A few years ago while working late into the night during a challenging surgery to reattach a severed hand, orthopedic microsurgeon Greg Kolovich knew there had to be a more efficient way to take the X-rays and photographs that helped guide him through surgery.
“I was trying to hold his hand and put a plate on it and it all kept falling… And I remember thinking, ‘we’ve got to do better than this, this is terrible,’” Kolovich said. At the time he was working through a fellowship at Massachusetts General Hospital.
In the fall of 2017, Kolovich - who now practices in Savannah - and his team at Micro C, Evan Ruff, chief executive officer, and Kirby Sisk, chief operating officer, plan to introduce the world’s first agile medical device, the Micro C, a handheld digital medical imaging solution that will take X-rays, photographs and video to guide surgeons during surgery.
The small device will replace the current fluoroscopy equipment, known as a C-Arm, which is similar in size to a hospital bed and is used by a physician to guide a needle to a specific area while watching that needle on a live X-ray screen.
“The devices we currently have, the Mini-C Arm and the standard C-Arm, are just too big and they shoot a lot of unnecessary radiation… They’re big and heavy and take a lot of time to set up,” Kolovich said of the older equipment.
Kolovich said he began the process by taking apart an older C-Arm model to see if what he wanted to do was even physically possible and being the customer as well as the inventor of the product has made him more aware of what elements are needed.
“Sure enough as we went through each step people told us it was impossible to do it, and that’s been driving us to do it. And now that it’s here and done, people are getting really excited about it because they didn’t think it was possible,” he said.
The image receptor used with the Micro C is thin, flat, and lightweight and can be easily positioned and moved behind the arm, leg or other extremity that is being examined. The extremity is placed on top of the receptor, and the Micro C is aimed at it. Radiation from the Micro C passes through the extremity and is received by the image receptor/intensifier. The images are then digitally processed and sent to a screen, so the surgeon can view them in real time.
“You never have to move the arm or leg. That’s revolutionary in my opinion because that’s going to make surgery so much more efficient, more accurate and then on top of that we created digitally radiography so the days of getting those old films that you put up on a light are gone,” he said.
The device, while specifically designed for orthopedic surgeons working on extremities, can also be used in a variety of other environments.
Kolovich said it’s useful for athletic trainers on the field, rural counties and third-world countries where X-ray capabilities aren’t readily available.
“It’s bringing high-powered, digital radiography to places that have never had that,” he said.
“When we were on a mission trip to Honduras, someone has a problem; you can’t get an X-ray in the middle of the jungle. You have to take them to the hospital and it could take weeks.”
The photographs taken by Micro C are also useful for patients who want to seek second opinions and can possibly protect doctors from a legal standpoint..
The device’s thermal camera will also help microsurgeons like Kolovich by providing instant feedback through thermal radiation.
“You always have to document what you do and sometimes saying it in the chart isn’t enough. Pictures are worth a thousand words,” he said.
“We have to have something to show what we did and I think pictures and video are a quick way to do that.”
After surgery is complete the doctor would be able to update family members on the procedure with the captured images, but the images are fully protected and can only be accessed by the doctor and patient.
“All of these images once they’re taken are encrypted and scrambled into a cloud, so even if you hacked my Micro C account, you’d just see a lot of zeros and ones,” he said. “You can’t descramble it unless you authenticate yourself with a key.”
The Micro C produces images that are clearer and more accurate, but it’s also safer than traditional equipment because it emits about 10 times less radiation.
“For someone like me who does 20 cases a week, that radiation exposure catches up to you and it’s certainly problematic when 45-year-old surgeons are getting cataracts or sarcomas on their hands,” he said, adding that if doctors are exposing themselves to less radiation they can take on more cases.
Kolovich, who graduated from Georgia Tech, said the proximity of Interstate 95 to Savannah is a tremendous asset to the company and the company is planning a long future in the Low Country.
“It’s not like we’re out in Silicon Valley, where we’re a dime a dozen. We’re special here and this company was born and raised here,” Kolovich said, adding that the company’s advisory board and most of their investors are all from southeast Georgia.
“This is homegrown, a grassroots thing… We’re really proud that we’re homegrown, we’re Tech engineers and the fact that we want to manufacture and distribute this in Georgia, specially this area, Chatham County.”
Prototypes are on schedule to be complete by February and then they’ll began the process of obtaining FDA approval, which can take six to eight months, but Kolovich and his team aim to market the device in foreign markets while waiting for approval in the United States. The device will also undergo extensive beta testing in order to fix any issues before the product launches.
“We’re not going to sit on our hands and wait for the U.S. government to give us the green light. We’re going to try to get this in the market elsewhere,” he said.
“Sometimes it’s a lot easier to get it to other places like Southeast Asia and in the meantime we can also use it for other things that aren’t medical related… You have to think outside the box.”