Photo By Paul Lagasse | Capt. Tyler Scaff’s airway management device couples a suction catheter with a...... read more read more
FORT DETRICK, Md. – The Medical Research and Development Command’s Office of Medical Technology Transfer is looking for entrepreneurs to help them fast-track a suite of innovative new tools that reduce risks to patients and surgeons during complex airway surgical procedures.
As explained in Part 1 of this two-part series, compromised and obstructed airways represent the second most frequent cause of potentially survivable death on the battlefield after blood loss. A Warfighter with a severe airway obstruction is at risk of death from suffocation within minutes. That’s why management of traumatic airway injuries is critically important for medical providers who work with combat casualties. The MTT is working with military surgeons to develop and de-risk airway medical devices they have invented to the point where they are ready to be licensed by small businesses.
Helping Surgeons See Better During Laryngoscopies
When intubating a patient, physicians frequently use a technique called hyperangulated laryngoscopy. Traditionally, this is accomplished by inserting two items into the patient’s airway: a breathing tube fitted on the inside with a rigid J-shaped probe called a stylet, and a specially designed blade with a camera on the tip. The stylet helps the physician guide the breathing tube into the airway, while the camera ensures accurate placement. However, particularly during emergency situations, the physician’s view can be blocked with blood, saliva, emesis, and other obstructions that cannot be easily removed with traditional equipment. When that happens, there is a risk that the stylet could be misdirected into the esophagus, with potentially life-threatening consequences.
“The literature has shown time and time again that getting the tube into the airway on the first attempt is the most likely to save the patient's life, and every time past that you accrue complications,” explains Capt. Tyler Scaff, an emergency physician with the 88th Medical Group at Wright-Patterson Air Force Base. “After about five attempts, the likelihood of the patient's survival is very low. So, it's essential that you place the breathing tube correctly as early as possible.”
During his emergency medicine residency at Mercy Health St. Vincent Medical Center in Toledo, Scaff wondered if the visibility problem could be solved by attaching a suction catheter to the breathing tube stylet as a way to clear the physician’s view as the tube was descending into the airway. Despite the reputation of emergency room physicians as “MacGyvers” – able to cobble together ingenious solutions using materials at hand – Scaff soon realized that that this problem required inventing a solution from scratch. When the medical center’s Innovations Department announced it was looking for ideas for new medical inventions, Scaff took a chance and submitted his idea. The department, seeing the potential of the device, funded the development of two prototypes and assisted Scaff with filing a patent, but released the rights to him to develop because of the challenges of marketing such a device in a field dominated by large manufacturing companies.
Undaunted, Scaff obtained a year-long scholarship with the Dayton Entrepreneur Center to finish the patent application and obtain additional funding. Through AFWERX, the Air Force’s innovation resource, Scaff met Beth Drees, the intellectual property and licensing manager for the DHA’s San Antonio market, who has been working with him to help generate interest in the invention – called the J-shaped Endotracheal Suction Stylet for Intubation, or JESSI – among small businesses that could commercialize his invention.
“My job is to be the medical expert who tells you why this invention needs to exist and gives you literature to back it up,” says Scaff. “As far as the actual logistics of developing and marketing the device, that's where the Technology Transfer Office really comes into play. Otherwise, you're shouting across a chasm trying to get other people to pay attention to what you're doing.”
Protecting Surgical Teams from Health Threats
New airway management devices can help protect medical professionals, too. Nose and throat surgeons, anesthetists, and dentists are frequently exposed to contaminants escaping from the patient’s airway and oral cavity – including viruses, aerosolized blood, smoke, and airborne particles from surgical procedures. In their mildest form, these contaminants impair a surgeon’s view; at worst, they pose a health risk. However, the tools used to suction away airborne contaminants are bulky and require a second pair of hands, and because they are located outside the oral cavity, they draw contaminants toward the surgical team instead of containing them as close to the source as possible.
“Working inside the mouth, sometimes you don't have a whole lot of real estate to work in, particularly with younger and smaller patients,” says Dr. Renee Serra, chief of otolaryngology at Madigan Army Medical Center, at Joint Base Lewis McCord in Tacoma, Wash. “That’s why we asked ourselves, ‘What's a different way to get suction positioned to draw contaminants away from the surgical team without impacting our view or our surgical field?’”
Spurred by the increased risk of airborne infection during the COVID pandemic, Serra and her colleague Dr. Douglas Ruhl, Madigan’s otolaryngology residency program director, set out to devise a suction tool that could be fitted to existing surgical tools. Such a device would enable physicians to remove contaminants at the source themselves, without the need for an assistant or extra gear.
Ruhl and Serra built and tested several designs, relying as much as possible on proven off-the-shelf components. They ultimately settled on using a short length of flexible chest tubing perforated with a row of tiny holes called fenestrations, attached to a standard tongue retractor. The tube can be attached directly to the retractor, or to a separate oral frame that is fastened to the retractor handle, and can be attached, detached and repositioned for maximum benefit. Tests conducted at Madigan demonstrated the efficacy and durability of their design.
Ruhl reached out to the Office of Medical Technology Transfer, with which he had worked to develop several previous inventions, to discuss how to generate interest among investors and device manufacturers in their fenestrated suction retractor. The potential applications for the device extend beyond hospital and dental operating rooms into ICUs and sedation centers, emergency medical services and first responders, and even veterinary applications.
“I think the Army has a great support system that facilitates innovation,” says Ruhl. “The military is a breeding ground of innovators just by the nature of our unique jobs. We think in different dimensions, and that allows us to engage in creative problem solving. That’s why it’s so important to have people who can help us translate those solutions into actual working devices that we can put into the hands of practitioners and Warfighters in the field.”
Putting Innovative Tools in Surgeons’ Hands
The Office of Medical Technology Transfer works with inventors, businesses and investors to commercialize and deliver innovative life-saving devices and medicines for the Warfighter and the public. MTT uses an award-winning process for systematically maturing and de-risking first-generation biomedical technologies called Assistive Technology Transfer, or AT2. More than 30 biomedical technologies have been successfully licensed using AT2, generating over $26 million in royalty income that MTT has used to reward inventors and invest back into the AT2 program to help move other new inventions through the development cycle – creating what MTT calls a feedback loop of success.
Scaff, the inventor of the JESSI stylet, says that the support provided by MTT is vital for inventors like him who do not have the resources to develop and market their devices by themselves.
“When you open the door to innovation, you also open the door to failure, and you have to accept the fact that all of this can go belly up and it can fizzle out into nothing,” says Scaff. “For people who don’t start with a certain amount of money that they're willing to lose, there's a higher risk. Many people in medicine and the military have good ideas, but good ideas are cheap. What really matters is finding people who believe in you and who think it's worth taking the chance to make it happen.”
This is Part 2 of a two-part series.
The intellectual property discussed in this story:
• Hyperangulated Stylet with Integrated Suction System and Method, International Patent Application PCT/US2024/022587
• Fenestrated Suction Retractor, U.S. Provisional Patent Application 18/139,130
To inquire about applying for a license on any of the technologies discussed in this story, visit https://technologytransfer.health.mil or contact the MTT at (301) 619-0033 or USArmy.Detrick.MEDCOM-USAMRMC.List.ORTA@health.mil.
| Date Taken: | 03.25.2025 |
| Date Posted: | 03.25.2025 14:27 |
| Story ID: | 493708 |
| Location: | FORT DETRICK, MARYLAND, US |
| Web Views: | 53 |
| Downloads: | 1 |
This work, MRDC Seeks Entrepreneurs to License Innovative Airway Surgical Devices (Part 2), by Paul Lagasse, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
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