Evan Flatow, MD, Joshua Bederson, MD, and Benjamin Rapoport, MD, PhD, are driving forces for Mount Sinai’s Comprehensive Center for Surgical Innovation (CCSI), a new high-tech center that aims to become a global hub for medical collaboration and training. The doctors’ dedication to advanced innovation is deeply rooted in a fundamental goal—creating the best care and surgical solutions for patients.
“When I started my career as an orthopedic surgeon, we had to cut a patient’s shoulder open in the hospital to fix a rotator cuff,” recalled Dr. Flatow, the Bernard J. Lasker Professor of Orthopedics and President of Mount Sinai West in New York City. “Today we do it by making tiny punctures in the skin, as an outpatient procedure. Such technological advances have transformed just about every type of surgery in all disciplines, but achieving those advances can be time-consuming and costly.”
“The best clinical innovations happen when device manufacturers work hand-in-hand with surgeons with deep knowledge and experience,” said Dr. Rapoport, assistant professor of neurosurgery and scientific director of Mount Sinai BioDesign, a group that helps experts across the Health System design new medical devices and bring them to market. “But for that to happen, people have to travel, often multiple times, to meet and refine the devices. So, the design loop is long.”
That will soon change at Mount Sinai. Drs. Flatow, Bederson and Rapoport are deeply involved in the Center for Surgical Innovation. Supported by an $11.6 million investment from the New York City Economic Development Corporation, the Center will provide a home for ongoing industry collaborations with small, medium and large medical device companies—a place where stakeholders can work together to accelerate the development and commercialization of technologies and instrumentation that will enhance the safety, quality and efficiency of surgical procedures, and most important, optimize outcomes for patients.
As CCSI Director, Dr. Flatow will oversee all facets of the new center, which will include an expanded home for Mount Sinai BioDesign and spaces dedicated to innovation in specialties such as Neurosurgery, Orthopedic Surgery, Interventional Radiology, Vascular Surgery and other procedural disciplines. The Center will be located in a new state-of-the-art facility at 432 West 58th Street, steps from the Mount Sinai West hospital campus. Construction is scheduled for completion by 2025.
Mount Sinai BioDesign is part of a long history of innovation at Mount Sinai. It evolved from the Neurosurgery Simulation Core, which was founded in 2012 by Dr. Bederson, the Leonard I. Malis, MD/Corinne and Joseph Graber, professor of neurosurgery and chair of neurosurgery at Mount Sinai Health System, to devise new ways to see inside the brain. BioDesign has been attracting innovative startup companies and venture capital to New York City since its inception, inspiring new ventures that generate commercial licensing agreements and millions of dollars in funding. In its expanded home in the CCSI, the medical device incubator will be well placed to amplify its work and partnerships.
The CCSI also will support a pipeline of diverse entrepreneurs who are launching start-up companies that bring novel ideas to the market and into operating rooms around the world. These initiatives will not only improve the delivery of care, but also generate new jobs, diversify the pool of life sciences talent and serve as a global model.
“Collaborations among clinicians and engineers lead to more effective procedures using the latest technologies—robotics and imaging, as well as virtual simulations,” Dr. Rapoport noted. A home in New York City for such partnerships is “ideal,” he said, because the city is easily reachable both locally and globally, and Mount Sinai offers exceptional clinical volume and clinical expertise.
Mount Sinai BioDesign benefits from established connections and is well poised to make more. These connections enable some momentous “firsts.” For example, the organization has a standing research agreement with a major medical valve manufacturer that recently led to the development of a novel valve model that is months away from commercial release. Separately, the group is also developing a minimally invasive device to assist with mitral valve repair procedures.
When a new device manufacturer was ready for a first-in-human pilot of a novel valve repair device in summer 2021, surgeons in the United States, France and Austria needed to prepare, since any one of them could have been the first to perform the procedure. To support these efforts, the BioDesign team prepared a simulator; the surgeons were able to come in and practice the technique, and they were live streamed across continents as they worked. “This was the lead-up to the actual first-in-the-world surgery of this kind, but certainly not the last,” Dr. Rapoport said.
The CCSI will support Mount Sinai’s commitment to accelerate the pace of life sciences and bioengineering innovation and entrepreneurship in New York City. That commitment is reflected in the spring 2022 announcement of the Center for Engineering and Precision Medicine—a partnership between Rensselaer Polytechnic Institute and the Icahn School of Medicine at Mount Sinai that will create one of the first centers in the United States to bridge engineering and engineering science with medicine. Synergies with the CCSI will further enhance the development of solutions that will improve patient outcomes.
Foundational to CCSI is an “Innovation Lab” with advanced equipment, including a 3D-printing lab. The lab will be run by the BioDesign team, but it will also be linked to Mount Sinai Health System’s animal laboratory, clinical trials office, and technology transfer office. “That’s an example of what’s great about Mount Sinai,” Dr. Flatow said. “We’re not just showcasing technology at a meeting at some resort. We’re doing it in the middle of an academic medical center. We’re putting all these different pieces together to make CCSI a comprehensive innovation hub.”
Surgeons with new ideas—like a minimally invasive strategy for the shoulder fractures that Dr. Flatow developed years ago—won’t have to work in isolation before having an opportunity to try out something new.
“Giving birth to a new innovation is not as simple as having an idea,” Dr. Flatow explained. “That idea has to go through a rigorous process before it’s ever implemented in patients. In fact, many patients needlessly worry, ‘Are you going to practice on me?’ But they can be reassured that we develop new procedures and devices in a systematic way, moving from preclinical models to small proof-of-concept studies to a larger scale only when an innovation is truly ready for the clinic. That approach, which we have honed over time, is now part of our standard clinical workflow. We have a very robust pathway.”
“At the CCSI, we’ll have a committee of surgical chairs and scientists. A surgeon can pitch an idea, and if we decide to go with it, there will be funds to support some development and proof-of-concept work,” Dr. Flatow said. “When they get it far enough along, Mount Sinai can either launch a company to produce the product here in New York City or partner with an existing company that will take it from there.”
Forging Forward and Giving Back
Part of Mount Sinai’s mission as a major teaching institution is to not only devote efforts into developing the best medical devices and the best ways of using them for patients, but also to be a training facility. “Surgeons can come to New York City from all over the world to train with us, which they already do to some extent, but the CCSI will really facilitate and expand it,” Dr. Flatow said. “We will have a conference center in the same building as the CCSI where surgeons can come to learn and discuss novel procedures, watch surgeries by video from our hospital operating rooms and demonstrations in the CCSI, and learn to use patient-specific virtual and augmented-reality simulations that can help them appropriately target a new device or procedure in actual patient cases.”
By training and working with a diverse generation of researchers, engineers and physicians, the CCSI will provide solutions that reflect a wider range of perspectives, cultures and backgrounds, and thus have wide-ranging benefits for patients for years to come.
“My lifelong dream has been to build a surgical innovation lab at Mount Sinai to bring surgical discoveries and innovative methods into commercial health solutions that benefit patients,” Dr. Flatow said. “This dream is now a reality.”