The Dante Grasper

“The world breaks everyone and afterward, some are strong at the broken places.” Ernest Hemingway

He felt tired exhausted from the day-to-day battle of being an engineer feeling like he was working hard without respect.  At home he was fighting non-stop with his wife.  He liked the comfort of being married but he was stubborn and he couldn’t understand why she wouldn’t allow him to be the man that he was.  One night after work he received word that his father had died from a heart attack.  That Christmas he had bought his father an elliptical machine but he could never get him to exercise or to want to try to eat a healthier diet.  He never felt like such a failure or so vulnerable in his life.  Jacques Lesperance at that point in time decided to take a permanent leave of absence from his position with the company that he worked for.  More than five years had passed along with a lot of the things that that the unemployed life brings.  He sat alone at the dining room table with pencil and paper sketching his scattered thoughts.

Jacques was a slave to the grind of work having moments of inspiration often spending long hours tinkering with contraptions and devices many of them being completely ridiculous in design failing miserably with use.  There was one design that came to him after a long bout with the flu along with bad thoughts and endless shivering with teeth grinding and perfuse sweating.  He was going through a divorce and his nerves were out of control along with his mind running madly.  During that time he felt like he was being bitten and eaten alive.  Being stubborn refusing to seek medical help through that time he sketched, drawing out his pain and anxiety and when it was all done he was left with many ideas that seemed like madness without end.  There was one design that stood out above the rest and it was the concept for a laparoscopic suture device.  The “Dante Grasper” was a device intended for laparoscopic vaginal cuff suture during laparoscopic hysterectomies.  It seemed simple enough with a typical grasper handle ending with a sealing jaw.  The device had a handle with dual bolt-action levers along the side of the handle.  He couldn’t believe that anything positive could come out of something that was filled with nothing but stress. Working in the medical field he preferred health and well-being. He held on to the belief that he was part of the solution by coming up with real ways to improve products that doctors either need or already use. Since he knew that he couldn’t cause the need for surgery or medicine and that the world of medicine is a collaborative his role was to work to develop a product that improved the condition of healthcare.

When pulled out of the package the Dante Grasper looked like a straight wand with a grasping handle and protruding pegs along its side.  In front of the grasper trigger was a side-to-side switch.  It was made in both 5mm and 10 mm size when it was placed down the laparoscopic trocar into the abdomen located over the vaginal cuff after uterus removal, the switch in front of the grasper would articulate the mouth of the internal suture jaw from straight to side.  With a grasp of the handle the device mouth would open to be placed over the vaginal cuff. The vaginal cuff is the term given to the stoma or open wound after the uterus has been removed during surgery. With the help of other laparoscopic graspers synching in all of the intended tissue to be sealed the grasper would be squeezed again to close the mouth of the jaw. While grasped the bolt action along the side of the device handle would secure the internal sutures synching it with a ratchet mechanism by pushing a button on the back of the handle then squeezing the grasper. When closed there was a safety on off button above the ratchet mechanism that would be activated to lock the jaw of the device.  While the grasper was locked with another swipe of the bolt action completes the synching of the sutures. On the front of the device handle another button would be pushed causing a small pop, it would secure the sutures with titanium alloy malleable steel clips. The clips were tempered and tested to ensure proper security.  Another small knob that was adjacent to the ratcheting mechanism along the device handle would be pulled at the end to finish the seal and cut the secured sutures.  When the cut was completed the push button lock mechanism would be reactivated to unlock the jaw of the device and the grasper would be used to open the mouth of the device.  Removing the device was simple.  When suturing was completed the switch in front of the grasper handle would be pulled back over to swivel the mouth of the device to straighten it out.  After that the handle would be grasped to ensure that the mouth was closed and the device would then be pulled out through the trocar.  It was a device that seemed a little bit complicated in concept but it worked wonderfully during surgery with the help of trained surgical device consultants. Jacques firmly comprehended the necessity to hire and properly train a clinical sales staff that would be competent to properly sell the features and benefits of the Dante Grasper, as well as to obserserve clinical cases to show the surgeon why the Dante Grasper improves the quality of healthcare within that particular procedure.  He knew that respect between a surgical consultant and a surgeon often forms when a rep offers a product that offers improvement to their surgeries.

