Lee Valley Tools founder and doctor plan a revolution in the operating room
Sunday 30 July 2000 - Almonte, Ontario - Dr. Michael Bell is an avid
woodworker and lifelong customer of Lee Valley Tools,
so when the handle on his carver's knife kept corroding,
he sent a letter to company president Leonard Lee.
As is his habit, Mr. Lee responded himself. He was
puzzled. Why would the handle be rusting out?
Dr. Bell explained that, after three of four times in the
autoclave, the handle developed a little corrosion around the tip.
An autoclave uses pressurized steam to sterilize tools. Surgical
tools.
"You're using this in the operating room?"
The surgeon told the toolmaker he had unknowingly designed
the world's best scalpel handle. And thus began a collaboration
that, this fall, will lead to the launch of a new line of products
that could lead to an evolution in
surgical hand tools, a field that
hasn't progressed in more than
50 years.
Mr. Lee's new company, Canica
Design, is developing manual
surgical instruments that could
allow surgeons to work,
unassisted, during minor
procedures and let them move
more surgeries from expensive
hospital operating rooms into
office clinics. For patients, it
could mean shorter operations,
smaller incisions, less anesthetic
and faster recovery times.
His design team is applying
technological advances in what they know best --
cutting, fixing, drilling -- to
medicine.
"Doctors told us for years they could get more
specialized tools for
woodworking than they can get for surgery," says
Mike O'Malley, Canica's
director of research and development.
The flat-sided scalpel still widely in use today was
developed in 1915 and hasn't
changed since. Surgical instrument makers have
concentrated instead on
high-speed drills and saws, endoscopes and other
innovative, high-ticket tools
that have allowed surgeons to do procedures they
never before could.
But basic instruments have been a totally neglected
area, says Dr. Bell, who is
director of Canica's medical advisory board. Many
are clunky and crude, and
weren't designed for the minimally invasive
surgeries doctors are now
increasingly being expected to perform.
"The advantage that Lee Valley has is that we're
really up to speed on
manufacturing processes," Mr. O'Malley says. "We've
learned about stainless
steels and how to make things cost effectively, and
cleverly."
Not that Leonard Lee had need of another career. Lee
Valley Tools is one of the
region's most successful privately owned companies.
Every three years the
company doubles in size. Born on a kitchen table 23
years ago, the company
now employs 550 people, with stores across Canada
and a booming mail-order
business in Canada and the U.S.
But, at 62, Mr. Lee said it was time to make himself
dispensable at Lee Valley
Tools. Besides, he says, the company has good
managers "who, to my chagrin,
function without me."
"This is a chance to start again," he says from the
renovated, century-old
hardware store on Almonte's Mill Street that now
houses Canica Design. It
smells like wood chips inside. There are 12-foot
ceilings, gleaming hardwood and
an "editor's" office with framed OPW Prints and
Varnishes calendars from the
1930s. The designers, who range in age from 24 to
79, work at computer
cubicles in the front. A machine shop that's been
tidied up for our visit is out
back; oak and glass cabinets display the evolution
in the design of the surgical
tools Mr. Lee hopes to bring to market in October.
Looking tanned and relaxed, Mr. Lee explains how he
wants to restore the
long-since forgotten relationship between the makers
of surgical instruments and
the doctors who use them. So he and his designers
have donned masks and
surgical scrubs to watch Dr. Bell and other surgeons
at work in the operating
room to better understand the problems they face.
One of the biggest problem for reconstructive
surgeons is how to keep things in
place -- like a hand during carpal tunnel surgery.
And who better than
woodworkers know how to "hold stuff," Mr. O'Malley
asks. "It's a fundamental
part of woodworking."
Canica designers developed the CHESS hand fixation
and retraction system. It
consists of stainless steel pieces shaped like chess
men that use powerful
magnets to fix them to a stainless steel plate
draped in surgical cloth. The
surgeon moves the magnets around the plate to
"capture" a finger, or spread
others apart, and to hold the hand in place.
Chemically milled, thin flexible
retractors that look like miniature back scratchers
can be hooked on to the
magnets, allowing the surgeon to control the
retraction himself.
The system has allowed Dr. Bell to perform,
unassisted, carpal tunnel procedures
in his clinic in 15 minutes, instead of the standard
45 minutes in an operating
room with one or two assistants.
The design team has refined the scalpel that began
life as a carving knife. Unlike
traditional flat-handled scalpels, which are "really
nothing more than a slab of
steel with a blade stuck in the end," Mr. Lee says,
the new scalpel handle is
shaped like a pen, allowing for fingertip control
and far greater precision and
accuracy when cutting. And it has a unique safety
feature: an ejectable blade.
"The most dangerous thing you can do is take a
scalpel blade off a scalpel
handle," says Dr. Bell, who has operated on six
doctors and nurses who have
lacerated fingers and hands removing blades from
their non-disposable handles.
Getting stuck with a scalpel is one thing. Getting
stuck with one contaminated
with HIV or hepatitis is another. So far, the best
traditional instrument makers
have come up with is a disposable scalpel made with
a plastic handle, "the most
useless thing in the world," Dr. Bell says, because
there's no weight or balance.
Canica has also developed a wound-closure system
that essentially uses a series
of steel clips and bits of thin, latex tubes to
gradually and gently close large
wounds, avoiding the need for skin grafts that
typically leave a substantial scar.
The system has been used to close a large,
elbow-to-wrist skin defect resulting
from a complication of a gunshot wound in an RCMP
officer's arm; it helped
save the leg of a teenage girl who last winter
contracted necrotising fasciitis, the
"flesh eating" disease.
They hope to develop small rods that can be used to
rejoin fractured bones in
hands, and new drilling bits for orthopedic
surgeons. And their preference is for
local manufacturers.
"The hope is that, over time, our design efforts
will create and hopefully grow a
community of small surgical manufactures [here] in the [Ottawa]
Valley," Mr. O'Malley says. "It
would be an ideal industry for our area."
Mr. Lee says the goal is to design instruments that
would work well in field
medicine -- UN disaster relief efforts, Third World
countries.
Exact figures are hard to come buy, but Canica
estimates that the global market
for surgical hand tools is about $70 billion
annually. Capturing even a fraction of
that market could rival the success of even Lee
Valley Tools.
The company founder is excited and enthusiastic. Mr.
Lee sounds like a medical
student when he talks about diabetic ulcers and
bedsores and how wounds must
close by "secondary intent." He keeps colour
pictures of gaping wounds that
have been repaired with his new wound closure system
in his briefcase.
"It's possible that we might be able to ..." Mr. Lee
begins, then stops. "Surgeons
might be able to ..." he corrects himself.
"This is not a God complex. It's problem-solving,
really, and that's always a lot
of fun. It's significant if a doctor is unable to do
a procedure because he doesn't
have the tools he needs.
"And it's a marvelous thing to be able to design
something that will allow him to
do it."
Sharon Kirkey
The Ottawa Citizen
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