How NERv won a life-changing prize for a life-saving technology (and made mom proud)

Jackie Gill - December 3, 2019 Youssef Helwa, co-founder and CEO of NERv Technology, wants to help save lives by detecting post-surgery leaks early

“Mom, why are you worried?”

Youssef Helwa looked at his mother across the dinner table. As an obstetrician-gynecologist, she works with patients every day through difficult surgeries, and sometimes she would get distracted thinking about their recovery.

Were they doing well? Was something going wrong? There was no way of knowing early on. That night, that’s what was on her mind.

“I have to play an elimination game to figure out what’s wrong,” she told him. “Sometimes there isn’t even a problem to treat – just symptoms.”

She had good reason to be worried, too. Anastomotic leaks – or fluids that leak from the gastrointestinal tract into the abdomen – are among the most feared complications after surgery, says Helwa.

The numbers back that up. According to NERv, the U.S. alone, there are about 1.7 million high-risk abdominal surgeries performed each year. This kind of leak affects more than 100,000 of those patients and accounts for 13,000 deaths.  

But if symptoms are caught early… well, that’s a game-changer, Helwa says. That’s why, in 2014, he founded NERv Technology and started building a simple but smart medical device that can detect leaks in real-time and prevent complications before they even begin.

Or, as their mission states: “to see that no patient loses their life because of an undetected post-operative complication.”

A hidden danger

Imagine you’ve just had a gastric bypass or colorectal surgery. Everything went well, and you’re recovering in your hospital bed.

Just because the surgery’s done doesn’t mean you stop worrying, says Helwa. The last thing you want: fluids from your stomach, intestines or bowels leaking into your system.

But if there is a leak, you won’t know for a few days at least. At that point, you could be septic. “Essentially, you’re waiting for physical signs that things aren’t normal,” he says.

Each year, there are 1.7 million high-risk abdominal surgeries, 100,000 leaks and 13,000 related deaths in the U.S.

Let’s say things aren’t normal, and you get some unusual abdominal pain or tachycardia (a very rapid heartbeat). Then it’s off to imaging and lab tests to see if your medical team can identify what’s wrong.

And if there is something wrong, you’re back on the operating table.

Like Helwa’s mother said, it’s a game of elimination. That’s what he calls the current standard of care. “It’s so bad and hard in addressing the quality of life for the patient. It clearly needed disruption.”

Helwa was a student at the University of Waterloo, wrapping up his nanotechnology engineering degree with his fourth-year project. Remembering that dinner with his mother, he picked anastomotic leaks as a research topic.

“Essentially, you’re waiting for physical signs that things aren’t normal… It clearly needed disruption.”

– Youssef Helwa, founder and CEO of NERv Technologies

“Engineers are first and foremost problem-solvers,” he says. “There’s this big push, big drive, to solve problems around you.”

The only problem: “It was obvious the problem was much bigger than me.”

He found support through his professors, his friends and his colleagues, including co-founder Amr Abdelgawad. And he took a few extra years throughout his masters program to continue digging into the problem to better understand it and the technology available to him.

Those were the building blocks to the technology they use today, Helwa says.

“We’ve fought long and hard to make the device easy.”

– Youssef Helwa

Basically, their first product is a series of sensors built into a catheter that gets inserted into the body. They monitor the fluids that naturally drain after surgery. When certain biomarkers are normal – think things like pH and bacteria levels – there’s no cause for concern. But when they spike past a certain threshold, both the patient and their medical team will know in real time.

(Just how real-time? Their sensors have a response time of 100 milliseconds. That’s like blinking your eyes once, really fast.)

Most of the time, unless it smells off or has a change in colour that fluid just gets thrown out even though it’s jam-packed with vital information that can indicate a leak of fecal matter, bile and more, well before those symptoms start.

Plus, it uses equipment that doctors and nurses know already – a big bonus since, “in the medical practice, there is resistance to change,” Helwa says. “We’ve fought long and hard to make the device easy.”

