Smart Shadow – making keyhole surgery safer

The company

Smart Surgical Appliances (SSA) is a spin-out company from Imperial College

London, founded in 2006. It develops advanced, sensor-enabled endosurgical

instrumentation designed to reduce costs, improve safety and outcomes and

minimise risk in the large, but complex keyhole surgery market.

The problem

SSA believed it had an idea with the potential to make keyhole surgery safer

and more widely available but had trouble getting early stage funding to develop

it.

The story

Keyhole surgeons could soon have a new device in the operating theatre that

provides a sense of depth during procedures, thanks to Dr Omer Aziz and

Adam James – two medical device entrepreneurs with a mission to get research

out of the lab and into surgical practice.

Grant funding from Innovate UK is helping them accomplish this mission with

Smart Shadow, a device that opens up new possibilities for keyhole

(laparoscopic) surgery.

Omer is a laparoscopic colorectal surgeon and Adam a biomedical engineer.

“We got together when we were doing PHDs at Imperial College London and

thought about how we could take the interesting research ideas we’d seen into

surgical practice,” said Omer.

When SSA was looking for a new project a few years ago they decided to

pursue research in the area of keyhole surgery evolving out of the college’s

Department of Surgery and Cancer.

Depth perception for surgeons

Omer is convinced of keyhole surgery’s benefits. The patient ends up with a

much smaller wound, a shorter recovery and less risk of complications. But

relying on a narrow field of view on a screen has its drawbacks.

“One problem is that you can’t perceive depth. You have a 2D view of a 3D

human,” said Omer.

This increases the risk of accidental damage to healthy organs through poor

tissue manipulation and longer procedure times.

“Smart Shadow gives surgeons a clear sense of depth by augmenting a digital

shadow into the video stream. This can be used to accurately judge the

distance between the instruments and the tissues,” added Omer.

Simulating surgery

SSA applied for a Smart Proof of Concept award in 2012. The programme

tackles the funding gap often experienced by many small and early-stage

companies with cutting edge, game changing innovative ideas and high growth

ambition and potential, looking to access global markets. SSA used their

£99,991 award to build a prototype that simulated what the Smart Shadow

device could do.

“We built an engineering prototype that could demonstrate our concept in a

number of settings. Essentially we did a keyhole procedure in a simulated

environment as close to reality as possible without involving a human,” said

Omer.

As a result of the Smart award SSA has raised £200,000 from a private,

cornerstone investor.

SSA are now developing both hardware and software components of the

product through to pre-production so they are refined for clinical use.

“One of the problems in the UK is that there’s a gap between ‘angel’ investors

who will invest small amounts and venture capitalists who want to invest larger

ones. Smart awards fill that gap,” said Omer.

“Innovate UK funding was absolutely pivotal for us. It enabled us to secure a

single cornerstone investor, and it was one of the reasons he chose to invest,”

Adam added.

An affordable solution

SSA has also been awarded a Smart Proof of Market award to fund further

research into the commercial viability of the device.

“Figures suggest that only 20% to 40% of what could be done using keyhole

surgery is being done,” said Omer.

He’s confident that Smart Shadow approach is preferable to other systems on

the market that require expensive capital investment in new 3D and

stereoscopic cameras.

“Smart Shadow works with existing technology. You don’t have to replace

screens and stacks, making it a faster route to providing depth perception.

You’re also talking lower costs, hundreds of pounds rather than hundreds of

thousands,” he added.

SSA now has a team of 3 working to push Smart Shadow forward. It’s currently

closing a second small funding round, which will be followed in 2015 with a

larger round to raise £1.3 million.

“The second round will be used to go through the CE mark process, taking the

technology into clinical practice. We think we will reach the stage where it’s

ready for human use in the first half of 2015,” Omer commented.

“This wouldn’t have been possible without Innovate UK funding that allowed us

to get past the chicken and egg stage where investors are interested but want

to see something working,” Adam said.

www.gov.uk/innovateuk