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Cutting Out the Knots in Surgery

Executive Summary

The needle-and-thread suturing process surgeons use to create anastomoses has been a staple in the OR, largely unchallenged for nearly a century. New developments in minimally invasive and endoscopic surgery, particularly in coronary bypass procedures, have created the need for a tissue-closure technique that can produce high-quality anastomoses in small spaces with limited visualization. As a result, anastomotic device technology, a long dormant area of product development, has become a hot subject at clinical meetings, and numerous companies, from major device firms to start-ups, are exploring a range of different approaches. Coalescent Surgical, a start-up, is one of the first to market in this area, with an anastomotic device that uses an approach different than its competitors--a proprietary self-closing clip that replaces traditional sutures. Coalescent's challenge: to gain acceptance from surgeons, who are notoriously slow adopters of new technology. The company is betting that the advantages of its device, combined with being first to market, will enable it to survive what appears will be a stampede of competitors, including major players that have superior resources and existing relationships with surgeons.

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Ventrica: Providing the Connection to Minimally Invasive Cardiac Surgery

In cardiac surgery, the slow shift to perform coronary bypass graft procedures off-pump has turned anastomotic device technology, a long dormant area of product development, into a hot subject at clinical meetings and attracted the attention of large and small device companies. One start-up, Ventrica, was founded to focus on a new bypass procedure, but shifted its emphasis to an important component of that procedure: an automated coronary anastomotic connector. The company's magnetic technology has given it a head-start on this hardest part of the bypass connector puzzle. Some industry experts and surgeons believe that an easy-to-use, reproducible, automated anastomotic device will boost adoption of off-pump bypass surgery, which has lagged far below initial expectations and will also be essential to the future of robotic surgery. Ventrica's challenge is to attract new groups of surgeons to this approach rather than simply preach to already-converted early adopters.

Ventrica: Providing the Connection to Minimally Invasive Cardiac Surgery

In cardiac surgery, the slow shift to perform coronary bypass graft procedures off-pump has turned anastomotic device technology, a long dormant area of product development, into a hot subject at clinical meetings and attracted the attention of large and small device companies. One start-up, Ventrica, was founded to focus on a new bypass procedure, but shifted its emphasis to an important component of that procedure: an automated coronary anastomotic connector. The company's magnetic technology has given it a head-start on this hardest part of the bypass connector puzzle. Some industry experts and surgeons believe that an easy-to-use, reproducible, automated anastomotic device will boost adoption of off-pump bypass surgery, which has lagged far below initial expectations and will also be essential to the future of robotic surgery. Ventrica's challenge is to attract new groups of surgeons to this approach rather than simply preach to already-converted early adopters.

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