Peter Verrillo, Co-Founder and CEO of Enhatch06.27.22
If you had the choice between an implant customized for you or one off-the-shelf, what would you choose?
Orthopedic patients today are fortunate to have this option before them. Innovation in orthopedics has come a long way, built on strong partnerships between surgeons and medical device companies. But with all this progress, some things stay the same: many surgeons are still using 2D x-rays to make 3D decisions.
Many cases today still involve manual templating using X-rays, despite having the technology to use 3D anatomic modeling and additive manufacturing to make personalized solutions. We’re overdue for a change.
Using X-rays to figure out approximate implant sizes means giving up on achieving the perfect fit for short-term convenience during surgical planning. Because of this, device manufacturers have to make sure they manage large inventories of implants and keep several implant and instrument kits ready for each case. This offers surgeons greater choice in the OR, but at what cost? As demand for surgery grows, the cracks in the system are beginning to show.
As outcomes improve, patient demand for surgery is through the roof. More people than ever are looking to get relief from their hip or knee pain - it is estimated that by 2030, the number of total knee replacements performed in the US will increase by more than 600 percent compared to 2005, while total hip replacements are expected to increase by almost 200 percent over the same time period.
People who used to delay getting surgery until they were older, now seek surgery earlier in life, so they can get back to the activities they love. While this development is great, the large number of surgeries is putting a strain on the entire healthcare system — orthopedic surgeons, hospitals, ASCs, and medical device companies.
By 2030, the demand for surgery will outpace the number of surgeons available. As same-day discharges become more popular, there is even more pressure for faster surgeries and higher patient satisfaction. 3D anatomic modeling and 3D printed solutions can take the guesswork out of surgical planning and massively reduce inefficiency in the OR. So, why is this technology not the standard of care in orthopedics?
Surgeons need to trust that the 3D anatomic modeling process offers accurate results. Currently, the process heavily depends on manual labor (who are not clinicians or surgeons) to interpret a patient’s scans, joint anatomy, and disease condition to offer implant and surgical guide recommendations. As a result, when a surgical plan is generated, surgeons often go back-and-forth with the device manufacturer to get the plan right according to their satisfaction. This creates inefficiencies and sometimes, it can take weeks before a plan is approved and 3D printed guides and implants are generated. Because of lingering doubt, surgeons still want the reassurance of standard instrument and implant sets to be available during surgery, just in case.
Already we see that this type of process adds significant time, inefficiency, and costs to the entire process — time and money that surgeons and hospitals could not commit to. And now, with same-day discharges and lower-cost procedures in ASCs, the pressure to deliver cost-effective solutions is even higher. Device manufacturers need to eliminate all doubt for personalized implants to become the default solution. But how?
Gaining a surgeon’s trust in the system is the biggest bottleneck for the entire process. If 3D anatomic modeling software generates the right output the first time, surgeons can approve their surgical plans faster. The corresponding surgical guides and implants can be generated quickly and the entire process can take days instead of weeks or months. This type of accuracy and efficiency can transform the world of orthopedics.
The benefits of AI in orthopedics also go beyond efficiency in surgical planning. Currently, the entire surgical flow is fragmented. In our data-driven world, this is a missed opportunity. Trying to input surgical plans into enabling technologies like surgical robots, navigation, or AR often involves duplicated effort by OR teams. Insights from post-surgery patient follow-ups do not always have a consistent feedback loop to pre-surgery planning to optimize all surgeries at a center. Hospitals and ASCs often have to spend considerable time and resources integrating new technologies into their existing technology platforms.
What we need is an open, digital ecosystem to deliver a universe of innovation that enhances the future of surgery not only for orthopedics but the entire medical device industry. That’s exactly what we, at Enhatch, are building. We believe this will be the most effective way to solve the impending challenges ahead for healthcare.
Peter Verrillo is the co-founder and CEO of Enhatch, the Intelligent Surgery Ecosystem Company. Enhatch is harnessing Artificial Intelligence and AR/VR to create a faster, safer and more personalized surgical experience for the millions of patients who face life changing surgery every year.
Before Enhatch, Peter launched multiple billion-dollar product lines in the orthopedic industry and also holds several seminal patents in joint arthroplasty. He graduated from Stevens Institute of Technology with a Bachelor of Engineering.
Orthopedic patients today are fortunate to have this option before them. Innovation in orthopedics has come a long way, built on strong partnerships between surgeons and medical device companies. But with all this progress, some things stay the same: many surgeons are still using 2D x-rays to make 3D decisions.
Many cases today still involve manual templating using X-rays, despite having the technology to use 3D anatomic modeling and additive manufacturing to make personalized solutions. We’re overdue for a change.
