Assignment: Minimally Invasive Surgery

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Assignment: Minimally Invasive Surgery

Assignment: Minimally Invasive Surgery

Assignment: Minimally Invasive Surgery

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As Jack Ferguson walked from the parking lot toward the offi ces of OR Solutions, he wondered what 2008 would bring for the medical device company, located in an upscale suburb of Tulsa, Oklahoma. Jack stopped by his offi ce, briefl y checked his email, grabbed his briefcase, and walked down the hall toward the OR Solutions boardroom. Jack looked around the boardroom and sighed heavily; it was quiet and serene now but he knew the serenity would not last long.

In an hour he and his business partner, Tom Marshall, would meet with consultants Michelle Brown and Greg Anderson from Market Research, a regional marketing consulting fi rm, to dis- cuss the future direction and organization of OR Solutions, one of their largest projects. A few years earlier, prospects for OR Solutions seemed so bright; however, now its future success was in jeopardy.

Jack Ferguson, a serial entrepreneur, had worked in software development for nearly 20 years, starting and running several prof- itable companies. His vision and attention to sound business prac- tices had made him a master at helping to turn around companies in diffi culty. Although he lacked direct experience in healthcare,


This case was written by E. Lanette Milligan, Gouri Gupte, Maziar Abdolrasulnia, and Peter M. Ginter, University of Alabama at Birmingham. It is intended as a basis for classroom discussion rather than to illustrate either effective on ineffec- tive handling of an administrative situation. *At the request of the organization, names, locations, and financial data have been disguised. Used with permission from the company.

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C A S E 4 : O R S O L U T I O N S R E A C H E S A C R O S S R O A D 5 0 0

his entrepreneurial instinct told him that technological innovations were part of the solution. OR Solutions ’ technological innovation, the OR Surgical System, could make a great contribution toward improving effi ciency and quality in healthcare.

Tom Marshall was an experienced engineer of medical devices. He had designed an infusion therapy monitoring system for the OSU Medical Center in Tulsa, Oklahoma; the largest hospital in the area with 331 licensed beds and over 6,000 inpatient surgeries, 5,000 outpatient surgeries, and 12,000 patient admissions. When OSU Medical Center surgeons and operating room nurses detailed the ineffi cien- cies and safety issues of the current minimally invasive surgery (MIS) operating procedures, the University Research Foundation contacted Tom for ideas. His idea was the OR Surgical System, currently the only product of OR Solutions.

History of OR Solutions

In 2000, Tom began working with the University Research Foundation to develop a single surgical control system that would (1) integrate and provide a single point of control for all electrosurgical devices used in minimally invasive surgery (MIS) procedures – regardless of manufacturer, and (2) activate a closed – loop smoke evacuator to automatically clear the surgical fi eld when using the operating devices that often generated smoke, making it diffi cult for the surgeon to see.

Minimally Invasive Surgery Marketplace

Minimally invasive surgeries (MIS), or “ bloodless surgeries ” as they were some- times known, accounted for about 30 percent of all surgeries in the United States. MIS procedures were performed across a variety of surgical specialty areas and were considered to have less associated complications than open surgeries. A surgeon performing MIS used a number of electrosurgical devices that performed different functions such as cutting, coagulating, and sealing. For each surgical function, separate instruments (often manufactured by different device compa- nies) each had its own foot pedal to operate the function. The foot pedals were generally out of the sight of surgeons and pedal operation could be somewhat confusing, partly because each device manufacturer used its own standards. In fact, the nurse would often have to crawl under the surgical table to press the foot pedal to let the surgeon know which instrument was attached to which pedal. Application of a wrong pedal during surgery could have serious consequences (for example, cutting instead of coagulating). Other problems included injuries related to heat, insulation failure, and reduced visibility as well as possible health consequences related to smoke generation during surgery.

According to the Director of the Oklahoma Institute of Minimally Invasive Surgery, “ A typical MIS procedure requires electrosurgical devices such as har- monic scalpels, lasers, and others functions with no designed method for coor- dinating the use of the instruments and the only way to know which pedal is pushed is by the sound it makes, which is often too late. ”

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5 0 1

Tom worked on an idea to coordinate the group of surgical devices required in MIS into one central operating unit and built the OR Surgical System, illustrated in Exhibit 4/1 . Tom realized the potential of the OR Surgical System and believed that thousands of these devices could be installed in hospital operating rooms all over the world. In fact, after seeing a demonstration of the OR Surgical System, Ralph V. Clayman, Professor and Chair of the Department of Urology at the University of California, said, “ Congratulations, you have built a better mouse- trap . . . it is no surprise that the world is beating a path to your doorstep. ”

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