Innovating and Iterating to Make Endoscopic Submucosal Dissection Easier

Innovating and Iterating to Make Endoscopic Submucosal Dissection Easier

This article was featured in the 2018 Annual Report. Dr. Bhatt was recently given the Outstanding Innovation in Medical Deviceaward at the annual Innovator Awards Reception, as well.

For Amit Bhatt, MD, 2018 was a good year – two of this endoscopist’s technologies were licensed to a major medical device manufacturer. These devices are used for Endoscopic Submucosal Dissection (ESD).

Pioneered in Japan, ESD was largely used for gastric cancers but has now been adapted to diseases more common in the West, like esophageal cancer and colon polyps. Dr. Bhatt recognized the beauty and precision of this procedure during his gastroenterology fellowship and won grants to study in Japan. In the time he was learning this complex procedure, he saw the precise, time consuming work that Japanese endoscopists were performing to admirable results: patients were getting curative resection, while keeping their native organs allowing them to preserve their quality of life. He also realized that the procedure needed to be improved for ease and reduced time, and his devices were born.

The first device, the Dissecting Endocap, was created in collaboration with colleagues in Japan. The Endocap allows for placement of the blade in the proper dissection plane throughout the procedure, while protecting the muscle layer from perforation. When Bhatt returned to Cleveland Clinic, he took this idea to Cleveland Clinic Innovations and Medical Device Solutions and began to sketch ideas for how to tackle the problem of resection.

In open surgery, surgeons have two hands to work with; Endoscopists only have the endoscope and the tools attached to it. The Retraction Strip is placed on the lesion and allows the endoscopist to cut underneath the tumor, while giving dynamic retraction and can act as a “second hand” for the doctor. These products can be used separately, or together in endoscopic procedures.

Before ESD was a mainstay procedure in the United States, Dr. Bhatt was working on a solution to this problem giving him and CCI a unique advantage when it came to shopping the devices to companies: the technology was mature when companies were ready to enter a new market segment. The team already had a funded prototype that had been tested in over 100 porcine models, allowing them to present a full picture.

While there are beginning to be similar products on the market, they are cumbersome and not necessarily more efficient. Cleveland Clinic’s devices offer a simple, efficient way of facilitating the procedure, reducing the time for ESD by about 50 percent.

Since the deal was inked, Cleveland Clinic has been involved in further development of the product. They are testing the device in other centers, and bringing the refinements back to Cleveland Clinic for Dr. Bhatt’s input. This is something rather unique and due, in part, to the relationships that Dr. Bhatt has fostered.

Dr. Bhatt hopes to continue his success by identifying the next great clinical need and utilizing the resources available to him to create his next product.

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