Why Do We Need More Personalized Surgeries?
Some may wonder, “Why fix it if it ain’t broke?” After all, THA and TKA outcomes are successful using this very process. The real reason is because orthopedic surgeries are successful despite deficiencies in the surgical workflow.Using X-rays to figure out approximate implant sizes means giving up on achieving the perfect fit for short-term convenience during surgical planning. Because of this, device manufacturers have to make sure they manage large inventories of implants and keep several implant and instrument kits ready for each case. This offers surgeons greater choice in the OR, but at what cost? As demand for surgery grows, the cracks in the system are beginning to show.
As outcomes improve, patient demand for surgery is through the roof. More people than ever are looking to get relief from their hip or knee pain - it is estimated that by 2030, the number of total knee replacements performed in the US will increase by more than 600 percent compared to 2005, while total hip replacements are expected to increase by almost 200 percent over the same time period.
People who used to delay getting surgery until they were older, now seek surgery earlier in life, so they can get back to the activities they love. While this development is great, the large number of surgeries is putting a strain on the entire healthcare system — orthopedic surgeons, hospitals, ASCs, and medical device companies.
By 2030, the demand for surgery will outpace the number of surgeons available. As same-day discharges become more popular, there is even more pressure for faster surgeries and higher patient satisfaction. 3D anatomic modeling and 3D printed solutions can take the guesswork out of surgical planning and massively reduce inefficiency in the OR. So, why is this technology not the standard of care in orthopedics?
How Do We Get to 100% Personalized Surgeries?
For industry insiders, ‘3D anatomic modeling’ and ‘additive manufacturing’ are not new concepts. However, there are two hurdles to overcome before every single hip and knee surgery uses personalized implants and instruments: trust and inefficiency.Surgeons need to trust that the 3D anatomic modeling process offers accurate results. Currently, the process heavily depends on manual labor (who are not clinicians or surgeons) to interpret a patient’s scans, joint anatomy, and disease condition to offer implant and surgical guide recommendations. As a result, when a surgical plan is generated, surgeons often go back-and-forth with the device manufacturer to get the plan right according to their satisfaction. This creates inefficiencies and sometimes, it can take weeks before a plan is approved and 3D printed guides and implants are generated. Because of lingering doubt, surgeons still want the reassurance of standard instrument and implant sets to be available during surgery, just in case.
Already we see that this type of process adds significant time, inefficiency, and costs to the entire process — time and money that surgeons and hospitals could not commit to. And now, with same-day discharges and lower-cost procedures in ASCs, the pressure to deliver cost-effective solutions is even higher. Device manufacturers need to eliminate all doubt for personalized implants to become the default solution. But how?
Artificial Intelligence (AI) Is the Missing Piece of the Puzzle
AI-based 3D anatomic modeling digests millions of anatomical data points and medical images to generate a 3D version of each patient’s joint anatomy to find the best-fit implant. Since 3D anatomic models are based on vast amounts of historical real-world patient data, they can offer a greater likelihood of accuracy. Comparing this to the manual process where the result depends on an individual’s skill and knowledge of anatomy, physiology, and the 3D modeling software, it’s a world of difference.Gaining a surgeon’s trust in the system is the biggest bottleneck for the entire process. If 3D anatomic modeling software generates the right output the first time, surgeons can approve their surgical plans faster. The corresponding surgical guides and implants can be generated quickly and the entire process can take days instead of weeks or months. This type of accuracy and efficiency can transform the world of orthopedics.
The benefits of AI in orthopedics also go beyond efficiency in surgical planning. Currently, the entire surgical flow is fragmented. In our data-driven world, this is a missed opportunity. Trying to input surgical plans into enabling technologies like surgical robots, navigation, or AR often involves duplicated effort by OR teams. Insights from post-surgery patient follow-ups do not always have a consistent feedback loop to pre-surgery planning to optimize all surgeries at a center. Hospitals and ASCs often have to spend considerable time and resources integrating new technologies into their existing technology platforms.
What we need is an open, digital ecosystem to deliver a universe of innovation that enhances the future of surgery not only for orthopedics but the entire medical device industry. That’s exactly what we, at Enhatch, are building. We believe this will be the most effective way to solve the impending challenges ahead for healthcare.
Peter Verrillo is the co-founder and CEO of Enhatch, the Intelligent Surgery Ecosystem Company. Enhatch is harnessing Artificial Intelligence and AR/VR to create a faster, safer and more personalized surgical experience for the millions of patients who face life changing surgery every year.
Before Enhatch, Peter launched multiple billion-dollar product lines in the orthopedic industry and also holds several seminal patents in joint arthroplasty. He graduated from Stevens Institute of Technology with a Bachelor of Engineering.