Jeffrey Rovell & Associates, Inc.
Aortic Punch

Jeff says: When I first met Carl Goosen in 1980, he was manufacturing his aortic punch himself in his garage. Today it is a standard part of nearly every coronary artery bypass surgery.

How It Started

In 1980 a product I had worked on, the Gabbay-Frater Suture Organizer, was just entering the market, and Dr. Frater mentioned that his friend, Carl Goosen, had a product he wanted to commercialize. Goosen's aortic punch made a precise, round incision in the aorta so that a bypass saphenous vein could be sutured in place -- a huge improvement over ordinary incisions made with scissors, incisions which are often ragged and asymmetrical. I headed down to Florida to meet Mr. Goosen and see his product.

As it turned out, he was manufacturing the punches every morning before he went to work as a perfusionist at a local hospital. They cost about $250 each, were made of hefty stainless steel, and were designed to be used, cleaned, and re-used.

Reusable or Disposable?

I saw immediately that Carl Goosen could have a significant business -- the question was how the product needed to evolve to create that business. How could we best turn the punch into a product with global appeal? The main decision we had to make was between a reusable product or a disposable one.

Mr. Goosen's current product, which was designed to feel like a typical surgical instrument, was satisfying to hold and use. Its stainless-steel parts could be easily manufactured on a small scale. But because of its construction it was very expensive; it also had to be disassembled, sterilized, and reassembled after each use. This was a problem because, in surgery, the device would become clogged with blood and debris which were not easily removable.

On the other hand, to make a disposable product we would need to work with plastics, requiring a more complex manufacturing process. This was a significant challenge, especially since Mr. Goosen wanted to retain control of the manufacturing process. Still I was convinced that making the product disposable was key to its success based on my years of experience with hospitals, surgeons, .and personnel charged with cleaning and sterilizing instruments.

Today's Aortic Punch

Ultimately I went to hospitals to see the punch in action, and discovered that in many case it was already being disposed of because it was so difficult to clean. I brought Mr. Goosen to Deknatel, a division of Pfizer Hospital Products Group, and worked out a deal more advantageous than the one Johnson & Johnson was exploring. I brought together a design, manufacturing, and marketing team to develop a disposable aortic punch with the same build quality as the original metal instrument -- plus the advantages of disposability. I made sure that Mr. Goosen was closely involved in the design, development, and manufacturing.

Disposability enabled surgeons to perceive the clear advantages the punch offered over scissors in the surgery. Since its commercialization, the punch has become a standard instrument, spawned many imitators, and generated more than $40 million in sales. Today, sold by Genzyme Biosurgery, it still commands a significant share of the world-wide market.