Rather than use scissors as per traditional technique, he operated with a flexible laser scalpel that a small manufacturer called OmniGuide had started selling earlier that year. It enabled Michaelides to avoid touching the inner ear’s delicate bones, which could cause more damage and more hearing loss. “It’s very accurate because you can place the tip of the instrument exactly where you want, change angles, and deliver precise amounts of cutting energy and coagulation throughout the middle ear,” says Michaelides. “The bottom line is that it is very precise and safe.”
Operating with flexible lasers isn’t new—surgeons have been using versions powered by carbon dioxide since the 1980s. Compared with a metal scalpel, carbon dioxide laser cuts are shallower, which means patients experience less postoperative pain, heal more quickly, and scar less. OmniGuide’s laser is one of the first to use optical fiber to guide its beam; previous versions used hollow metal tubes. The fiber permits even more precision, says OmniGuide founder Yoel Fink, making tricky procedures in challenging areas of the body safer.
OmniGuide, which has $80 million in venture capital investment, is one of a handful of companies that make flexible optical lasers. While competitors such as LuxarCare market mostly to small medical offices and veterinarians, OmniGuide, a 130-employee Cambridge (Mass.) manufacturer, has been gaining traction at hospitals across the U.S. So far, surgeons in about 500 hospitals are using OmniGuide's devices to perform about 1,400 surgeries a month—mostly for surgeries above the neck.
Now the company, which Fink expects will generate $21 million to $22 million in 2011 revenue, up from $18 million in 2010, is expanding its factory and developing a new line of laser fibers for procedures to treat disorders such as fibroids and other gynecological disorders.
Dr. Sharyn Lewin, a gynecologist specializing in oncology at Columbia University Medical Center, has used OmniGuide’s system to treat growths from papilloma virus and sees potential advantages for other procedures, such as endometriosis. “It’s a little more flexible for getting into smaller crevices,” says Lewin, comparing it with a traditional carbon dioxide laser. “It’s more precise, and there’s less tissue trauma. It’s easy to use and appears to be quite safe.”
Laser surgery isn’t without hazards. Accidents can happen if, for example, the laser beam touches a patient's sterile coverings or if oxygen and anesthetic gases build up while a surgeon is operating on the patient’s airway, says Michaelides. “But these instances are rare. It’s not a dangerous tool any more than a scalpel is, and surgeons are trained to use both to minimize risk.”
OmniGuide’s laser scalpel, which attaches to a small machine typically mounted on a rolling stand in an operating room, costs about $80,000, including two years of service. The laser, controlled by the doctor holding the fiber, acts as a scalpel to cut tissue close to the fiber’s tip. The fibers, which are designed to be used during a surgery and then thrown away, cost $500 to $1,500, depending on the procedure. "We try to be as [clinically] specific as we can," says Fink. "It's important because we want to do value pricing ... obviously the amount a patient or insurance agency will pay to restore hearing is less than to remove cancer from your brain."
Worldwide sales for surgical lasers will be $1.3 billion this year, up from $96 million in 2000, according to a 2010 report on medical laser systems by market research firm Global Industry Analysts.
Fink’s invention was sparked by a 1996 challenge by the Defense Advanced Research Projects Agency to scientists to design a highly reflective mirror. Then-graduate student Fink’s winning structure reflected objects from all angles, what he calls a “perfect mirror.” Fink’s mirror worked on differently shaped surfaces—flat, cubic, tubular. He reasoned that alternating rings of the chemical linings—an insulator and a semiconductor—would transmit the light through a hollow glass fiber. Because the laser beam could be controlled with the fiber’s tip, he envisioned, it would enable surgeons to reach difficult nooks and crannies more easily.
Fink, who holds a PhD in materials science from MIT, returned to academia this fall to run MIT’s Research Laboratory of Electronics, passing the reins at OmniGuide to Chief Executive Scott Flora, formerly a division president at surgical products maker Covidien. Fink’s lab is looking for other applications for his fibers, using funding from the U.S. Army to research material that images surroundings and garments that capture information from the body such as blood flow, temperature, and calories burned. And he envisions clothing woven of fibers that recharge cell phones, as well as chameleon-like apparel that changes color when the wearer leaves work. “Material will become a high-tech object, or the object of high-tech,” says Fink.
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