Alexander Veenhof is an oncological surgeon at the Antoni van Leeuwenhoek hospital in Amsterdam. His love of technology and innovation led to the start-up Corporis Medical at Brightlands Maastricht Health Campus. “This is how you can make healthcare cheaper.”
Born in Heerlen in 1981, Alexander Veenhof’s grandfather was the prominent and charismatic surgery professor Frits Buytendijk (1913 – 2004), his mother’s father. Alexander still remembers the great stories his grandfather told. “I think these stories played a subconscious role in my decision to study medicine.” For 30 years, he worked in hospitals in Heerlen where he trained numerous surgeons.
It still wasn’t an easy choice. “I vacillated between a career in medicine and something in the technical field. I always played with Lego as a kid and was often busy designing technical things.” It ultimately became a combination of the two. “As a surgeon, your work also involves certain technical aspects; you’re trying to find handy ways of putting things together, to put it in very trivial terms. “And yet – to be very honest – I still missed the technical part of things, so yes, that’s how those two worlds collided. Think of it as a hobby that got a little out of hand.”
It was mainly Professor Cuesta’s enthusiasm that led to his decision to specialize in intestinal, esophageal, and gastric surgery. The idea of starting a company came to him back in his time as an intern. “Sometimes, during a perfect operation, we would remove part of an esophagus or stomach. When we would suture the two remaining pieces of the intestine or stomach back together, the suture would start to leak a few days later. If a new connection leaks like this, the intestinal contents end up in the abdominal cavity. This makes a patient very ill, so you have to operate again. Some people can even die as a result; in Europe and the US, this is an estimated 20,000 people per year. What really struck me was that there was no good method for testing the quality of the tissue. How good is it? Will it grow back together, or will there be a leak after a few days? The only thing surgeons did was look at the tissue to see if it seemed to be perfused with blood, and that was it. And that’s how the search began, to find out how to prevent as many leaks as possible.”
Veenhof started thinking about a device that could measure tissue quality during surgery. He started working with prototypes that he made from various cheap or discarded materials. Some possible solutions were already on the market, such as a liquid that could make holes visible or a sealant. However, it still involved a surgeon’s estimate rather than an objective measurement. Veenhof: “As a young doctor, I was a little naive about the whole thing. When I started this, I didn’t know which path to take to make progress. You don’t think about the fact that a prototype has to be scalable; that it has to be possible to produce thousands or hundreds of thousands of them. After all, so many operations like this are performed all over the world. As a surgeon, you don’t view it from that perspective. It’s great to have a good idea, but you still have to make it happen. And then you have to start protecting it with patents and continue developing it. There also has to be an official prototype that you can start using in tests. You also need money, of course.” In other words, starting a business was inevitable.
Interest from investors
Investors started showing interest, the first of which was Inkef Capital in Amsterdam. Corporis Medical moved to Maastricht when LIOF and Brightlands Venture Partners joined the effort. John Marugg became CEO and now has a team of about ten people. “This isn’t something you can do on your own on the side, in addition to your surgery practice,” Veenhof says. “Sometimes in life, you also have to have a little luck. I think many surgeons and technicians here have also examined this problem to find a solution. With a little bit of luck, it looks like we have found it.”
Currently awaiting European and American approval before it can start being produced and used, the device doesn’t test the adhesion itself but the quality of the tissue. It does this simply by using a number. If the number is too low, this means a high risk of leakage. If there is enough adhesion, it means the tissue should be sufficiently alive to ensure that the sutures stay closed. Nature can take it from there; the bits of tissue have to start sticking together and healing.
The prototype was tested on 215 patients by multiple surgeons at different hospitals. Alexander Veenhof: “We got the results we were hoping to see; we can predict whether leakage will occur. In the future, if you take a measurement and find you are below a critical value, we can predict with 90% certainty whether a leakage will occur. You can then associate consequences with this during the operation. Or you could say, I got a low reading, so I’m going to look in the intestines for a spot showing a higher reading and which won’t cause that kind of leakage. And if you can’t find one, you have to make a decision: is the patient young and someone with a good chance of surviving such a leak, or is it an elderly patient with a bad heart who would be better off getting a colostomy? As unpleasant as that may be. Measurements can be used to help make these kinds of critical decisions.”
Corporis Medical is now working on a second innovation, a novel device that can prevent complications during exploratory surgery, such as the rupture of scar tissue. It helps wounds to close automatically, safely, and efficiently so that fewer people need to undergo a reversal procedure. “The goal is to make things better for patients and more efficient for us as surgeons,” says Veenhof. “It’s also a way of making healthcare cheaper. After all, being able to reduce the number of reversal procedures saves a lot of money.”
Even though he has a family with three young children and a surgical practice at the Antoni van Leeuwenhoek hospital in Amsterdam, he can’t picture his life without a business. He believes that having a mix of a hospital, university and investors near a campus is working out well. “A campus like this holds an attraction for young, talented people that startups like ours can benefit from. We have to rely on people who have just graduated and are looking for a good place to get professional experience. There’s always a risk that they will later move to large companies like Philips or ASML, so it’s important for start-ups to be located near the university to remain visible for young people.”
Teamwork appears to be the magic word, both at Corporis Medical and at the Antoni van Leeuwenhoek Cancer Institute. The hierarchy seems to have faded out of the medical profession to a great extent. “My grandfather used to do all of the surgical procedures. This is no longer the case. I only do esophageal, gastrointestinal, and pulmonary surgery now. This super specialization also applies to radiologists, internist-oncologists, and pathologists. There are even wards specialized by tumor type, as it were. This is incredibly valuable for the treatment of patients and also benefits innovation.”