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University spinout aims to make microvascular surgery quicker and safer
22 March 2023
Imagine if you had to hand-sew one piece of garden hose to another to connect them. Now imagine you have a few to do, and if you don’t do them quickly and correctly, your lawn could die. Oh, and make the hoses 1.5 to 4mm in diameter.
It may sound ridiculous, but this the sort of thing surgeons do in reconstructive surgeries, which can take as long as 16 hours.
As a plastic surgery resident, Dr Nandoun Abeysekera took part in many microvascular surgeries. There was a coupler to connect veins – a device comparable to the ring you use on garden hoses. However, there was nothing for arteries.
Arteries have a thicker and stiffer muscular wall than veins do. If surgeons were to use vein couplers on arteries, they would risk introducing vascular injuries that could result in clots or leaks and perhaps the death of the tissue.
Currently, arteries are hand-sewn. However, this is technically sensitive and time-consuming – 40 to 60 minutes to reconnect a single artery. Failure rates are three to five percent.
Abeysekera figured there had to be a way to create a coupler that would work on arteries and thus make microvascular surgery quicker and safer.
From Batman fan to inventor
Abeysekera’s early interest in bioengineering was piqued by none other than the cartoon show Batman of the Future.
“Batman in that universe had the coolest suit,” says Abeysekera. “It augmented all human functioning through tech, which got me interested in what you could do with the human body.”
Abeysekera completed a Bachelor of Biomedical Engineering at age 19 before entering med school. When, as a surgical resident, he had the idea of developing an arterial coupler, he therefore had support. He’d maintained contact with bioengineering professors Poul Nielsen and Andrew Taberner, and Jon Mathy, his mentor in plastic surgery, had a background in biodesign. With feedback from these mentors as well as an industrial designer friend, Hans Kim, his arterial coupler design took shape.
A little help from the entrepreneurship community
Abeysekera has benefited from institutional support too. He has an honorary academic position at the Auckland Bioengineering Institute (ABI), which allows him to collaborate with scientists and access the resources of Waipapa Taumata Rau, University of Auckland.
Early on, people at ABI put him in touch with UniServices, the research application and commercialisation company of the University. UniServices encouraged him to pitch his idea to a Return On Science investment committee, which awarded him pre-seed funding.
Avasa was incorporated in 2018 – the year Abeysekera left surgery.
Another source of help came through the Velocity $100K Challenge. Avasa won the New Ventures prize in 2018, which allowed Abeysekera to take part in the VentureLab incubator programme. There, he was introduced to mentors who had deep experience in medical device commercialisation.
“The Velocity programme really changed the way I understood this project and helped define some of the goals and directions of the company,” says Abeysekera.
Avasa raised more funds through a 2022 seed round led by Bridgewest and now employs two engineers in addition to Abeysekera.
The road from idea to approved medical device
Avasa’s arterial coupler relies on eversion – exposing the inner lining of the vessel – to facilitate connection with another artery. Pins lock each side in place, so the procedure only takes five minutes. Made of biocompatible materials, Abeysekera believes the device will be proven safe to leave in the body as vein couplers are.
In 2021, Abeysekera successfully carried out a live animal study in which his coupler was used to reconnect a pig’s 3mm femoral artery and re-establish blood flow.
“That was amazing. It was a surreal moment seeing years of work realised in a live study that very closely mirrored what you’d encounter in human reconstructive microsurgery,” says Abeysekera.
There’s still a lot of testing ahead before the device can be certified. If all goes to plan, Abeysekera expects to have enough data for an FDA submission around the second quarter of 2024 and the device should enter the U.S. market by the first or second quarter of 2025.
It’s a long road – longer than Abeysekera expected – but the vision that led to the project still drives him.
“Patients will have safer surgeries,” he says. “They’ll experience fewer complications. Surgeons will be able to perform reconstructive microsurgery safely and efficiently, so they’ll be able to do more. Different types of surgeons will be able to do these surgeries as well because of the simplification of the process.”
