fter receiving my PhD in neurophysiology and biophysics, I pursued my medical degree in ophthalmology at Hahnemann University in Philadelphia. Upon graduating in 1979, I started my private practice in my hometown. The practice grew quickly, but nonetheless, I found I had a great deal of spare time at my disposal. I decided to take advantage of the free time to hone my surgical skills, and I began to perform a great deal of eye surgery on animals. As I did so, I became very disenchanted with the capabilities of the cutting instruments I was using.

I began practicing with many different devices, including electrosurgical devices, diamond blades, sapphire blades, and scalpels. The shortcomings of each device led me to realize that we really did not have a good surgical device. My background in electrophysiology and biophysics led me back again and again to electrosurgery. I tested many different electrosurgical units, most of which I was borrowing from the hospital where I was working. I found that all of the units worked poorly. They all burnt the tissue and the surgical area, giving off fumes that smelled disturbingly like burning human flesh.

I read every article that I could on electrosurgery and even visited with experts in the field of electrosurgery. I spent a great deal of time trying to understand how electromagnetic radiation functions in making an incision. Textbooks provided superficial explanations, so I consulted advanced physics descriptions written by eminent physicists. I found a great deal of divergence among these experts in their opinions on electromagnetic fields and their interaction with matter.

Eventually, my extensive study of the field of electrosurgery and electromagnetic field interaction with matter brought me to a rather interesting conclusion. I formed the opinion that our concept of the electromagnetic field as proposed in textbooks and by most authors in electrical engineering and physics is incorrect. I buried myself in advanced physics and electrical engineering texts and attempted to integrate theories of optics with those of electrical engineering. I soon realized that we had a gross misunderstanding of the “photon.” If my own theory regarding the photon was correct, then electrosurgical systems were designed incorrectly. I made up my mind to design a new, high-efficiency electrosurgical system based on my new concepts of the interaction of electromagnetic waves and matter.

This is, of course, a simplification, since slow and fast are relative terms and a true relativistic discussion of this is warranted. Nonetheless, my aim is to present just a few of the thoughts that were the basis for my approach to electrosurgery. If you think about it, it makes a lot of sense. The object of electromagnetic surgery is transferring electromagnetic energy into matter and using this energy to create an incision in matter. Because the objective of the electrosurgical systems has been to pass sufficient energy through matter to create heat—effectively causing a burn in matter—they have classically been extremely inefficient. I objected to the caustic nature of the burn and was sure that there must be a way to elevate the bond energy of the molecular lattice without creating oxidation, charring, or burning in the path of the incision. This ambitious goal led me and my colleagues to many failures along the way.

Our Fugo blade project encountered immense hurdles, yet a door would always open at the 11th hour to allow us to pass through. After about 10 years of work, we found that system power was not actually the most important aspect of an electrosurgical system. Instead, an energy source had to be tuned such that it had a high-efficiency component to transfer the energy into a molecular bond lattice. So as we tuned our system to transfer energy in an efficient manner, the amount of total system energy required actually decreased. (For this reason, the device that is currently used for capsulotomy, glaucoma, and iridotomy is powered by rechargeable flashlight batteries. The device is sharper than a diamond blade and can cut for over an hour, yielding incision walls that are pristine, as demonstrated by histologic studies from major medical centers across the United States.

Word of our progress got out, and in 1997 I was invited to lecture at the American College of Eye Surgeons. It was there that I met Dr. Daljit Singh. Dr. Singh clearly understood how technology works and instinctively knew that this was the device that he had been waiting for to revolutionize his surgical capability. He believed that it was a “great equalizer” that would provide the same quality of care to all in both industrialized and third world nations. Our united goal to bring about universal health care paved the way for a very close friendship that has spanned years and oceans.

Since our first meeting, Dr. Singh has followed through on his promise to stand by and work with me on the Fugo Blade Project. He is still actively involved in the project on a humanitarian level. The Dr. Daljit Singh Eye Hospital in North India is modern, clean, efficient, and extremely well equipped. At his hospital, Dr. Singh has completed more clinical studies over the course of 10 years than anyone else in the world and is truly the expert on clinical applications of Fugo blade technology.

The Fugo Blade Project has truly taken on a life of its own by receiving outstanding approvals both nationally and internationally. The U.S. Food and Drug Administration has cleared the device for use in capsulotomy, a novel form of glaucoma surgery called “transciliary filtration” or “Singh filtration,” iridotomy, and dental surgery. Protocols also currently exist within and outside the field of ophthalmology. We are developing fantastic systems that have immense potential to radically change the way that surgeons perform all types of surgery. The device will give the surgeon high-efficiency incisions that have pristine incision walls that achieve hemostasis without charring or burning, yet still provide resistance-free cutting. This technology also decontaminates incisions; plasma is the key. We are now working on novel techniques that will provide surgical fields with prolonged antimicrobial characteristics and with accelerated healing capabilities. Plasma ablation of bone is also a fascinating field that has unlimited potential.

One point repeatedly raised by doctors who have used our plasma cutter is that the Fugo blade allows them to do things that are impossible without this device. This is absolutely true. We believe the Fugo blade is the first paradigm-shifting technology since the introduction of the laser back in the mid-20th century. Thus, it allows us to approach previously impossible tasks in a straightforward and surgeon-friendly fashion. The Fugo blade takes us into uncharted territories to dramatically improve the delivery of desperately needed health care to patients worldwide. We believe that the Fugo blade offers the greatest hope for delivering health care in a more efficient and effective manner to all races, religions, and economic classes.

The future of the Fugo blade is great and offers unlimited avenues to dramatically improve the entire field of surgery.