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Innovator Q&A: Insoo Suh, M.D.

Suh Insoo 345 Large HeadshotInsoo Suh, M.D., is Assistant Professor of Surgery at UCSF and Co-Founder of Prescient Surgical. After completing a fellowship in endocrine surgery at UCSF, Dr. Suh particiated in the Stanford University Biodesign Innovation Fellowship program in 2011 before joining faculty at UCSF. We sat down with him to learn more about his journey as a physician-innovator.

Tell me about a device you're working on and the problem you're trying to address.

Laparoscopy and other minimally invasive techniques have revolutionized our field in so many ways, but there definitely still remains room for improvement. One problem that surgeons have all encountered in one way or another is related to the limitations of the standard laparoscopic instruments that we use to grasp and handle tissue. These instruments are basically adaptations of open tools and are typically made of metal, have a compressive mechanism, and have relatively sharp edges. These tools, especially when used improperly or in higher-risk cases, can cause tissue injury at critical time points—whether to visceral organs or tumor capsules—which can contribute to increased complications and patient morbidity. To address this problem, we are developing the Lamprey, an atraumatic vacuum-based grasping device optimized for minimally invasive surgery.

How did you get the idea for it?

Broadly speaking, the idea for the underlying mechanism was originally invented nearly 20 years ago by my mentor Orlo Clark, Professor Emeritus and endocrine surgery legend. His original idea was to make a device that would aid in atraumatic manipulation of delicate glands such as the parathyroids during open endocrine surgery, and was inspired by the lamprey fish that he would encounter on fishing trips. He generously invited me to take on this technology and see if I could adapt and refine the design for modern surgical needs—basically try to make it a reality.

How did you become conveinced you should pursue it?

I definitely think that my excitement for the underlying idea and technology had a lot to do with it—I think it is really elegant and clever. I may be biased! But as we all know, making a medical or surgical technology a reality takes so much more than just thinking that it’s really neat. The degree of risk involved, number of stakeholders, difficulty of regulatory requirements, and time to market are among the most daunting of all commercial industries. So even though it’s an imperfect predicting-the-future exercise in a sense, I go through a mental checklist to make an educated guess as to whether an interesting idea or project stays just that, or actually has legs to become a commercially viable and sustainable technology that can benefit patients. The checklist covers everything from the likelihood of the technology actually working, the degree of anticipated difficulty in obtaining regulatory approval, the strength of the IP, who can actually work on it other than me, whether the proposed price of the technology compared to the cost of making it makes financial sense for the number of patients it may treat, among other things. I did this exercise for the Lamprey project and most of the boxes checked green.

How does your identity as a clinician influence your ability to innovate?

I think it’s absolutely critical. We have such a privileged and unique position to see and influence how health care is delivered. I think one thing that is particularly advantageous for us is that we can not only see what is and isn’t working, but we have an innate sense of how a proposed solution may or may not work in a real world setting.

What's your ultimate vision/hope for your technology?

Simple—for it to become an actual, tangible product that benefits surgeons and patients.

What's the most helpful advice you received along the way?

One particularly wise mentor told me once that—paraphrasing here—navigation of different egos and self interests is unavoidable in any collaborative endeavor, but if you find yourself spending more time on this theme at the expense of moving the project forward, it's time to either make a drastic change and/or close up shop. Highlights the importance of trust and chemistry within the team from the very beginning.

What advice would you give someone like yourself who is just starting down the path?

Have patience! It’s a very, very long road from idea to product, particularly in the healthcare sector. Expect it to take 6-8 years, at least for medical devices. The good news for people in our shoes is that we have the financial benefit of having a day job, so we can take our time a little bit with early strategic decisions that would otherwise be difficult if one were to take the plunge on a project from day one.

What's been the hardest thing about the innovation process?

The ups and downs in fortune of an innovation-related project is probably the hardest thing. This isn’t necessarily unique to the innovation process, but the swings can definitely go from really great (e.g., “we finally made a working prototype!”; “we had a great animal study result!” etc.) to really terrible (e.g., “FDA disagreed with our proposed 510(k) path!”; “our best engineer just quit!”; “we’re running out of money!”; etc.). I think especially when a project is completely spun out is when the exhilarating terror and stress get much more real.

What's been the most rewarding part? 

That is really easy: the moment that a product that you helped develop is first put into clinical use—that is pretty special and obviously makes it worth all the effort.

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