Smarter stitching for a better quality of life

Closing the abdominal wall requires absolute concentration from the surgeon, who has just performed major surgery. Handling the needle holder and tweezers, with which a semicircular needle is transferred, requires the necessary skill and use of both hands. Surgeons can put so-called “big bites” in this way, sutures that are one centimetre apart. Research led by Erasmus MC, published in top medical science magazine The Lancet, has shown that finer suturing, with “small bites” five to seven millimetres apart, yields better results. It results in fewer complications; the number of scar fractures is halved, for example. The number of recovery operations required is drastically decreasing as a result, and an estimated $2 billion a year in healthcare costs can be saved in the US alone. 

Setting “small bites”, however, is very difficult in the conventional way. Mellon Medical came up with a solution; the Switch suturing device. This instrument has two jaws that the surgeon can move together to automatically transfer a straight needle from one jaw to the other, using just one hand. The surgeon can use his, now free, second hand for presenting the tissue that needs to be sutured. This improves the precision, and thus the quality of the suturing. The surgeon can also stitch twice as fast with this technique. The first tests were very positive, says prof. dr. Hans Jeekel, emeritus professor of surgery at Erasmus MC and co-author of the 2015 Lancet article. “Very experienced surgeons have tested this instrument at Erasmus MC, for closing the abdominal wall on patients. Their experiences with this user-friendly instrument, even if it was still in the prototype phase, show that it can contribute to a simple and precise application of the “small bites” technique. We believe it is of utmost importance that surgeons all over the world become familiar with this technique.”

Demcon was called in for an expert review after Mellon developed the first design; is the design robust? What needs to change for use in general surgery (after having sought for an application in vascular surgery first)? Is the Switch easy to produce? An important question was also which indication technique can ensure that the sutures are indeed places five to seven millimetres apart. The results of the expert review and the contact between Mellon and Demcon were so satisfactory that the partners decided to start working together, for the further development of the instrument and the subsequent production. “We chose Demcon because they have extensive expertise in developing medical instruments”, Mellon-CEO Jan Benschop explains. “They have everything we need for that here in the Netherlands; development, production and quality control.” Demcon production has the necessary assembly facilities, and Demcon has the appropriate technique for making precision part of the Switch, metal injection moulding, at its disposal. 

Demcon is participating in the new financing round of four million euros to seal the mutual commitment. Mellon closed that round with the current shareholders this month; Thuja Capital, development agencies Oost NL and BOM, and RvO (Netherlands Enterprise Agency). These new investments will allow Mellon to introduce the Switch to the medical market.  The global market size for sutures is estimated at $3 billion a year. Benschop expects that their instrument can accelerate the introduction of the “small bites” technique for stitching. “This can improve the quality of life for the patient, and it contributes to reducing healthcare costs.”

The collaboration with Mellon is in line with Demcon’s vision on social responsibility, says Jemy Pauwels, investment director at Demcon. “We develop technology that can provide solutions to social problems. The conversations that we have with surgeons confirm that this new instrument responds to the wishes of the medical world. It will allow them to place sutures much easier and faster. It increases the patient’s well-being and the surgeon’s efficiency, who now has a free hand because of the instrument. He can perform the procedure himself in a more controlled way. As a result, making him less dependent on OR assistants. In our expert review, we investigated what our developers still need to do to make this a market-ready product. We have also researched how our product can be meaningful, and what a realistic price is. We are now investing in Mellon because we are confident about the potential of the product and technology, and we trust the management’s quality. That is why we would like to be an engineering and manufacturing partner.”