Thursday, September 24, 2009

(Pituitary) 'Car nut' turns into a creative surgeon

By Gail Appleson

ST. LOUIS POST-DISPATCH

09/24/2009

When Richard Chole was a boy, he learned welding while helping his father refurbish a 1958 Jaguar. In fact, Chole's teachers thought he was so much better with tools than at his studies that they recommended he go to technical school rather than college.


Well, they were wrong about the studying part, but they were right about Chole's skill with his hands. Today, Chole is a surgeon and chairman of the Department of Otolaryngology at Washington University School of Medicine. He's also an inventor whose creations include a wristband warning system to prevent surgeries on the wrong site and a surgical device that allows less invasive surgery on pituitary tumors.


"Building is relaxing for me. I've always done things with my hands," said Chole, who describes himself as a car nut. He creates his inventions in a garage and superorganized, soundproof workroom in his Frontenac home, where he's also done much woodworking and other projects including constructing dollhouses for his five granddaughters.


"I'd like to build a house some day. I can do all the framing and electrical work," said Chole.

He's come a long way from grade school where he received C's and D's, the result of what he now suspects was a mild form of dyslexia. But Chole began to excel in math and science in junior high. Like his father, the first cardiologist in California's San Fernando Valley, he went on to medical school. He was recruited by Washington University in 1998 from the University of California, Davis, where he was chair of the Department of Otolaryngology-Head and Neck Surgery.
When he and his family moved to St. Louis, he said his wife wanted a brick house and he wanted room for his projects and inventions. They both got their wishes.


Among the creations to emerge from that home is an alarm system called CheckSite, which helps prevent wrong surgeries.


The system uses a patient wristband with a microchip and two sensors near each operating room door. If the operating team does not mark the proper spot to operate on a patient and fails to place a sticker on the wristband to deactivate the microchip, the sensors sound an alarm.

Chole got the idea for his system after a discussion at a medical staff meeting in 2004 centered on wrong-site surgeries. Shortly afterward, Chole saw security sensors in Home Depot and developed a way to track the pre-operation procedure. He initiated the patent process in spring 2004 and launched CheckSite Medical Inc., a Town and Country company formed to develop and distribute the product.


The same year he began working on an idea for a device that would allow for less invasive surgery on pituitary tumors. He came up with a speculum that's inserted up the nose and through the sinuses. Without such a device, the surgery required entry through an incision made under the lip.


Chole said he started making the device in his garage and went through about 20 prototypes before coming up with the model that's now been used in about 120 to 140 surgeries at Barnes-Jewish Hospital and St. Louis Children's Hospital.


"Necessity is the mother of invention," Chole said. "It's a safer surgery. There's no incision, no swelling."


Chole performs the surgery with Dr. Ralph Dacey Jr., Washington University's chair of neurological surgery, and Dr. Michael Chicoine, associate professor of neurological surgery. Chole does the first part of the procedure to expose the area of the tumor and the neurosurgeon removes the tumor. Chole and Dacey are working with Florida medical device maker Anspach Cos. to obtain a patent. Anspach will produce the device and there will be a royalty agreement with the surgeons, Chole said.


So what's he going to build next?

"My next project is a grandfather clock," he said. "It gets my mind off the problems of life."