SURGERY
Practice makes perfect WEB CONTENT EDITOR, IAN BOLLAND WRITES ABOUT HIS RECENT VISIT TO ST HELENS TO LEARN HOW MANUFACTURER INOVUS MEDICAL CREATES USEFUL TOOLS TO AID SURGICAL TRAINING.
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eginning with simply a sheet of plastic and a heat gun, the team at Inovus Medical has come a long way since the development of its first laparoscopic simulator. The St Helens-based team is expanding, with much of its manufacturing done in house. While it builds its own simulators to allow junior doctors and surgeons to practice procedures using digital aspects, augmented reality and virtual reality, it has also started to develop its own electronics and materials behind the use of medical devices. This year alone has seen £1 million investment going towards another augmented reality system. Elliot Street, Inovus CEO and cofounder, worked as a junior doctor in the early years of the business. His co-founder, Jordan Van Flute, had only just graduated. Addressing how the company began, Street said: “What we wanted to do first was answer an unmet need which needed to be answered. We wanted to answer it affordably and we set up a company where we had to really hustle, and noone would hear of us apart from the exact end users using the kit. “All we were going to do in those first five years was developing really good kit in front of the people who need to buy it.” The “kit” Street refers to was at first just a plaster box with a webcam in. Street realised when he began his surgical training how there was a “real lack of access to good quality, affordable laparoscopic trainers,” and this is how the idea was created.
Talking about the industry, Street said: “We’re vertically integrated in the processes of manufacturing, we’re vertically integrated in the process of design and product development, but we’re also vertically integrated in the actual products themselves and the portfolios.” As well as the digital simulators, Inovus also manufactures original materials in-house. “Our haptics are real haptics, you don’t need sensors because we’re putting in models that feel like real tissue,” Street added. “The thing that’s giving you all that haptic feedback is a real, tangible model and then we build a digital environment around that.” Street explained that a major driver of the idea was the desire to allow trainees to perform a virtual procedure in the most realistic way – repeatedly stating his desire for products to be affordable, accessible and functional. Simulators have been developed for multiple purposes including those that can be taken home, and those that are designed for use in an institutional setting. The materials developed in-house allow Inovus to try and make procedures like appendix surgery and ectopic pregnancies as realistic as possible – the latter specifically having its own mass that can be removed from the model. Polyps and lesions are among the ‘dummy scenarios’ that have been manufactured for surgical practice from silicone material. The simulators therefore conjure up a mixture of the digital environment and reality. To take it as close to reality as possible, with some of them 3D printed in their entirety like the Bozzini Hysteroscopy Simulators and Sellick Cricoid Pressure Trainers. Talking about the materials Inovus is developing in-house, Street commented: “Some materials we have are proprietary to us and we spent a long time developing those materials, which allow us to perform electric surgery, use energy devices in theatre on them and they react like real tissue.” Elliot Street, CEO and co-founder, Inovus
Inovus’ first device was made by bending a piece of plastic with a heat gun around the side of a fridge, and then drilling some holes in to it. Street and Van Flute took photos of the product and shared the images on their self-coded website. Every time they sold something, they constantly reinvested the money, using it to initially buy a safer method of bending plastic and later, more kit.
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