Less invasive medical technologies have revolutionised many aspects of surgery. We catch up with a pioneer of the field – cardiovascular surgeon (and fisherman) Dr Thomas Fogarty on his recent visit to Galway.
What does fishing have to do with minimally invasive medical technologies? On the face of it maybe not much. But around half a century ago, Dr Thomas Fogarty’s dexterity as a fly fisherman helped him to develop a pioneering device for removing a blood clot from a blood vessel.
At that time, the surgery required to address the problem carried high mortality and amputation rates. Fogarty was working in a hospital in Ohio and his mentor Dr Jack Cranley encouraged him to do something about it.
"He said to me ‘Tom, let’s solve this problem and I will help you’ – that was the start of it," recalls Fogarty. The end result was an invention called a balloon embolectomy catheter, which inserts a catheter into the blood vessel and inflates a balloon to displace the clot.
Learning from fly fishing
So where does fishing come in? That was a key to developing the prototype. "I tied the balloon on with a fly-tying technique," recalls Fogarty, who had acquired the skill growing up. The less invasive approach the invention enabled could be carried out with two small incisions and, crucially, under a local anaesthetic, he explains. "That was the benefit that allowed them to save their lives."
Yet it wasn’t an easy sell at the beginning. It took years for the approach to gain ground, and it eventually became an industry standard.
"It got momentum primarily from private practitioners," says Fogarty. "If you got someone to use it, it became apparent that that was the best way to do it and this the most appropriate instrument to use."
Paving the way for new inventions
The balloon innovation literally blew open the field of less invasive procedures, saving an estimated millions of lives, which Fogarty agrees is gratifying. "It is better than taking care of one patient at a time," he quips.
However, he did not rest on his laurels and has since developed many other innovations, and has founded or co-founded more than 30 medical device companies and a venture capital firm.
In 2007, spurred on by seeing people with good medical technology concepts unable to get financing in the US, he founded the Fogarty Institute of Innovation.
“We decided to develop the institute to allow young entrepreneurs and inventors and physicians to come and innovate," says Fogarty, who is today chairman and director of the institute. "We try to reward them for innovating; we try to help them in every way we can to innovate."
That includes bringing in experienced mentors, legal and regulatory experts and industry, he says. "We know everything an inexperienced person would not know. And we get a lot of people of significant stature to come in and mentor – it’s a not-for-profit effort."
Fogarty is no stranger to Ireland – he estimates his latest visit here was his 12th one. As well as a fishing expedition, his packed itinerary also included visiting a company site in Galway, a public talk and finding out more about the BioInnovate programme, which recruits fellows each year to observe clinical practice and develop innovations.
"It’s very positive," he says. "When you get a group of young people and they are bright and they are working on a project that has value to society, it’s amazing the enthusiasm that they develop."
The next big thing?
So what does he see as the next big thing in medical technology? "I think [it’s around] anything that is less invasive, where you don’t need big incisions to get it done, new technologies that most of us are not familiar with, that is going to happen for sure, it’s doable."
And to the upcoming innovators and inventors, his advice is to never give up. "You have to be persistent at pursuing what you think is going to benefit patients," he says. "You will be discouraged along the way, but if you stay at it you will make all the progress."
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