Making ideas work.

Designing from
the inside out

Sometimes you just need
to take a step back 

Esophageal stent delivery used to be a two handed operation for surgeons. The original challenge from Cook Medical was to find a way to develop a single handed approach to esophageal stent delivery.

Insights delivering innovation

We carried out ethnographic research in the US, UK and Europe, interviewing and observing surgeons in their place of work and gathering as much data as possible. One key insight became a critical pivot point for the project; One surgeon mentioned “sometimes it might be nice to be able to reposition the stent”.

Stakeholder needs are paramount

Upon further investigation we discovered that though the esophageal stent delivery procedure was generally a 45min day procedure and very straightforward, if a stent was badly positioned things would take a significant turn for the worst.
It would lead to minimum 3 days in hospital, open chest surgery, health risks for the patient and reputational risks for the surgeon. This was definitely an opportunity worth exploring.


Technical innovation across industries

During our technical research stage we found a reversible gearing system that was coming off patent in a different industry. We were able to take this technology and re-apply (and re-patent) for Cook Medical.

The insight from the surgeon allowed us to create a single handed operation with an actuation trigger, a reverse clutch and 14 gear wheels.

Hands holding the early cook evolution prototype

Impact from insights

The Evolution is still the only controlled release stent system in the world and has become a platform product for Cook Medical, resulting in significant revenues for the global company.

CAD render of the internal gears of the cook evolution gun
Corridor in the Dolmen studio office

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