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50 Smartest Companies of the Year 2021

Rethinking the Operating Room to meet tomorrow’s surgical care needs: Claude Nogard, CEO of ErgoSuture


As our populations grow older and chronic diseases such as diabetes and obesity drive surgical care needs to new heights, the Surgical Instruments industry has to step up to provide surgical solutions that can be readily delivered to those in need of surgical care. It will be important that these solutions are good enough so that less experienced surgeons or healthcare providers can deliver promising care in this time, where there is a scarcity of trained surgeons. Led by innovator and leader Claude Nogard, ErgoSuture has set out on a path to elevate the universal standards of care through its surgical solutions.

ErgoSuture is leading the surgical instruments space with its innovations. Their leading product, Drive’N Roll, is a promising new-age suturing solution that is designed, built, and vouched for by experienced doctors and surgeons. Drive’N Roll’s promise has had several surgical experts come on board as investors. But this is just the beginning as ErgoSuture’s goals are vast and the scope of its solutions - broad and far-reaching.

In an interview with us, Claude Nogard, CEO of ErgoSuture, explained what makes Drive’N Roll such a great innovation. He also emphasized that the Surgical Instruments industry needs to step up its innovations to bridge the apparent gap in delivering surgical care.

Here are the excerpts from the interview:

Q. What was the motivation behind starting ErgoSuture? Tell us about your journey

so far.

ErgoSuture’s technology, the Drive’N Roll, is the brainchild of Dr. Luis Almodovar. Like many surgical interns before him, Luis was tasked with being proficient at suturing, but the needle drivers available were made for right-handed people. So, he set out to develop a solution that would decrease the number of steps in the suturing process. Luis and I met through mutual acquaintances who thought my expertise could help him convert his invention into a product. We have since tapped into an ever-increasing network of surgical experts, some of whom have become investors, to advance the development and maximize our technology’s potential.

Q. How are ErgoSuture’s design and development driving surgical innovations?

Instrumentation used in laparoscopic surgery has evolved little since the inception of laparoscopic surgery. There are two main choices for the advanced minimally invasive surgeon – either standard or “straight stick” laparoscopic surgery or robotic-assisted surgery. Either choice relies primarily on a static relationship between the needle and the needle driver, which means that to drive the needle through tissue, surgeons have to twist their wrist, somewhat mirroring open surgery suturing technique step-by-step. ErgoSuture’s technology, Drive’N Roll, eliminates the steps by transferring elements of the surgeon’s know-how to the device; we have created a dynamic relationship between the needle and the needle driver, enabling a continuous fluid motion of the needle along its arc, easing use for forehand and backhand suturing, or reversing motion of the needle without releasing and re-grasping. Moving forward, we will continue to rely on in-depth knowledge of various surgical techniques to revisit surgical product development, delivering simpler and affordable solutions with the goal to expand access to surgical care worldwide.

Q. Advances in suturing technology have helped decrease hospital stay and accelerated patient recovery time. But these advances have their limits. How is Drive’N RollTM bypassing these limits?

When used properly, advanced suturing systems used in minimally invasive surgery have reduced hospital stays and faster recovery time. However, very few surgeons have reached such a level of proficiency. Today, surgeons rely primarily on straight shaft needle drivers (traditional needle drivers) and robot-assisted needle drivers to suture patients in minimally invasive surgery. The long learning curve and specific suture techniques required to master devices, such as the Endo Stitch, have pushed surgeons towards more expensive but reliable suturing solutions such as the robot.

At its core, Drive’N Roll innovation is going to change the relationship between the needle and the needle driver by replacing flat tips with rollers. We purposefully preserved the overall architecture of the needle driver so that first and foremost, Drive’N Roll looks and feels familiar to surgeons. This has led to a device that appeals at first to new and average surgeons, who have less skill in handling surgical needles when operating laparoscopically or even have some difficulty suturing in hard-to-reach locations. At present, those surgeons rely on the robot, which is substantially more expensive and not always available.

Q. How is Drive’N RollTM making suturing cost-effective?

Though we need more data points and structured studies to quantify Drive’N Roll cost-effectiveness, early tests have shown a reduction in suturing time over 20% when used by non-experts. We are also evaluating the optimal combination of device, needle, and suture threads, which should improve the suturing time. For example, barbed sutures have shown suturing time reduction ranging between 20% to 40%.

Not often mentioned, training and learning curve directly impact a hospital’s bottom-line, since a surgeon cannot operate during that time. Drive’N Roll was designed to be readily used by less proficient surgeons, shortening their learning.

Last, Drive’N Roll’s overall design and architecture is optimized to be priced on par with top-of-the-line straight shaft needle drivers, substantially below the competing advanced suturing systems. This was achieved by carefully evaluating which components could be re-used over hundreds of autoclavable cycles (sterilization between surgeries) such as the handle, and which parts had limited re-usability due to wear and tear, such as the distal ends on which the rollers are mounted.

Q. What do you think are the biggest challenges that the Surgical Instruments industry will face in the next few years?

The facts are that we currently cannot meet the needs of the global surgical burden or diseases treatable by surgery. Compounding that problem, we have a scarcity of trained surgeons that will only be amplified over the next few decades as our populations grow older and chronic diseases such as diabetes and obesity drive surgical care needs to new heights. This is not a problem of developed countries versus under-developed countries; this is about surgical care access. There is an important role the Surgical Instrument Industry can play in developing surgical solutions that can be readily delivered by less experienced surgeons or other health care providers, so that we can start closing the gap on the global surgical burden of today and tomorrow.

Q. What does the future hold for ErgoSuture?

Our vision is to deliver global comprehensive and accessible surgical solutions that become universal standards of care. Addressing the current suturing skill-set gap (in minimally invasive surgery) with Drive’N Roll is the first execution of this vision. Rethinking the operating room seems the logical path forward.

“We purposefully preserved the overall architecture of the needle driver so that first and foremost, Drive’N Roll looks and feels familiar to surgeons”