Invuity: Taking Surgery Out of the Dark Ages

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Advances in minimally-invasive surgery have made for smaller and smaller incisions, thereby reducing the risk of infection and greatly improving patient recovery times. Yet, operating in tiny spaces comes with its own challenges. “You’re a slave to the light,” says Dr. Stephen DeSantis, a breast surgeon and chief of surgery at Mission Viejo Hospital in Mission Viejo, Calif. “If you’re using a headlight, your field of view is only as wide as the light that goes into the incision and depends on where your head is pointing.”

Fiber optic light sources – imagine a small cable with light coming out the end – attached to surgical instruments help, but they’re not a perfect solution. “You still have tunnel vision, and that light is hot,” says DeSantis.  So hot, in fact, there’s a risk of burning the patient or even starting a fire in the operating room.

Many years ago, an orthopedic surgeon presented this very problem to Alex Vayser, an optical engineer and entrepreneur who had successfully developed other surgical and imaging devices. “I had some ideas for how to guide light into those openings,” says Vayser, who in 2004 cofounded Invuity, a San Francisco firm that now has more than 30 employees.

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The result of those ideas, and many years of development and testing, is a thin optical lens that’s attached to the end of a fiber optic cable and integrated with surgical tools, such as retractors. This tiny high-tech lamp directs and shapes light across its entire surface, thereby reducing shadows, glare and heat. “Think of a theater with lots of lights pointing in different directions to create a perfectly lit stage,” says Vayser.


Late last year Invuity began commercially releasing products specifically designed for use in orthopedic, spinal and oncology surgery. It plans to begin selling internationally this year.The first time using Invuity’s Saber, a hand-held illumination device with an integrated suction tool, “I was blown away by how much I could see,” says Dr. Michael Gratch, an orthopedic surgeon in the Philadelphia area. “It was multiple times brighter and without any heat.”

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“It’s a game changer,” says Dr. DeSantis, who is one of some 200 surgeons who have tried Invuity’s illuminated retractors designed specifically for lumpectomies and mastectomies. Among other benefits, he says, they give surgeons the ability to make incisions that have a better cosmetic outcome.  “Imagine a woman who has breast cancer close to the neckline. That’s a terrible place for a scar,” he says. “This makes it feasible to make an incision closer to the nipple and go all the way up to the tumor.”

Given that several million minimally-invasive procedures are performed every year, the market potential for Invuity is substantial. For now, the company is targeting some 2.4 million orthopedic, spinal, thyroid and breast procedures, and demonstrating its technology to surgeons at conferences around the country. “The barrier isn’t the volume of procedures,” says Vayser, who has received funding from venture capital firms InterWest Partners and Kleiner Perkins Caufield & Byers. “It’s the process of getting hospitals to approve new technologies.”

The retractors are reusable; the disposable lenses snap on and off, and sell for up to $500 each. It’s worth it, says Gratch, who successfully lobbied to get Invuity’s products approved by Abington Health in Pennsylvania.  “The better the visualization,” he says “the safer the procedure.”

After all, says Mission Viejo’s DeSantis, “nobody wants to operate in a dark hole.”

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