# Koli: A non-surgical solution for gallstone disease

> **NIH NIH R44** · KOLI, INC. · 2023 · $731,133

## Abstract

Symptomatic gallstone disease affects nearly 5 million people in the United States and consumes over
$6.3B annually. Complications occur when gallstones move from the wide body of the gallbladder and enter the
narrow system of ducts connecting the gallbladder to the small intestine. The incidence of gallstones increases
with age and is higher in women and obese people. Other risk factors include pregnancy, hormone replacement
therapy, rapid weight loss, diabetes, Crohn's disease, family history, older age, and prolonged fasting. As
Western-style diets gain traction across the globe, the worldwide rate of gallstone disease is rising quickly in
areas where surgical treatment is not always available.
 The most common and effective treatment for gallstone disease today is surgical removal of the
gallbladder, or cholecystectomy. Unfortunately, surgery is not always an option. Patients may be unable to
tolerate surgery due to comorbidities such as uncontrolled heart or lung diseases which make general anesthesia
impossible or they have temporary conditions which delay surgery, for example a recent heart attack, stroke, or
sepsis. The risk of a recurrent gallstone-related complication increases with waiting time and patients with a
surgical contraindication or scheduling delays are subject to increasing risk of developing gallstone-related
complications. Acute cholecystitis can force a decision to perform emergency surgery in these patients with very
high mortality and morbidity risks.
 Kōli has developed a non-surgical alternative to treat gallstone disease. A small implantable filter is
deployed in the gallbladder to prevent complications associated with gallstones obstructing the outlet of the
organ. Kōli replaces surgery with a minimally invasive outpatient procedure designed to be safe in high risk
patients, including the elderly, pregnant women, and patients with recent MI, stroke, or surgery. Kōli fits into
existing referral and reimbursement patterns, would utilize conventional ultrasound and fluoroscopic techniques,
and will be performed by interventional radiology, gastroenterology, or general surgery.
 The company’s technology was developed with support from an NSF SBIR award (#1248295) and private
investment. Over the past 5 years, Kōli has advanced their novel gallstone filtering system from proof-of-concept
bench testing, GLP-like large animal studies, and recently completed a successful first-in-human clinical
feasibility study in the Philippines.
 The current iteration of the Kōli system relies on sharp barbed anchors to penetrate the luminal wall of
the gallbladder and hold the self-expanding filter in place. Penetrating anchors carry risks associated with
perforation, scarring, and mechanical failure. Once deployed, the anchored device cannot be removed without
surgery. To address these risks, Kōli has partnered with Hoowaki, LLC to integrate a novel anti-migration micro
surface into our filtering system in place of barbed anchors. Thi...

## Key facts

- **NIH application ID:** 10698949
- **Project number:** 1R44DK135204-01A1
- **Recipient organization:** KOLI, INC.
- **Principal Investigator:** Christopher Cheng
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $731,133
- **Award type:** 1
- **Project period:** 2023-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10698949

## Citation

> US National Institutes of Health, RePORTER application 10698949, Koli: A non-surgical solution for gallstone disease (1R44DK135204-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10698949. Licensed CC0.

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