Case study: Creo Medical

About your organisation

Creo Medical is focused on the development and commercialisation of technology and minimally invasive devices by bringing advanced energy to therapeutic endoscopy. Creo’s first device, Speedboat Inject, is now in use worldwide, providing physicians with new treatment approaches and patients with life-changing outcomes.

What are the physics-based technologies that you are developing in your business?

Professor Chris Hancock founded Creo Medical in 2003, initially to target the treatment of cancers through use of high-frequency microwave energy and dynamic matching techniques. Creo has harnessed the power of advanced bipolar radiofrequency and microwave energy to perform resection, dissection, haemostasis, and ablation.

Our product range allows these energies to be utilised in the gastrointestinal tract, lungs, liver, and pancreas through miniature devices in minimally invasive treatments.

Research continues into the possibilities offered to extend our capabilities, through the use of cool plasma and electroporation, into more wide-ranging fields including laparoscopy and sterilisation.

What was your innovation journey like?

For founder and chief technology officer Chris Hancock, the driving purpose behind Creo is to help people; to improve patient outcomes by leveraging, optimising, and controlling the right energy for the right reason.

His original vision focused on a very R&D-led organisation, and the company was initially funded via a venture capital-backed UK incubator. This allowed them to buy initial equipment, produce prototypes and begin to gain the company’s first patents. However, he realised that a different approach would be required to take those prototypes to market and treat patients.

At this point, Craig Gulliford came on board as an angel investor and helped raise seed capital and additional funding through government grants, which allowed further advancement of the technology, including initial animal studies.

In 2013, as Craig became Creo’s CEO, Finance Wales offered funding and support. This was followed by additional investment by Pentax Hoya and the Development Bank of Wales, which resulted in the first use of Speedboat Inject in a human case in 2015 and regulatory clearance from both the Food and Drug Administration and CE Mark in 2017, by which time, Richard Rees had joined in 2016 as CFO.

We have subsequently developed our technology further with regulatory approval for a suite of innovative devices for use with our CROMA advanced energy platform. During 2020, David Woods also joined the Creo team as chief commercial officer, overseeing global commercial activities.

“Today, we can say that our patients are really excited to follow this pathway because we save the bowel, we preserve the bowel function and of course we improve the quality of life.”

– Dr Zacharias Tsiamoulos, Creo Medical

What is your approach to achieving physics-based innovation?

One advantage Creo has experienced has also presented some challenges during the development of the CROMA platform and endoscopic devices. The way we use bipolar radiofrequency and microwave energy modalities is unique.

While this is a great commercial differentiator it has meant that we need to make sure that everyone, from investors, to regulators, to customers, first understands what is involved in the product and how it works. We have invested in robust clinical training to address this.

We have also worked hard to keep up with the evolving technology of endoscopy equipment and the different approaches used by physicians. Endoscope working channels are becoming smaller, for example, and so we’ve worked to develop a narrower version of our Speedboat device.

Some physicians prefer to use a separate device for injection and so it was important to offer a device without an injection needle for those customers. We are always listening to the market so that we can make sure we are making the devices to meet their clinical needs.

How have you gained the skills and knowledge to drive out innovation? 

Creo realised that in order to gain adoption in the market and ensure the safe and effective use of the device, professional education would play a crucial role. We created a new procedure called Speedboat Submucosal Dissection (SSD) and implemented a comprehensive training course for doctors and nurses consisting of an initial two days in-vivo training course, which is followed by one-to-one mentoring by clinical trainers for the first few cases.

Staff are offered the chance to participate in training courses alongside trainees and to interact with them where possible to promote better understanding of the challenges faced by clinicians and feed this into design and development projects.

We also work closely with several universities, both in terms of offering placements to students and in supporting staff to gain further educational qualifications, which have allowed them to put their learning and insights into practice as well as progressing in their careers.

“If you had a platform that could deliver any energy modality with all the tools and you add the imaging, that could allow you to actually see inside the body, inside of any organ and ‘see and treat’. That’s the holy grail really, isn’t it?”

– Professor Chris Hancock, founder and CTO, Creo Medical

What has the result of your journey been?

All employees at Creo have a commitment to improving patient outcomes. This has created a ‘can do’, purposeful culture, where we always keep in mind that there is a patient at the end of all of the activities that we do as a company.

R&D inception to commercialisation has taken 10 years, but we have now achieved an international customer base. We sell our technology directly via offices in the UK, the US and the Asia-Pacific region, and also have routes to market through a channel of certified distributors globally.

The CROMA advanced energy platform, powered by Kamaptive technology, remains the heart of our technology and has now allowed us to develop a range of devices to treat lesions throughout the body. We are also exploring other uses for our technology, including the ability to generate gas plasma allowing limitless possibilities for sterilisation applications within healthcare and industry.

What tips would you give to businesses developing commercial services underpinned by physics and requiring innovation?

As well as having the ability to create amazing technology, it is important to have a clear focus on what the ‘end game’ should really be. Our focus has always been on improving patient outcomes and this has helped to channel the energy that is needed to bring the technology to life in the commercial world.

• These case studies were commissioned by the IOP from CBI Economics