On the world stage

If the name NERv sounds familiar, it might be because they made headlines in November after battling on the big stage at this year’s first-ever Entrepreneurship World Cup, a pitch competition that includes mentorship, advice and an acceleration program.

Through 102,000 entrants from 187 countries ranging from Australia to Zimbabwe, Helwa’s team made the cut to the top 100 in Canada’s regional competition over the summer and flew to Riyadh to pitch in front of judges like Shark Tank investor Kevin O’Leary at the global finals held on Nov. 13.

Amr Abdelgawad, co-founder and COO of NERv, receives a trophy and $500,000 cheque after winning the Entrepreneurship World Cup
NERv co-founder and COO Amr Abdelgawad swayed the Entrepreneurship World Cup judges in Riyadh to their cause, winning US$500,000 in the process.

And spoiler: they came first, snagging the top prize – a cool US$500,000 – along with a “Shenzen Prize” to help them expand into China and a support package from partners like HubSpot and Twilio.

“All of the 99 other ideas were amazing,” says Helwa. They ranged from other healthtech startups to agriculture, retail, transportation and more. “Any one of them would have amazing impact on the environment and ecosystem.”

For the most part, Helwa attributes their win to Abdelgawad, who does most of their pitches.

“It’s very different how you would pitch an [academic] idea and how you would pitch a business.”

– Youssef Helwa

“He always says even though he always appears very composed on stage, inside his heart is pounding,” he says. “It’s a talent, and he believes in his mission.”

But that doesn’t mean pitching is easy – especially when the stakes are so high and the world is – quite literally – watching.

“At first, given that we’re from an academic background, it’s very different how you would pitch an idea and how you would pitch a business,” he says.

How? In academia, you don’t need to think about your business plans, for example – things like, “how to scale, how to understand your market, how to find your niche.”

Then there’s the problem of terminology. “We’re working in a very specialized area, and if we’re not simple in how we send out our message, it can sound complicated,” he adds.

“We love to get feedback in our solution, business model and design.”

– Youssef Helwa

They learned those lessons the hard way, through experience pitching in the past.

“We love to get feedback in our solution, business model and design,” Helwa says. “In every single pitch competition we’ve been to, we’ve gotten a lot of feedback.”

They’ve come a long way, he adds: “It’s been a fascinating transition in our approach.” And it culminated (but doesn’t end) with the Entrepreneurship World Cup. “I had a belief we were going to win it. We try to take that approach with everything we go for.”

Still, he remains humble. “I don’t believe we were special. We just did our best.”  

Passing the grade

As for what’s next, NERv is targeting the end of 2020 for an early launch, and will continue to work on their clinical studies. Early results from their pre-clinical trials have been promising so far.

“We don’t want to wait too long. We want to make it as simple as possible, as soon as possible,” adds their CTO, Abdallah El-Falou – because then they can start saving lives faster.

Although their proudest moment hasn’t happened yet – “We’re waiting for a time when, as a team we can say, here’s Patient One where things were going south and we were able to bring them back to the community, back to health” – Helwa’s proud of his team and thankful for the support he’s received.

“We have an amazing and incredible team. Amr and I are just a tiny piece of the puzzle,” he says. The real work happens behind the scenes, with the employees who make the tech tick. “They’re the ones that teach us the most. They’re the ones that work the hardest.”

“I don’t believe we were special. We just did our best.”

_ Youssef Helwa

But let’s not forget Helwa’s mother. Not only is NERv’s solution a hit with judges on a panel, but it’s also a favourite with her, too.

“Other than there’s that huge bias there, she loves what we’re doing,” he laughs. “She’s one of the company’s biggest supporters.

“I’m very grateful for what she’s done, not just for the company but in my life.”


Draft Card Logo
  • Name: NERv Technology Inc.
  • Solution: Medical devices that save lives by detecting post-operative complications early
  • Owners: Youssef Helwa and Amr Abdelgawad
  • Employees: 14
  • Headquarters: Waterloo, Ont.
  • Founded: 2014
  • Initial investment: $2 million
  • Contact: [email protected]

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