Away with the knife . . . .

British Biotech company leads the way towards new treatment

Prostate surgery could turn into an out patient operation with a new device that can vaporise tissue at the touch of a button.

Invented by Mark Goble, a urologist, the device creates a powerful plasma - a high temperature cloud of atoms - which appears as an orange glow around the end of a fine electrode.  The surgeon can use the plasma to vaporise material from an enlarged prostate, without using conventional surgical instruments like scalpels and still clearing the blockage cleanly and quickly.  The same technology has also been used in keyhole operations on knee joints and in hysteroscopic procedures.

Simon St Clair Carter, consultant urologist at Hammersmith Hospital says the device works better than any other technique he has used.  "Cells explode into tiny fragments and disappear before your eyes," he says.

The device is made by Gyrus Medical, based in Cardiff and Bourne End, Bucks.  Nearly 200 patients have been treated in the past 12 months with excellent clinical results.  The company has recently been granted a US approval which will enable it to move discussions forward with a number of potential US partners who have been identified.  The company was founded in 1989 to develop radio frequency energy based systems for advanced minimal access and outpatient surgical procedures.  Now with products successfully brought to market, Gyrus employs 180 people and has been quoted on the Stock Exchange since 1997.

Not quite the story of the man who liked the product so much that he bought the company but along the same lines, is the experience of the Chairman of the Gyrus company, Brian Steer.  He was diagnosed with benign enlargement of the prostate and was so confident in the company's methods that he elected to have his own prostate treated using the system.

"In less than 48 hours after surgery I was out of hospital" he said.  "According to my surgeon, that was two days earlier than would have been expected using conventional techniques.  And here I am back at work just four days after the operation".

. . . . Away with the needle

Another British success story

PowderJect is a company formed to exploit ideas coming out of Oxford University which may make injections a thing of the past.  The company has patented a technology for the delivery of medicines into human tissue without using the long established hypodermic needle.

Amazing as it may seem, the answer is to have the medicine in the form of very small solid particles and then to blow the powder through the skin or other tissue at high speed with a rapid puff of gas.  PowderJect has developed a moulded plastic hand held device which contains inside it a small cylinder of helium gas.  Actuation of the system allows the gas at high pressure to enter a chamber at the end of which is a drug cassette containing the powdered drug or vaccine between two plastic membranes.  As the membranes break, a strong shock wave is created which travels at speeds of up to 900 metres per second.  This carries the drug particles straight through the outer skin layers, which consist mainly of dead cells, and into the dermis itself, where the highest density of blood capilliaries are to be found.  All the patient feels is the puff of gas on the skin.

Wide application

The PowderJect system can of course deliver any medicine, drug, vaccine or genetic material which can be formulated as a solid particle of the appropriate size, mass density and strength.  What the company expects to bring to market shortly is one of the world's most widely used local anaesthetics, lidocaine.  Phase 2 clinical trials with children have now been going on for a year.

Other drugs which are being developed in the powder form include alprostadil, which is an effective treatment for erectile dysfunction, whose market acceptance has always been held back because the method of delivery was an eye watering, self administered injection into the penis.  Also in the pipe line are drugs for the treatment of osteoporosis, acute migraine and prostate cancer.