Sanovas (Sausalito, CA) is a company founded on bold ambition. “Only so often in life does the opportunity to leave a footprint on the legacy of mankind come along,” reads a quote in the company’s shareholder’s report from the first quarter of 2012. And the firm takes those words seriously, having collaborated for years with interventional pulmonologists, to give hope to patients suffering from chronic lung diseases such as lung cancer and chronic obstructive pulmonary disorder (COPD). Lung cancer is the deadliest all cancers. In the United States, it claims the lives of nearly 400,000 people annually, according to the American Lung Association. COPD is the third leading cause of death in the country.
|Larry Gerrans, CEO of Sanovas holds a prototype of one of the firm's products with a model of an artery.|
Treating pulmonary diseases in general and lung cancer in particular, however, has remained daunting for surgeons, partly because the spaces within the lung are difficult to access. Complicating matters further is the fact that, unlike the heart, the lungs must continue to function during surgery. Managing the airways has also remained difficult, which makes interventional pulmonary procedures inherently risky.
The company realized that to significantly advance patient care in this field, they would need to develop a suite of technologies. “Interventional pulmonologists need not just a new tool, but a new tool belt,” explains Larry Gerrans, the company’s president and CEO, who cofounded the company with CTO Erhan Gunday. “Over the last couple of years, we have reached out to some of the best minds across the interventional pulmonary science to assess their skills, their capabilities, their comforts, and their concerns,” Gerrans says. The two men used the resulting input to develop a comprehensive portfolio of technologies. The firm, which has more than 25 international patents pending, plans to begin commercializing the first of its product portfolio this year.
One of the things the two men recognized was that interventional pulmonologists lacked sufficient access to the pulmonary anatomy, Gerrans says. “The technology had not been miniaturized enough to get to the places in the lungs to access, image, diagnose, to remove obstructions, and treat cancer and pulmonary diseases locally.”
“We can achieve hemostasis without the use of thermal ablative technologies... It is kind of an organic approach and we have found that it is a very efficacious and safe way to remove obstructions.”
To fill that need, the company developed what it calls the world’s smallest endoscopic steerable camera. It also developed a novel transbronchial needle aspiration technology for detecting disease in the lymph nodes and to diagnose the pathology that is found in the lungs. Once a pathology is found, it inevitably creates some type of obstruction. “We have created some very novel technologies to remove those obstructions,” Gerrans says.
Traditionally, removing such obstructions has been a challenge. Endobronchial neoplasms and fibrotic lesions are difficult to access and manage. The anatomy in the lungs is highly vascular. Consequently, removing tissue is dangerous because of the risk of excessive bleeding.
There are other risks, as well. “A lot of doctors venture in with electrosurgical-type tools, like laser and Argon-beam devices and whatnot. The smoke plume that gets created from electrocautery and thermal ablative technologies creates a vaporous discharge that could result in embolism and a stroke and even death,” Gerrans says. “And so we created a nonthermal re-cannulization technology that manages the airway.”
One of the main focal points of the firm’s technology is its ability to manage the airway and control bleeding. “We can achieve hemostasis without the use of thermal ablative technologies to mitigate the risk of embolism and stroke,” Gerrans says. “It is kind of an organic approach and we have found that it is a very efficacious and safe way to remove obstructions.”
|The lungs are the last frontier of innovation in the interventional sciences as a result of their inability to be turned off during surgery and the lack of safe, efficacious technologies to manage the airways, which creates a high procedural risk.|
A 'One and Done' Approach to Diagnostics
Sanovas developed a proprietary biopsy system to obtain tissue samples for diagnostics, which differs from other similar products on the market in that it uses a pressure vacuum actuated system. The device allows a surgeon to go into the pathology and suck the target tissue into a biopsy forcep. “The reason that is important is because a lot of times with current transbronchial needle aspiration procedures, they use a 21-gauge needle and make multiple passes into the tissue, to acquire a large cell sample, causing trauma ,” Gerrans says. “When you insert it, it effectively goes through the mucosa, into the bronchus, and then into the lymph node.” Consequently, the amount of target tissue in the sample is limited.
“When you look at personalized medicine companies, their capacity to deliver immunologically morphed genes and drugs is limited by the physician's ability to obtain a quantitative analysis of immunology.” At present, obtaining sufficient immunologic cell samples from the target tissue is a difficult and imprecise process can cause trauma to the patient. “So our focus is to create something of a one and done approach to the diagnostic. Our device is almost like a liposuction type thing. It sucks the tissue in and seals the chamber. The physician then pulls it out, breaks of the hermetically sealed capsule, puts it in a specimen jar and then sends it off to pathology hermetically sealed,” Gerrans says. “In the end, you have got a very robust, large volume cell sample for diagnosis.”