Insightec |

Focused Ultrasound is Replacing the Surgeon’s Scalpel

The Israeli start-up Insightec has developed a revolutionary technology for non-invasive treatment of human tissue, leading to significantly reduced damage, bleeding, infections and hospitalization

Assaf Levanon
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In 1999, Dr. Kobi Vortman founded Insightec to fulfil an ambitious and ground-breaking vision: non-invasive surgery that uses sound energy instead of a scalpel and incisions. Dr. Vortman was disturbed by the fact that surgical procedures, while beneficial, also cause damage because surgeons must make incisions in healthy tissue in order to reach the affected organ.

Insightec’s groundbreaking ultrasound technologyCredit: Insightec

Brain surgery, for example, requires opening the skull, using medical instruments inside the skull, harming healthy brain tissue and exposing the brain to a risk of infection. Dr. Vortman believed that such procedures could be done differently, and his knowledge of ultrasound technology strengthened his conviction. Although ultrasound is mainly used for imaging organs, it is capable of penetrating the body to treat tissue in different organs. “If we develop a focused ultrasound, we will be able to achieve this goal,” he declared at the time.

“Just as the sun does not harm dry leaves on the ground and the same energy, when focused on a spot through a magnifying glass, can burn the leaf, ultrasound can penetrate the body without harming tissue except at the targeted specific area,” explains Dr. Eyal Zadicario, Insightec’s COO and General Manager in Israel. “The idea is to burn the damaged tissue and destroy it without harming surrounding areas or organs. The vision was to enable focused treatment with complete control using imaging, so that the surgeon sees everything in real time. Dr. Vortman understood that combining ultrasound and MRI is the key to safe, precise and successful treatments – this combination is like precision guided weapons.”

How does it work?

“Imagine a virtual scalpel. The energy enters the patient’s body, concentrates on an area that was pinpointed in advance, and destroys it without causing physical damage. In a regular operation, the surgeon sees what he cuts and physically damages it. With the virtual ultrasound scalpel, the doctor works with an MRI machine, which is ideal for making the body transparent. The doctor sees everything clearly and can identify the specific target. The MRI replaces the surgeon’s sensations and eyes and, combined with a virtual scalpel, creates a non-invasive surgical platform that makes it possible to treat patients without incisions and avoids harming organs except for the target. This means much less damage to other tissue, as well as reduced bleeding, infections and hospitalizations.”

Precisely focusing sound

It took four years to develop the basic technology and get into clinical trials. The company also developed a technology to treat benign uterine fibroids, prostate glands, and bone metastasis. However, the holy grail was non-invasive brain surgery that can treat tremors and other neurological impairments such as those experienced by patients with Parkinson’s disease.

From left Insightec founder Dr. Kobi Vortman, CEO Dr. Maurice Ferré, General Manager for Israel Dr. Eyal ZadicarioCredit: Insightec

“Treating the brain is a huge challenge for ultrasound energy,” Dr. Zadicario points out. “It was always thought that ultrasound energy cannot pass through the skull, and standard ultrasound cannot do so. It took us eight years to develop an ultrasound technology that is capable of penetrating the skull. It is done using a special helmet that is able to focus the ultrasound in a precise manner, within a millimeter, and enables non-invasive treatment of cells in regions of the brain that previously required invasive surgery to be reached. This is a unique technology that took a long time to develop. We received approvals for these applications in 2013 in Europe and in 2016 in the U.S.”

Many years passed between the company’s foundation and the approval of these applications. It is difficult for so much time to go by without a marketable product. It also gives the market a lot of time to generate competition.

“Exactly. Belief in the vision kept us going. At first, it seemed more like a dream, a fantasy, rather than a vision. But we believed that we would succeed in solving the challenge and that it is only a matter of time. Today we have a working technology that we are continuing to develop and that is protected by many patents, so that it is hard for competitors to close the gap. No other company currently has our capabilities. It’s wonderful to see tremor patients undergo a single two-hour outpatient treatment and leave with their tremors completely gone, or significantly reduced. Without Insightec’s treatment, due to the risk and discomfort of invasive surgery, many patients decide to forego an operation and continue living with tremors.”

David Dillow from Virginia, who has Parkinson’s, is one of these patients. “As the disease progressed, the tremors got worse. It was hard to eat, especially in public places,” he recalls. After the Insightec treatment, his hands stopped shaking and he could even write again.

“Around 7,000 patients have already undergone this procedure. Approximately 30,000 people in Israel and around the world have been treated with various Insightec treatments, and this is only the beginning. We are in the midst of conducting research to find treatments for a range of different medical conditions.”

What are your main markets today?

“Around 50% of our treatments are carried out in the U.S., a third in Europe, 15% in Asia – mainly China and Japan – and the others are spread across the rest of the world. Our technology is being offered in over 100 leading medical centers. In Israel, our technology is used at Sheba Medical Center at Tel Hashomer and Rambam Healthcare Campus in Haifa – both of which have been working with us from the beginning of our research and are also taking part in the research on future applications, as well as helping patients in Israel receive the most advanced medical care using our locally-developed technology.”

Clinical trials for epilepsy and pain disease

Insightec is growing rapidly. In the past four years, its workforce grew from 200 to almost 500 people. This raises the question of whether it is planning a stock issue.

“Till now, more than US$ 500M has been invested in the company’s R&D. Today, our main shareholder is the investment arm of Koch industries in the USA,” replies Zadicario. “The company is expecting to accelerate growth and seek additional capital.”

Into which other types of medical treatments are you planning to expand?

“We are currently carrying out clinical trials on epilepsy and certain pain diseases, such as neuropathic pain that originates in the brain. In addition, we are working on a neuro-oncological solution for brain tumors and on oncological applications in the body.”

Where will Insightec be ten years from now?

In ten years, I believe we will see medicine develop towards non-invasive surgery being standard of care for some procedures. Our technology will expand to treat additional indications that will extend and expand beyond what we do today. Another channel we are already studying is the use of ultrasound to deliver drugs more efficiently to tumorous areas and to other areas they need to reach. Today, when we take a drug, the entire body is exposed to it. Ultrasound that targets specific tissue can deliver the drug to the exact point it is needed and at a much higher concentration – especially in the brain, and other parts of the body as well. In this way, we plan to focus on targeted drug delivery. If we succeed, this will be another revolution that we will bring the world.”

How do you explain this Israeli success story?

“There is a significant core group of people at Insightec who have believed in the company from day one and have been here since the beginning. We have leading science and technology experts who built a company with a vision and enabled it to grow to what it is today. Everything is done with Israeli audacity. It is not accidental that Insightec is an Israeli company and will remain so. Our R&D and Operations Center employs hundreds of people in Israel. We indirectly employ thousands more through suppliers and subcontractors, and we plan to stay and grow here in Israel. This type of groundbreaking innovation and overcoming such complex difficulties require daring and a vision that is customary in Israel, and these traits are essential for succeeding.”

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