Canadian tech company GestSure is changing the way doctors perform surgery
WRITTEN BY WILLIAM PARKER ON OCTOBER 13, 2015 FOR THE MEDICAL POST
Founders Dr. Matt Strickland, Greg Brigley and Jamie Tremaine with the GestSure console.
When the initial idea for GestSure was formed five years ago, two of the company’s founders, Dr. Matt Strickland and Jamie Tremaine, were just friends out for a run on a beautiful spring night in Toronto. Dr. Strickland, a medical student at that time, was talking to Tremaine, a mechatronics engineer he’d met while studying electrical engineering at the University of Waterloo, about life in school.
Medical students often feel like “scut monkeys,” writing notes, transferring patients, retracting fat in the OR and, in Dr. Strickland’s case, un-scrubbing from the sterile field countless times to help the surgeon with clicking a few buttons on a computer screen. “There were days where I would scrub in over a dozen times! It was exhausting,” Dr. Strickland explained. Still, as any physician knows, sterility is essential in the OR—a patient’s safety relies on it, and thus touching a dirty computer while sterile is not acceptable.
Enter technology
Around the time that Dr. Strickland was discussing the joy of med school life with his friend, Microsoft was readying the release of Xbox Kinect, the first commoditized 3-D camera gaming system that was actually affordable. Unlike the Nintendo Wii, Xbox Kinect does not require a remote control. Rather, the system responds when a person moves in front of a special 3-D-sensing camera, in turn moving the character on screen.
Dr. Strickland and Tremaine wondered if a camera gaming system might help avoid the annoyance of constantly scrubbing in and out in the OR to touch a few computer buttons. If a scrubbed-in surgeon could move his hands and arms to manipulate the computer, it could help to save time and improve patient safety, they reasoned. By the end of the following year, they had teamed up with Greg Brigley, a software engineer, and had built their first prototype. Dr. Strickland was a first-year resident in general surgery at Toronto’s Sunnybrook Health Sciences Centre then, and would use the operating rooms after hours to test and improve the technology. He would also meet with Tremaine and Brigley in any free time they had and spend hours coding to perfect the software.
They realized early on that the system needed to understand enough hand-waving gestures to be useful, but not so many that it would make it difficult for surgeons to learn how to use the system. They eventually developed the software around six core movements: scrolling in three planes, moving the mouse cursor, clicking, swiping pages, locking and unlocking motions, and magnification. “By keeping it at simply six gestures, it eliminated a false-positive problem we were having, and surgeons now love how intuitive it is to use,” Dr. Strickland said. Soon after perfecting the code, they incorporated and applied for a patent, and the company was officially born in 2011.
The growth of GestSure
Today, Dr. Strickland, Tremaine and Brigley’s company is called GestSure. Its flagship product is an OR-ready system that uses an Xbox Kinect 3-D camera to capture the events of the OR and interpret the gestures of the surgeon. Especially for advanced oncology cases, surgeons rely heavily on imaging to identify important anatomical structure locations and determine surgical strategy. For example, if a surgeon needs to remove a tumour near the abdominal aorta, CT and MR imaging modalities can be closely analyzed from multiple angles, to ensure that the vessel is not going to be damaged.
The ultimate goal is patient safety—not only does the system increase sterility, it is arguably the easiest way for surgeons to access patient information quickly and conveniently.
Despite the obvious application possibilities, GestSure’s journey has not been easy. “Medical devices are a slow sell because we have to deal with hospital administration instead of directly with the surgeons who inevitably use the technology,” Dr. Strickland said. “Further, it is not necessary to use a computer during every operation, so sometimes it’s hard for hospitals to justify it.” Promotional campaigns and meetings directly with individual surgeons and hospital administrators have helped overcome these challenges.
International profile
Despite the challenges, GestSure has been growing steadily. In Canada, it has been adopted at Credit Valley Hospital in Mississauga, Ont., as well as at Sunnybrook. However, the majority of progress has been made internationally, with GestSure systems now in use at Seattle’s Swedish Hospital, Rochester General in Rochester, N.Y., and St. Jude’s Hospital in Orange County, Calif. Recently, the company was also contracted to install their technology at hospitals in Qatar to assist with handling the pressures of the upcoming World Cup. “We were even highlighted in Microsoft’s Super Bowl commercial due to all of the positive attention we have been getting,” Dr. Strickland said, referring to articles on GestSure published in the Globe and Mail, Forbes and the Wall Street Journal.
One of the early adopters of the GestSure technology was Dr. Calvin Law, a surgical oncologist at Sunnybrook. “GestSure has been ideal for integrating imaging into the operating room at Sunnybrook,” he said. “It has allowed me to review images in real time, saving time while keeping the sterile field intact.”
Dr. Law went on to explain that in his practice, complex surgical procedures, such as the excision of a tumour that is invading multiple abdominal organs, require navigation of the human body from multiple angles. Being able to manipulate high-resolution X-ray, CT and MRI images from any angle, while scrubbed into the surgical suite, provides surgeons with the increased confidence to successfully complete the operation, without compromising patient safety.
In the immediate future, GestSure is focusing on growing its presence stateside. And the system’s applications are still being discovered. Indeed, perhaps it’s not unfathomable for GestSure to one day be used in family practices-imagine talking to patients about their health while projecting information on a screen controlled only by hand motions?
William Parker is a fourth-year medical student at the University of Alberta in Edmonton.
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