Nandoun Abeysekera
Nandoun Abeysekera
22 March 2023
Imagine if you had to hand-sew one piece of garden hose to another to connect them. Now imagine you have a few to do, and if you don’t do them quickly and correctly, your lawn could die. Oh, and make the hoses 1.5 to 4mm in diameter.
It may sound ridiculous, but this the sort of thing surgeons do in reconstructive surgeries, which can take as long as 16 hours.
As a plastic surgery resident, Dr Nandoun Abeysekera took part in many microvascular surgeries. There was a coupler to connect veins – a device comparable to the ring you use on garden hoses. However, there was nothing for arteries.
Arteries have a thicker and stiffer muscular wall than veins do. If surgeons were to use vein couplers on arteries, they would risk introducing vascular injuries that could result in clots or leaks and perhaps the death of the tissue.
Currently, arteries are hand-sewn. However, this is technically sensitive and time-consuming – 40 to 60 minutes to reconnect a single artery. Failure rates are three to five percent.
Abeysekera figured there had to be a way to create a coupler that would work on arteries and thus make microvascular surgery quicker and safer.
From Batman fan to inventor
Abeysekera’s early interest in bioengineering was piqued by none other than the cartoon show Batman of the Future.
“Batman in that universe had the coolest suit,” says Abeysekera. “It augmented all human functioning through tech, which got me interested in what you could do with the human body.”
Abeysekera completed a Bachelor of Biomedical Engineering at age 19 before entering med school. When, as a surgical resident, he had the idea of developing an arterial coupler, he therefore had support. He’d maintained contact with bioengineering professors Poul Nielsen and Andrew Taberner, and Jon Mathy, his mentor in plastic surgery, had a background in biodesign. With feedback from these mentors as well as an industrial designer friend, Hans Kim, his arterial coupler design took shape.
A little help from the entrepreneurship community
Abeysekera has benefited from institutional support too. He has an honorary academic position at the Auckland Bioengineering Institute (ABI), which allows him to collaborate with scientists and access the resources of Waipapa Taumata Rau, University of Auckland.
Early on, people at ABI put him in touch with UniServices, the research application and commercialisation company of the University. UniServices encouraged him to pitch his idea to a Return On Science investment committee, which awarded him pre-seed funding.
Avasa was incorporated in 2018 – the year Abeysekera left surgery.
Another source of help came through the Velocity $100K Challenge. Avasa won the New Ventures prize in 2018, which allowed Abeysekera to take part in the VentureLab incubator programme. There, he was introduced to mentors who had deep experience in medical device commercialisation.
“The Velocity programme really changed the way I understood this project and helped define some of the goals and directions of the company,” says Abeysekera.
Avasa raised more funds through a 2022 seed round led by Bridgewest and now employs two engineers in addition to Abeysekera.
The road from idea to approved medical device
Avasa’s arterial coupler relies on eversion – exposing the inner lining of the vessel – to facilitate connection with another artery. Pins lock each side in place, so the procedure only takes five minutes. Made of biocompatible materials, Abeysekera believes the device will be proven safe to leave in the body as vein couplers are.
In 2021, Abeysekera successfully carried out a live animal study in which his coupler was used to reconnect a pig’s 3mm femoral artery and re-establish blood flow.
“That was amazing. It was a surreal moment seeing years of work realised in a live study that very closely mirrored what you’d encounter in human reconstructive microsurgery,” says Abeysekera.
There’s still a lot of testing ahead before the device can be certified. If all goes to plan, Abeysekera expects to have enough data for an FDA submission around the second quarter of 2024 and the device should enter the U.S. market by the first or second quarter of 2025.
It’s a long road – longer than Abeysekera expected – but the vision that led to the project still drives him.
“Patients will have safer surgeries,” he says. “They’ll experience fewer complications. Surgeons will be able to perform reconstructive microsurgery safely and efficiently, so they’ll be able to do more. Different types of surgeons will be able to do these surgeries as well because of the simplification of the process.”
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