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Vol 24, No. 02, February 2020   |   Issue PDF view/purchase
COLUMNS
Game Changers
Established in 2015, NDR Medical Technology is a medical device company which focuses on leveraging artificial intelligence technology to help improve clinical outcomes during surgery.

NDR Medical developed the Automated Needle Targeting (ANT) robotics system that combines artificial intelligence (AI) and medical image processing for needle positioning, at a time when these technologies are still in nascent phases of development for broad application in surgery. This development embodies pioneering technology used in dynamic organ lesion targeting and various other medical procedures that require precise needle trajectory access, characteristic of procedures such as biopsy, ablation, substance delivery, tissue/fluid extraction and kidney stone removal. ANT can easily integrate with existing imaging modalities like CT and Fluoroscopic C-Arm to perform calibration and navigation. The system replicates how surgeons would otherwise perform access in the conventional way, thus does not disrupt the procedure. The ANT system integrates well into the current standard of care protocol for the above procedures without incurring additional risk and has shown to be easily adapted by both senior consultants and medical residents.

The current application developed for ANT focuses on assisting surgeons during fluoroscopic kidney stone removal and CT lung biopsy respectively. Lung biopsy in current practice is done during the late stage via needle biopsy when symptoms are clear, and nodules are larger. As compared to open biopsy, needle biopsy is safer and less traumatic. Nevertheless, whilst these achievements are trail-blazing, they are fraught with unmet clinical needs. Lung biopsy performed with the objective of attaining access to a moving target continues to be performed free hand today, bringing with it a series of attendant but avoidable risks. These include a considerable risk for a number of procedure-related adverse events such injury to adjacent organs, bleeding, infection and pneumothorax. The number of attempts and procedural time required to access and reach the target also very much depend on the surgeon’s skill and experience.

NDR Medical developed the Automated Needle Targeting (ANT) system - an affordable and smart device which can automate significant parts of the surgical procedure, increasing accuracy and precision. This in turn shortens procedural time and reduces radiation exposure and complications.

Lung biopsy procedures conventionally deals with larger nodules as they are typically carried out during stage 3 or 4 of cancer. With an accuracy of up to approximately 3mm, the ANT system can be utilised to conduct such biopsies at earlier stages of cancer by targeting smaller nodules. In this context, the ANT system assists the surgeon in accelerating the process of accurately aligning the needle to the smaller lesion target, withdrawing a sample, and consequently, allowing early stage biopsy-based detection and the confirmation of cancer in patients.

As such an early stage, early detection provides cancer patients with the ability to seek and receive earlier treatment for their conditions, thereby increasing their chances in achieving better clinical outcomes.

The robotic surgery technology by NDR Medical sought to be applied in real-world applications. It has earlier validated the technology for Percutaneous Nephrolithotomy (PCNL) kidney stone removal procedure in eight animal models and 26 human patients using the ANT-X System. The procedure is considered complex due to the difficulties in gaining precise and safe access into the calyxes of the kidney, the use of a system like ANT-X could certainly help address the substantial portion of untreated kidney stone patients in countries that may lack surgeons who are skilled in this procedure.

Other than PCNL, the development of our ANT-C System which represent CT guided biopsy has completed animal trial and pending first-in-man.

Looking towards the future, NDR Medical Technology will continue to invest significantly in innovation and research programs that can be expected to further improve ANT functionality, further improve ANT for Kidney Stone Surgery and Lung Biopsy. Delving into new areas like Liver Biopsy, Pancreas Biopsy, Lumbar Puncture, Orthopaedics and Neurosurgery, will continue to be key areas of interest for NDR which will seek to bring the utility of image-guided surgical robotic into practical application in these additional anatomic body systems. The company aims to push the boundaries of medical image processing for robotic controls, and to include other forms of imaging devices such as ultrasound.

NDR Medical Technology will pave the way in building the next generation of medical robotics for assistive surgery automation, enhancing precision and safety of surgical procedures.

About the CEO

Alan Goh, CEO for NDR Medical Technology Pte Ltd

Mr Alan Goh graduated from the Nanyang Technological University in Singapore, he specializes in Mechatronics; with a professional Graduate Diploma in MedTech manufacturing and completed courses in Charter Financial Analyst. He started his career in A*STAR working on advance automation equipment with the industry and was awarded the Outstanding Team Award in 2007. He further advanced his career in the automotive manufacturing industry on product test development, gained in-depth manufacturing experience and received Six-Sigma Green belt. Before starting NDR, he was a commercialization manager responsible for incubating and seeding disruptive MedTech/BioTech start-ups, developing business plans, supported in product development and have helped companies and start-ups garner investments and grants

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