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Casey Grage of Hubly Surgical Tells Us How an Integrated Electric Drill System will Streamline Bedside Intracranial Access and Decreased Operating Room Reliance

kokou adzo



Casey Grage Hubly Surgical

First of all, how are you and your family doing in these COVID-19 times? 

Casey Grage: We’re all doing well and chugging along — thanks for asking!

Tell us about you, your career, how you founded Hubly Surgical 

Casey Grage: My background is in neuroscience and engineering. I was diehard academia with goals of professorship. At Northwestern University, I enrolled in a medical device entrepreneurship course to learn about the end-game applications of my more fundamental research. In this class, I met my co-founder Dr. Amit Ayer. He’s now a neurosurgeon at Stanford Health, but at the time, he was working at Northwestern Hospital and getting his MBA at night from Northwestern Kellogg. We came together over our shared passion for neurology — Amit on the clinical side and me on the engineering side. Amit told me about intracranial access.

Today surgeons drill holes into the brain at the bedside with a hand-crank drill from the 1980s. He said not only is this method incredibly antiquated, but it can also be extremely dangerous with a 20% failure rate. He thought we could do something about it. Amit’s solution for this grave problem in medicine was so novel and life-changing, I had no choice but to dive all in. Enter Hubly Surgical.  

How does Hubly Surgical innovate? 

Casey Grage: Hubly Surgical is a cranial and orthopedic platform drilling solution first focused on modernizing bedside intracranial access, then elective neurosurgeries, then elective orthopedic surgeries… then even more indications! 

Targeting neurosurgeons, our first product utilizing this technology is an integrated electric drill system that streamlines bedside intracranial access, decreases operating room reliance, and facilitates treatment for emerging indications. This product, the patent-pending Hubly Drilling System, is new and innovative because it includes safety, guidance, and ease of use features for both inside and outside of the operating room. Our device includes: 

(1) Entirely mechanical, pressure-based plunge prevention.

(2) Battery power – rather than wired, electric power as is used in the operating room. 

(3) Hardware catheter guidance utilizing the Ghajar guide technique, which has been proven to facilitate accurate freehand placement. 

(4) Hardware drilling path guidance. 

Hubly Drilling System will save an estimated 15,000 lives each year through catheter guidance alone and also eliminate plunging into brain tissue, which in total, cost the U.S. healthcare system $4 billion annually on this single procedure. As mentioned, the platform technology underlying Hubly Drilling System will be adopted for elective neurosurgeries and orthopedic surgeries, then indications such as spinal taps and epidurals, which have lower failure rates but enormous markets

How the coronavirus pandemic affects your business, and how are you coping?

Casey Grage: We’re really lucky in that the pandemic hasn’t negatively affected us. We were able to secure additional grant funding in May, which gave us a lot of runway to work with. We have had to get creative with care package hand-offs for prototyping and testing, but it hasn’t slowed us down! Overall, it’s been relatively easy to conduct all business operations virtually and all prototyping operations with a very small team. And Hubly Surgical’s planned market launch in Q1 2022 aligns well with current quarantine projections. 

Did you have to make difficult choices, and what are the lessons learned?

Casey Grage: The most difficult choices, without a doubt, has been around the team. Who to hire, to promote, who to take on as an advisor… And these decisions lead to really hard conversations. Thankfully the Hubly Surgical team, down to every single intern, has been absolutely incredible. I have hired or would hire every single one of them if I could. The reason I’ve had such great experience is thanks to my coaches guiding me along the way. Although, I’ve certainly gotten better at independently hiring as I’ve continued this company.

The lessons learned are that I can’t be too critical when choosing employees, coaches, or whose advice to listen to. It’s like dating. I only take on someone who is PERFECT. I accept nothing less.

How do you deal with stress and anxiety? How do you project yourself and Hubly Surgical in the future?

Casey Grage: I have to have something I’m passionate about outside the company. Entrepreneurship exists in extremes of frustration and fulfillment. I wouldn’t trade Hubly Surgical for anything — it’s amazing to work day in and day out on my passion. My work is my hobby. That said, it’s a hobby with intense pressure from investors and employees. To abate stress from that pressure, I need a stress-free passion for the odd night or weekend to keep sane. For me, during COVID, that’s Duolingo. I’ve completed all of Duolingo Spanish, French, and German, and now I’m working on Mandarin! 

Who are your competitors? And how do you plan to stay in the game?

Casey Grage: Today, the Integra Life sciences Kit has 100% of the market, including a freehand, hand-cranked drill, without any features for guidance or stability. The second bedside competitor, Phasor Drill, is a battery-powered drill with FDA clearance but has yet to penetrate the market. It doesn’t include any features for safety or guidance, either. The lack of plunge protection means that battery power makes it more difficult for the surgeon to prevent drilling past the skull and into the brain. There are three main competitors in the operating room market: the Medtronic Midas Rex MR7 Pneumatic Surgical Drill, Micromar EasyDrill Autostop Cranial Perforator, and the Stryker pi-drive CORE drill. Such products include features such as electric power and plunge protection but lack control and guidance, yielding egregiously high failure rates for the operating room. Hubly Surgical provides all of these missing safety features. 

We are competing by being the iPhone of medical drilling. We plan to stay in the game by continuing to be the BEST solution for drilling holes through bone. Hospitals want that. Through reducing complications with safety features, Hubly will save hospitals millions of dollars on reduced ICU stays, reduced re-admittance rates, and improved outcomes. 

Your final thoughts

Casey Grage: Today, if you get in an accident and are rushed to the hospital. If the fluid is rising in your brain and it’s an emergency, no matter where you are, no matter who your doctor is, a 1980 hand-crank drill is going into your head. That is insane. The 1980s don’t belong in 2020 hospitals. Hubly Surgical goes above and beyond the bar, creating what is the iPhone of medical drilling solutions, saving hospitals money from complications, and, more importantly, to save lives.

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Kokou Adzo is the editor and author of He is passionate about business and tech, and brings you the latest Startup news and information. He graduated from university of Siena (Italy) and Rennes (France) in Communications and Political Science with a Master's Degree. He manages the editorial operations at

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