new work for healthcare workers. The O.R. team is already juggling two jobs, taking care of patients and documenting into the EHR every step of the procedure. Second, it needs to be on and collecting data all the time. There is a lot of room to improve in the O.R. other than during the surgery itself. And finally it should be ubiquitous, applying to every O.R., endoscopy suite, cath lab and outpatient center.
This is what we are building at Apella, the first systematic data collection, analytics and communication system to profoundly and dramatically move the curve in surgical quality and cost.
I am incredibly excited to have closed our Series A financing, welcoming an incredible group of financial partners to lead this third revolution in surgery and bring the O.R. into the digital age.
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