Clinical Engineers at UCSF Hack The Operating Room

The UCSF Department of Surgery’s longstanding partnership with engineers to invent new medical technologies in response to patient needs was featured in a recent story by UC Berkeley journalism student Alex Orlando. The article profiles Richard Fechter, Principal Development Engineer at UCSF Medical Center and UCSF Benioff Children’s Hospital, and long-time collaborator of Michael R. Harrison, M.D., Professor Emeritus of Surgery at UCSF, who pioneered the field of fetal surgery in the 1980s. 

As medical technology continues to cross the threshold into the 21st century, clinical engineers at UCSF are hacking the operating room by coming up with homegrown inventions to address problems that plague physicians and patients alike. Due to the difficulty of satisfying the requirements for approval by the U.S. Food and Drug Administration, commercial medical devices are frequently unable to keep up with the rapid-fire pace of technology development.

At UCSF, Fechter and his colleagues have worked with surgeons to develop diagnostics for patient compliance, a surgically implanted, magnetically activated device to treat sleep apnea and pair of tiny, magnetic rings that connect pieces of intestine without the need for staples or sutures. The last, named Magnamosis, is used in surgery for obesity or to treat bowel obstruction.

Several of these projects have made it into clinical trials, and their success has helped to launch the Surgical Innovations program at UCSF. An effort to facilitate collaborations between surgeons and engineers, the program aims to develop new medical devices that can be commercialized into viable products — and implemented in operating rooms across the country.

When fetal surgery emerged in the 80s and 90s, Fecter and Harrison worked together to develop many of the devices that made the new field of medicine possible.

"We had to, essentially, invent, many, many tools and tricks to do this brand-new enterprise, because nothing existed,” said Harrison. “So I went to Rich and other folks like him and we started building things. It was all in response to immediate needs."

Fechter’s lab is responsible for over 40,000 medical devices and pieces of equipment in their inventory. While clinical engineers at UCSF are primarily responsible for the repair and maintenance of operating room equipment, these one-off innovations showcase the potential of surgeons working with engineers to improve and invent new technologies. 

Surgical Innovations, a homegrown effort by the UCSF Department of Surgery in partnership with the Department of Bioengineering and Therapeutic Sciences, formally supports surgeon-engineer collaborations in medical device development. The program includes seed funding for projects, a training program for residents and graduate students, and a network of external medical device professionals to nurture nascent projects into commercial products.  

While the weekly meetings among the Surgical Innovations group have been interesting and productive for Fechter, he looks forward to the moments when physicians come to their discussions not with a solution, but with a problem. 

“I think there’s a huge room for improvement in the sense that there’s so many ideas out there that these guys have that I would never think of,” he said. “It would never even remotely dawn on me. But, I might have a good solution to them.”