Plastic surgeons who perform tissue transplantations face a challenge. The only way transplanted tissue can survive is when the blood flows through the tiniest vessels of the new tissue. However, this is not visible to the naked eye, which leaves the surgeon mostly with guesswork. That uncertainty motivated Kiki Liu and Wiendelt Steenbergen of University of Twente spin-off Twente Medical Optics to develop a portable device that allows surgeons to visualize the blood flow in real time.
This article was previously published in TTT Magazine #10.
A successful tissue transplantation doesn’t necessarily mean a successful recovery. Currently, surgeons have to check the patient frequently to ensure everything went well. Kiki: “The earlier you see the signs of necrosis, the sooner you can do something, which reduces the complication rate.” That turned out to be necessary for this type of surgery. “The complication rate can be up to 15 or 20 percent. That’s because it’s still difficult to measure the blood flow. Some surgeons merely check the colour or temperature of the tissue, and in some cases, they use a fluorescent dye. However, the use of that is limited to the operating room because you need to have an anesthetist present. You’d need to inject the drugs, and it takes 30 minutes before it flushes out of your system, and only then can you use it again. Additionally, the drug is dangerous to patients who are allergic to it. That strongly reduces the flexibility and safety of this application.”
Lightweight and handheld
It was obvious to the team that this was a gap to be filled. That’s why they developed their device: a portable handheld device that can measure blood flow in real time in a non-invasive manner. “We use laser light in the near-infrared,” explains Wiendelt their technology. “If you shine that light on the tissue and you image the tissue on a camera, you will see a pattern of tiny dots, or so-called speckles. They will move depending on the amount of blood flowing through the tissue. The more blood flow in the tissue, the faster the speckles move. We developed a way in which we can quantify the motion of these speckles with a normal camera, rather than a high-speed camera. That way, we can make our device lightweight and handheld. The real novelty of our innovation lies in the stabilization. The technology is very sensitive to motion, so every hand-movement can disrupt the measurement. A lot of research in our Biomedical Photonic Imaging group revolved around getting rid of this disruption or reducing it to an acceptable level.”
First step-up
That technology proves to be promising, as the team has already received non-dilutive funding of over €1M in total. But one of the first financial injections came in 2022 – from TTT MedTech. “That has been crucial in getting a good clinical researcher in the team who could reach out to various hospitals,” Wiendelt recalls. “We were working on the development of the wireless system. The technical physician we were able to hire took the first steps in taking the technology into the hospital. The TTT voucher enabled this.” Eventually, Twente Medical Optics was founded as a University of Twente spin-off in 2024.
Funding, exposure, and network
Since then, the team has made the most of all the opportunities coming their way. Kiki: “Next to the voucher itself, TTT has given us a bigger network and exposure. We’re very grateful for that. The ecosystem allows us to get funding, find inspiring partners, get exposure, and join networking events. That really helps us forward.” For Kiki and Wiendelt, it’s a good place to start making an impact. Kiki: “We really want to get our innovation into the hands of clinicians. We want to ensure fewer re-operations, minimize the amount of amputations, and help the patients heal better. Eventually, we envision our solution as a platform technology to expand our services to applications such as dermatology, burn surgery, diabetic foot care, plastic surgery, and colon surgery. In essence, we want to show how such an easy-to-use, non-invasive, portable device can help surgeons and other clinicians to make better decisions effectively and objectively.”