Navy Veteran's Invention Being Evaluated For Use at Deployed Surgical Units

A San Antonio Navy veteran’s medical invention may soon be available for wider use by deployed military surgical teams in the field.

Dr. Ramon Cestero spent 10 years after medical school as an active-duty Navy trauma surgeon. Today, he’s a professor of surgery at University of Texas Health Science Center at San Antonio and a University Health trauma surgeon – and the co-founder and chief medical officer of Advanced Surgical Retractor Systems.

In October 2019 he co-founded ASR Systems to patent, produce and commercialize a new surgical retractor he invented to facilitate abdominal surgeries – the TITAN Cestero Surgical Retractor, or TITAN CSR

His co-founder, Mike Girouard, who serves as CEO and president, said the TITAN CSR is comparably priced with existing retractors, which typically range from $25,000 to $80,000.

While the retractor is patented and commercially available to hospitals throughout the country, Girouard said, this week it’s being evaluated by Brooke Army Medical Center at Fort Sam Houston to see if Army, Navy and Air Force surgeons recommend that it be integrated into deployed surgical units.

“(Military surgeons) have told me, ‘That would be perfect in a deployed environment … that’s really our end goal with the military, is to get it in a deployed setting,” Girouard said.

Cestero had seven Navy deployments – three to combat zones in Iraq and Afghanistan – and served in disaster-relief roles in Haiti and the Philippines.

“Usually, you have a trade-off as a military surgeon, so you either sacrifice speed or you sacrifice functionality,” he said. The only retractor available for abdominal surgeries in the field is the self-retaining Balfour retractor, invented in 1911, which is quick to set up but doesn’t provide much exposure to infected or damaged organs.

“As a result of my multiple deployments, I was challenged and frustrated … because of the limits of the retractors we used,” Cestero said. “My hope in designing something better is to prevent those frustrations for future surgeons and hopefully allow them to do their job better, and in so doing, saving lives.”

In surveys after use, Cestero said, 98% of surgeons say they like the new instrument and find it more efficient than its predecessors. Many surgeons – especially military surgeons – have become investors in the company.

Cestero is looking forward to the results of the Brooke Army Medical Center evaluation.

“There are cases where seconds matter and the faster a surgeon can get control of bleeding, ultimately, the better the patient will do,” he said. “So if we can just facilitate a surgeon’s ability to do his or her job, we can hopefully improve patient outcomes.”