neoSurgical Reaches Procedural Milestone

neoSurgical Inc. announced the company’s U.S. Food and Drug Administration-cleared device, neoClose, has now been used in 8,000 procedures in U.S. hospitals.

Three recently published* clinical studies show that hernia incidence is often “grossly under-diagnosed” and “highly prevalent” in port site closures after lap and robotic surgeries, which can trigger a vicious cycle of repeat surgical interventions and hernia repairs.

“Surgeons in hospitals across the United States are rapidly adopting our neoClose device because neoClose is designed to be to the standard of care for closing port sites — a standard that absolutely must be improved to enhance patient outcomes and safety,” said Barry Russell, CEO of neoSurgical.

Laparoscopic abdominal surgery requires small incisions or “port sites” in the abdomen. The port site must be closed after lap surgery. While lap surgery itself is minimally invasive, “herniation”, or protrusion of abdominal tissue through the port site after closure (commonly referred to as “trocar site hernia”, or “TSH”, among doctors), can lead to morbidity due to small bowel strangulation, for example, or nerve and vessel entrapment, resulting in infection, bleeding and pain.

Until 2014, TSH complications were thought to occur at a reported rate of about 1 percent to 6 percent among the 6 million lap surgery port sites closed each year. But in a clinical study (Comajuncosas, J, et al. Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study. Am J Surg. 2014 Jan; 207(1):-6), nearly 26% of patients were diagnosed with TSHs. Thus, TSHs have been grossly under-diagnosed.

Following the Comajuncosas study, a second published study* (Scozzari et al. High incidence of trocar site hernia after laparoscopic or robotic Roux-en-Y gastric bypass. SurgEndosc. 2014 Oct; 28(10):2890-8), showed the total trocar site hernia rate was 39.3 percent at three years.

Most recently a third, multi-institutional study* (Holihan JL et al. Adverse events after Ventral Hernia repair: The vicious Cycle of complications, JACS 2015) revealed that hernia occurrence can lead to a repetitive cycle of repeat procedures and complications. The standard for port site closure has been closed loop suture. neoClose works by the use of a Vector X closure, approximating the tissue together and tying into place for a secure closure with up to 75 percent less tension compared to standard closed loop suture, according to the company.

neoSurgical is a commercial-stage developer of surgical products. The company’s initial product is neoClose, approved for sale in the United States and Europe and designed to be the new standard for lap surgery port site closure, a potential $300 million opportunity. 

Studies cited:

* Comanjuncosas J. et al, Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow up study Am J Surg. 2014 Jan; 207(1):1-6.

* Scozzari G, et al. High incidence of trocar site hernia after laparoscopic or robotic Roux-en-Y gastric bypass. Surg Endosc. 2014 Oct; 28(10):2890-8

* Holihan JL et al. Adverse events after Ventral Hernia repair: The vicious Cycle of complications, J Am Coll Surg. 2015