Neuroscience. Neurosurgery. Engineering. Entrepreneurship.
It’s not often we see these diverse skills lumped together in one place, especially within medical circles. However, when they all intersect at the right time, at the right place—and for the right reason—the results can be extraordinary.
Dr. Bill Wang has practiced neurosurgery in prestigious medical centres around the world. He is an assistant professor of neurosurgery at McMaster University and holds a degree in Mechanical and Materials Engineering Science.
Dr. Wang is also the Founder and Chief Scientific Officer of iMIRGE Medical Inc. and co-creator of a portable image guidance system device they call a ‘GPS for surgery.’
The device represents a radical departure from traditional approaches, which was exactly why, and how, it was designed in the first place.
“I’m passionate about innovation,” said Dr. Wang. “As a surgeon and end user, I thought, ‘I need something that’s easy and quick to use. As an engineer, I thought, ‘How can I solve this problem?’”
What got the gears turning
The idea for iMIRGE came about during residency rounds when Dr. Wang and his colleagues were taking care of neurosurgery patients.
With these patients, increased intracranial pressure is common. One of the procedures often needed to be performed is insertion of a catheter into the brain (external ventricular drain, or EVD) to relieve pressure.
When performed in the operating room, this procedure uses image guidance technology to improve surgical accuracy. It helps visualize a targeting line by registering markers or landmarks to navigate a catheter (or other medical instrument) through to perform a procedure. In cranial surgery, it guides surgeons to structures deep in the brain.
But after-hours or with vulnerable patients, the procedure is often urgent. And with no image technology to guide attempts to insert catheters at the bedside, the risk to patients increases.
“It occurred to me that if we were doing the EVD in the operating room, we would have lots of wonderful technology available to guide us,” said Dr. Wang. “However, it’s highly impractical to move that technology out of the OR because of logistics, limitations in resources, and the sheer bulkiness of the devices. I thought, ‘Why can’t we have something to use at the bedside to help our patients?’
That’s when, according to Dr. Wang, the gears started turning.
“The physician side of me could see the need and the true problem, and the engineer part of me allowed me to focus on a solution. It was time to put on both hats.” -Dr. Bill Wang
Where collaboration meets synergy
Dr. Wang began conceptualizing a device by tinkering with lasers. He knew that when you rotate two planes in space, they always form a line. He thought, “What if we use two laser lines – a plane of photons?”
By “happenstance,” according to Dr. Wang, he was discussing the development of the device with Dr. Neil Duggal, a London, Ontario-based neurosurgeon whom he considered to be a mentor. “I had come up with this idea, and I had a concept, but I really didn’t really know where to go from there.”
The two recognized the need and tremendous potential of the device and began to strategize. The collaboration proved to be invaluable. Together, they co-founded iMIRGE.
“Dr. Duggal offered a totally different perspective that made the end product so much better,” said Dr. Wang. “He had experience with IP, strategy, fundraising, and business development. There was lots of natural synergy there.”
A portable GPS
The iMIRGE device—small enough to fit in the palm of a hand—is placed on a baseplate on the patient’s forehead. A small nick is made on the skull in which to insert the catheter. By using the two intersecting planes of laser light, physicians can mark out a unique trajectory in space that helps guide the catheter.
Just like traditional image guidance systems, the iMIRGE system Dr. Wang designed is incredibly accurate. What sets it apart is that it’s portable, disposable and cost-effective―meaning it can be used to deliver urgent treatment at the bedside without the need for cumbersome or lengthy set-up.
Created for surgeons, by surgeons
“When we showed it to surgeons, the response uniformly has been very enthusiastic,” reported Dr. Wang. “Surgeons want to have minimal complication rates, and with the improved accuracy of the iMIRGE device, we can drop that rate significantly.”
Although it was created for surgeons by surgeons, the iMIRGE device was designed to be simple to use. According to Dr. Wang, non-neurosurgeons and sub-specialists could be trained to use the device. This could have significant impacts in underserviced areas, as well as in situations where quick and accurate procedures can make a difference in patient outcomes.
What makes this device even more accessible for care centres in emerging markets is the price tag. Compared to $300,000+ for a larger, OR-based system, iMIRGE only costs $250 per device.
When will it hit the market?
“One of our goals is to continue developing the device for cranial application,” reported Dr. Wang. At present, he and Dr. Duggal are taking steps to secure regulatory approvals and FDA clearance which they expect to take 18 – 24 months. iMIRGE is also working with engineers on designing a similar device for spine procedures and one for ear, nose and throat.
Unique experience, unique perspective
Dr. Wang believes that his unique combination of education and experience allowed him to recognize the opportunity to innovate, in the right time and the right place.
“In med school, there aren’t too many of us with an engineering background. I intuitively see two ways of looking at things. I didn’t realize until later that it gave me a different perspective.” -Dr. Bill Wang
This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule. Feel passionate about physician-led innovation? Please connect with us at firstname.lastname@example.org.