Avasa arterial couplers advance reconstructive surgery
Avasa CEO Nandoun Abeysekera is a man on a mission to simplify microvascular surgery in people disfigured by injuries and illness.
The joy of making things better
Even when he was little, Nandoun enjoyed inventing ways to make things better. After studying engineering, he went on to study medicine. He then found himself a residency under the mentorship of plastic surgeon Jon Mathy. Witnessing Jon’s surgical craftmanship and dedication to his patients was inspiring, and he considers this period of training one of the highlights in his career.
Jon specialises in microvascular and reconstructive surgery. We’re talking complex operations lasting six to 14 hours, so long that there are 2 surgical teams. Some examples are head and neck, and breast reconstructive surgeries after removing cancerous tissue. Removing these cancers can leave open wounds as large as 10cm by 10cm or more. To reconstruct these defects, you can transfer tissue from another part of your patient’s body such as their abdomen or thigh. For any piece of tissue to survive, there has to be a blood supply going into it and out of it. This type of surgery is is called free flap surgery where you disconnect a flap of tissue from its local blood supply, then reconnect the arteries and veins in its new location. This is a critical part of the operation, because if the arterial reattachment fails, the tissue dies.
As Nandoun was assisting Jon with his operations, he noted how difficult and time consuming it was to hand sew these tiny arteries. Each took 30 to 45 minutes. A coupling technology for veins had transformed venous reconnections. But arterial reconnections were still hand sewn. So Nandoun started imagining ways to reconnect arteries better, faster, and more safely.
“We went through over a hundred iterative cycles of design because we were doing something that had never been done before. The arterial coupling devices are 3-5mm long, and we had no experience designing at that scale, let alone prototyping, or manufacturing.”
From med school to start-up CEO
In 2018, Nandoun quit his job as plastic surgery resident to start designing an arterial coupling solution. He says, “It needed to happen. It seemed so obvious. There was this clear unaddressed clinical need.”
His journey from med student to CEO wasn’t exactly planned. Nandoun explains, “I imagined I’d do a scientific research project. But then we entered the Velocity Challenge, and won the new ventures category. During the challenge you work with mentors to develop a business proposal. This shed light on the commercialisation process of taking an idea into the clinical space and helped us understand what the next few years would look like.”
Making reconstructive surgery faster, safer, and more accessible
Avasa’s arterial coupler reduces the time required to reattach arteries to only five minutes. Increasing the speed of this procedure also increases the safety of reconstructive surgery.
Arterial couplers simplify microvascular surgery and may also make reconstructive plastic surgery more accessible. In the future, you may not need to train as a microvascular surgeon to do reconstructive surgery because a complex part of the procedure has been simplified by the arterial coupler.
Potential applications for arterial couplers include reconstruction for mastectomies, head and neck cancers, limb amputations, and injuries from trauma. Nandoun also sees the tech translating into the gastrointestinal and cardiovascular space after proper clinical testing and regulatory oversight because these specialties share similar needs.
A spirit of collaboration
Nandoun was introduced to Bridgewest through a personal recommendation from a fellow founder. He explains. “My first meeting with Bridgewest Ventures was one of those moments where I intuitively felt we would become partners. They’re good people, and there’s a spirit of collaboration. Bridgewest are in there with me.”
“This device is important to New Zealand because of the clinical need. We’ve one of the highest prevalence of skin cancer in the world. The way plastic surgery restores form and function to people deformed from disease or trauma is profound. It’s inspiring to witness the work that plastic surgeons do, and having the opportunity to help make reconstructive surgery better and more accessible is such a joy.”
For the next step, Avasa have partnered with an engineering company certified to do medical device development and testing, and a regulatory specialist to advise during preclinical trials.
He also feels to have made it so far within the small New Zealand ecosystem is already a win. “The medical device industry is young in New Zealand. The route to market is far more mature in Europe, the United States, or even Australia. But while our medical device industry may not be as mature, we do have incredible people here. This venture could not have reached this stage of development without the generosity and mentorship of other founders, clinicians, professors, and the ecosystem of support at the University of Auckland. This allows us to go further with less.”
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