D(r)eamteam helps to develop an innovative medical instrument
Every invention begins with an idea or, to put it another way, with a dream. In the late 1990s, Dr Paul Breedveld (KNAW researcher with TU Delft and DEAM advisor) had a dream. He wanted to develop a surgical instrument with an fully controllable moving head, to be used in minimally invasive surgical techniques (‘keyhole surgery’). Now, not all dreams come true, and at first it seemed that Paul Breedveld’s dream would end with the production of a prototype. However, that was until Dr Jules Scheltes decided that Paul’s ideas were worth taking further.
It is a hot midsummer’s day and the fans in the DEMO workshop are working overtime. Jules Scheltes (founder of DEAM) and Aad Beeloo (project manager at DEMO) are enjoying a cup of coffee. On the table are two long, narrow cases. “Let me show you what it’s all about,” says Jules, clicking open one of the cases. He reveals a long, narrow instrument with a small metal pincer at one end. “This is the instrument, called a laparoscope, which surgeons use for keyhole surgery,” he explains. “As you see, the pincer can open and close but the metal rod to which it is attached is rigid: it does not move.” He replaces the instrument and opens the second case. “The instrument that Paul and I have designed has an extra feature. With this one, not only does the pincer open and close, but the entire head of the instrument can move in any direction. The flexible tube is controlled by an ingenious mechanism which is incorporated into the handle.”
An octopus’ tentacle
“The basic idea of the controllable head is Paul’s,” Jules continues. “He first started thinking about an instrument like this in the late 1990s. Paul did the necessary research and had a prototype made. Then he applied for a patent, by which time his research period was more or less over. But I realised that this idea had so much potential that it would be a crying shame not to take it further. In addition to my work at TU Delft, I therefore carried out a study into the commercial viability of the product. Paul and I then continued to develop the invention. In 2004, I founded DEAM, which became a limited company a year later. Paul and the investor Malcolm Begemann are now both partners in the enterprise.”
The invention for which a patent has been applied for is known as a ‘cable ring mechanism.’ This allows the tip of a flexible tube to be precisely controlled by manipulating the handle at the other end. It is based on the way in which an octopus’ tentacle works. “If you dissect a tentacle, you find a huge collection of interlinked muscles. Paul analysed those muscles from both the anatomical and functional perspectives. He identified the exact function of each before setting out to find a way in which to replicate the action by technical means. To give one example, within the tentacle is a sort of balloon which the octopus uses to extend the tentacle. If the balloon is contracted, the tentacle becomes both longer and thinner. A technical alternative to this is a pressure spring, which can generate a similar outwards force.”
“In the world of mechanical engineering we tend to minimise everything as much as possible in order to reduce the number of components required. In nature, we see the exact opposite: there are a lot of ‘components’ which actually do more or less the same thing. Our concept therefore differs from the standard mechanical engineering approach. In fact, Paul has used nature as a source of inspiration only. He has not copied it, but has studied the mechanisms and has determined which are useable and which are not.”
Unique components
Let us return to DEAM and to the patent that Paul and Jules applied for in 2004. A good idea, thought Jules, which should not be allowed to go undeveloped. “Especially if you are a ‘techno-starter’ like me.” (See insert). And so he produced a business plan and thought about how to convert the idea into a hard product. He brainstormed about the criteria such an instrument must meet, and at this time he also got in touch with the people at DEMO. “In my previous project, which involved developing surgical clamps for blood vessels, I had very close contact with DEMO. The cooperation was ideal, since in that project it was essential to determine whether an idea was a good one or not, and to do so very quickly. DEMO has a very short development lead time and a member of staff was assigned to me full time. His name was Koos and he gave me a lot of support in developing the prototypes. He knew exactly what I was trying to achieve, as he had been involved in the research project from the very start and his insights had kept pace with developments. If I went to a hospital to watch an operation, Koos would often go with me. Before long, if I wanted to have something made or tested, he knew exactly what was required.”
Jules once again enlisted the help of his colleagues from DEMO when developing the cable ring mechanism. “DEMO has the expertise and machinery required to make even the most advanced prototypes,” he explains. “It is very useful to be able to consult them on what is feasible and what is not.” Aad Beeloo nods in agreement. “DEMO has often worked for Jules in the past and we were once again involved in the development of the prototype, this time with Rik van der Hoeven assigned as the permanent support worker.”
Aad continues: “Whenever Jules has an idea, he makes a drawing which he brings to us. Take the handle of this laparoscope, for example. It is crammed full of tiny components which we have made especially for this specific product.” He stands up to retrieve a drawing, while Jules finds the relevant component. It is roughly the size of a ladybird. “Look,” says Aad, pointing to the drawing and then to the actual component, “the drawing is clear, all the specifications are there, but how do we actually begin to produce something like this?” That is a question to which I have no ready answer. There are no ‘Workmates’ the size of a thumbnail, and merely holding the material between your fingers does not seem a viable option. “Exactly!” exclaims Aad. “We usually begin by making a number of accessories to hold the material in place. Only then can we start on the actual design.”
“DEMO makes prototypes. We are not here to go into full production, but to make unique components which are necessary for the development of a certain product. We rarely say no. Of course, we sometimes see something in the design that we say has to be done differently, because the sketch is just impossible to realise. But that’s a different matter: all part of translating the idea into reality. Only later, when Jules actually starts production, will it be necessary to look for less expensive alternatives. If you are producing a thousand of these instruments, you cannot make every part by hand as we do. You could then produce a pressure die cast which, depending on the material properties required, can be filled with plastic or aluminium.” Jules intervenes: “Yes, and then of course you have to take into account all the criteria of safety and hygiene that hospitals will impose.”
Dream Team
The plan is for the first instruments to come onto the market next year. “It will not be a simple process,” concedes Jules, “because surgeons are accustomed to using certain instruments and they will not readily switch to something new. It is probably easier for a junior surgeon to try out a new instrument, since he or she will not have had very much experience with the existing ones. I was reminded of this only last Tuesday. I was in the Academic Medical Centre in Amsterdam to watch an operation, and at a certain moment the junior had to fit a catheter. He struggled with it for some time, until the senior doctor came to the rescue and had it in place within seconds. Of course, he has years of experience, not only with patients but with the instruments he uses. At times like that, I think: wouldn’t it be wonderful if there was an instrument for which you didn’t need years of experience, or at least not quite so many?”
The future clients of DEAM are the manufacturers of the instruments themselves. “What we shall do is to develop our idea to the greatest extent possible,” explains Jules. We shall also establish contact with doctors and technicians in order to coordinate exactly what is required and what is possible.” This is what sets this idea apart from the plans of the garden shed inventors who apply for a patent on some hastily conceived idea as a ‘get rich quick’ scheme. “We are surrounded by a team of people who have enormous expertise and experience in technical and medical matters. That is reflected by the name of the company – DEAM – which is not only a contraction of ‘DElft’ and ‘AMsterdam’ (where the company is located), but also calls to mind the words Team and Dream. Needless to say, everyone in our team hopes that the dream of the cable ring mechanism will soon come to fruition and that surgeons will actually use our medical instrument in the operating theatre.”
What is a ‘technostarter’?
A technostarter is a young technologist who starts up his or her own business. Every successful company is built on good ideas. However, as a businessman, it is also important that you learn how to write a business plan, and that you can translate your good ideas into practice. Yes!Delft (Young Enterprise Society) was founded to help technologists such as Jules Scheltes in these areas. For further information, see: www.yesdelft.nl