Israeli startup makes laparoscopic surgery less painful
By David Brinn May 27, 2007
Many startups toil away for years before they finally see results - if they see them at all.
That's why the achievement of Israel's Virtual Ports is so remarkable. Less than one year
old, the incubator company in Misgav has developed an innovative surgical medical device
and received FDA marketing approval.
But more importantly, the company's innovation - the EndoGrab - is going to help the more
than three million Americans and Europeans who undergo laparoscopic procedures each
year. Forecasts are that in the near future this figure will increase by some 20 percent a
In laparoscopic surgery, surgical devices are inserted into the abdominal wall through small
holes, instead of cutting open the entire stomach. A length of tubing is inserted into each
hole and a surgical device which looks like a long knitting needle is passed through it into
the stomach. The surgeon moves the needle around, viewing the stomach through a minute
camera which is introduced into the stomach in the same way.
The EndoGrab is a device for retracting internal organs and anchoring them to the internal
abdominal wall during laparoscopic procedures. An internally anchored, hands-free
retracting device which eliminates the need for a hand held retractor during surgery, the
EndoGrab is introduced at the start of surgery, attached to the organ requiring retraction
(such as the colon) and then to the internal abdominal wall, thereby exposing the operative
For Virtual Ports CEO Udi Gordin, it's all in a year's work. The economics graduate and
former software engineer at Intel decided to change career paths in 2005.
"I was looking for more independence and started to explore opportunities in the
entrepreneurship area," he told ISRAEL21c.
After talking to many people in the medical field, he was introduced to Dr. Adrian Paz, the
head of the Urologic Laparoscopy at Barzilai Medical Center in Ashkelon who provided the
concept, technical background and expertise for the EndoGrab system.
"Together we started looking for investors around June of 2005 and we launched the
company in the Misgav incubator in May of last year," said Gordin.
But that's where the similarities between Virtual Ports and other startups ends as the
fledgling company made a move that launched it on its journey of success.
"Most startups find two or three key opinion leaders they mine for information, learn about
the industry and act as advisors.
We did that, of course, and found the top endoscopic surgeon in Israel, Dr. Amir Szold, and
Dr. Yoav Avidor who has worked for Ethicon Endo-Surgery, Inc. a Johnson & Johnson
company and who knows the market inside out," explained Gordin.
"But in addition to them, we commissioned a survey in the U.S. last October with about 60
American surgeons. We asked them 25 questions, mostly about what they thought about
improving the abdominal procedure."
Using the results, Virtual Ports was able to confirm the definite need for their idea and,
according to Gordin, fine tune the device based upon the points the MD's raised.
"This was an important beginning - to be able to work not with one or five physicians but to
find out the quantitative area of needs."
What they learned from the surveys is that American doctors were not totally pleased with
the way laparoscopic surgery was being performed. Generally, the instruments are inserted
into the abdomen through small incisions (ports) and controlled by the surgeon from
outside the patient's body.
"During the laparoscopic procedures in the abdomen, there's a need to shift the location of
some organs to enable the surgeon to approach a specific location. The way it's done today
is that an assistant holds back the internal organs through a dedicated incision while the
surgeon works through another incision," said Gordin.
This conventional technique employs the use of hand-held retractors and additional
auxiliary personnel for manipulating them. The result is additional post-operative patient
discomfort and scarring as well as increased surgical costs.
"We eliminate the need for a dedicated incision and extra assistant. The EndoGrab holds the
internal organs and connects them to the abdominal wall."
The advantage? More efficient laparoscopy for the surgeons and faster recovery and less
scarring for the patient.
This month, Virtual Ports received the go-ahead from the FDA to market EndoGrab, a
landmark gain very early in the startup's life.
"Since the EndoGrab is a mechanical device without electricity or external energy, we were
able to quickly receive FDA approval to market the product," explained Gordin, adding that
the company is working on receiving certification from Israel's Health Ministry to conduct
clinical trials on humans.
Simultaneously, Virtual Ports is in the process of applying for FDA approval for their second
device called the EndoClear, designed to clean the lens of the camera that guides the
When doctors perform laparoscopic surgery today, they insert the instruments they need in
one incision and in the other they place a camera that helps guide them through the
procedure. "During the procedure, the lens of the camera often gets covered or dirty with
body fluids," explained Gordin.
"Presently the surgeon needs to remove the camera periodically, an assistant cleans it and
they re-insert it. The problem here is that it takes time and more importantly, the surgeon
loses the focus of the procedure. It takes him time to get back to the point of concentration
he was in, and according to the surveys we conducted it's very irritating."
The Virtual Ports solution makes it possible to clean off the camera lens inside the
abdominal cavity. The EndoClear is a stand-alone cleaning station that's inserted along with
the camera in the cavity.
"Anytime the camera gets blurred the cleaning station is brought into action and not only
cleans the lens faster but enables the surgeon to keep his concentration and focus," said
With two full time and four part time employees Virtual Ports is still part of the Misgav
incubator located in the north of the country. Gordin is receiving the dizzying success of the
EndoGrab in stride.
"While we didn't think it would take too long to get FDA approval, we were still surprised
that the process went so quickly," he said.
If this is what Virtual Ports accomplished in its first twelve months, just wait till its second