As the lead engineer and prospective owner of the small start up company Jacques Lesperance drew up the design of the device before seeking a patent for it along with many meetings with venture capitalists to gain enough funding to produce the product therefore starting up the company.  After several years along with altered specifications with a long line of clinical trials and clinically certified studies the “Dante Grasper” had recieved 510k medical device status.  Jacques Lesperance was excited about this product because he knew that there was a clinical need for a device of this sort helping both the surgeon with creating a secure surgical seal along with helping the patient avoid surgical complications. During these the trials Jacques began to hire employees.  Among the many hires most of them to build an internal structure along with manufacturing workers was a well tenured clinical sales representative David Rudelle whom would serve as the VP of sales. With the hires Jacques being humble in personality decided to learn about clinical sales because for all of his experience with engineering he had little knowledge or love of sales or the real world of surgery.  Of course as an engineer occasionally he observed surgeries but it was mainly in a university setting where a strong structure was set in place where there was little variance.  In the smaller affiliates and hospitals the surgeons had larger surgical responsibilities often owning their own practices.  They also had more control over what products they would or wouldn’t use for their procedures. 
When the company officially started production Lesperance Surgical manufactured it’s product out of an old warehouse in the northern part of Rhode Island.  Jacques considered outsourcing production however; he held firm to the belief that a product made in the United States by tax rolled employees not only made for a better product but also for a company story that was American.  He knew that since he had only one product to sell that it better be a good product that was reliable and having made in America on the package he believed to help with marketing. The company had a rough start because it failed to win contracts with hospital group purchasing organizations.  Hospital group purchasing organizations help hospitals secure lower pricing by being a member of that particular organization.  If 1000 hospitals are members of them and if Lesperance Surgical had their product on the contract it would make stocking hospital shelves along with distributorships stocking their shelves with the Dante Grasper more affordable and easier.  That price benefit would have helped Lesperance Surgical gain instant access to larger Universities but unfortunately that was not the case.  The light at the end of those negotiations was the fact that while Lesperance Surgical did not win G.P.O contracts the Dante Grasper was a proprietary technology.  Propriety technology means that the Dante Grasper did something that no other product in that particular field had the capacity to do.  There was a product that was somewhat similar in this particular market.  The difference was that the Dante Grasper allowed for a complete automatic suture instead of one by one manual suturing that could get tangled in its own threads.

During the first year of the products release they failed to gain access into universities because of its independent product with non G.P.O status.  However; the Dante Grasper was a product that when the surgical gynecologist used it there was an automatic response because it drastically cut down the suture time for the procedure.  Along with the shortened suture time was the secure suture with a thicker gauge thread used for the sewing and clinically tested titanium clips to ensure its reliability. The end result was faster suture time with a secured seal.  Surgeons that had even one instance of having to repair the internal incision after initial surgery instantly bought into the Dante Grasper.  A line that David would use was this, "With all of the litigation and non reimbursement for what is considered "never events" that occur is it really worth the risk of not using the Dante Grasper?"  David Rudelle had more than twenty years of experience within the field of surgical gynecology and knew many of the surgeons that he consulted.  He was honest with Jacques informing him that while the product worked well it would seem complicated to a surgeon at first.  For this reason and because it was a small company he decided to personally hire and train every clinical sales rep himself. 

There were instances where both Jacques and David were thrown out of hospitals and in those cases they found that it was because of a non compete environment.  Of course they were expecting that reaction from time to time because of not only sole source contracts even with proprietary technology but also because of hospital administrations that did not want reps even company CEO’s trying to surgical sell.  A surgical sale is when the products are being sold directly to the surgeon instead of going to the hospital purchasing asking permission to be able to sell a product to be stocked at the hospital.  The problem that both Jacques and David knew was that the Dante Grasper was a surgical product that wasn’t directly intended to be of benefit to hospital purchasing. There were times when Jacques himself got into shouting matches with hospital administrators because he knew that the surgical benefit did in fact save hospitals money and those heated debates often went un watered.  Many of those times they decided to go to the head of the surgical gynecological department to plead their case for a product trial.  Often because they offered free samples the surgeon would make a call to hospital administration.  During the day of the product trials when David Rudelle along with Jacques Lesperance went to hospital administration in order to gain access into the operating room there would be a silent tension often with hospital administration watching their movements.  On the way back to return their badges there was often a silent gloat to their movements happy with the products clinical outcome.