Precision is crucial in surgery. Minimally invasive procedures offer benefits like smaller incisions (compared to open surgery), which can reduce complications such as blood loss, infection and scarring. This is driving the growth of robot-assisted surgery.
Driven by technology upgrades and increased demand for minimally invasive procedures, leading international management consulting firm Oliver Wyman predicts the robot-assisted surgery market will reach US$14 billion ($18 billion) globally by 2026, with a CAGR of nearly 11%. The management consulting firm also foresees surgical robots being used for various applications in the operating theatre, including general, orthopaedic, gynaecological, urological surgeries and neurosurgery.
Yet, surgical robot adoption lags. Roughly 2% in Europe and 15% in the US use them. Oliver Wyman notes barriers: High upfront costs, intricate devices, limited surgeon training, and lack of evidence on clinical benefits.
To help hospitals overcome those challenges, NDR Medical Technology is developing affordable AI-powered interventional robotics solutions in collaboration with key opinion leaders from leading hospitals. The solutions are designed to be easy to use.
“Clinicians should be able to master and use the system independently with considerably short learning curves. The hardware setup is a plug-and-play, requiring just 1 training session. By making our solutions accessible to the wider [healthcare] market, we aim to
disrupt the industry and ultimately save more lives,” says Alan Goh, CEO of the Singapore-based medical technology start-up.
Surgery with precision
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NDR Medical Technology’s solutions focus on automated needle targeting (ANT). “They leverage artificial intelligence (AI) and robot vision to empower needle navigation for safe and precise access into lesions for biopsies, ablation, surgery access and more,” adds Goh.
Among those solutions is ANT-X, which Goh explains is an interventional robot that integrates C-arm fluoroscopy and AI software to assist clinicians in percutaneous needle placements. A C-Arm fluoroscopy device is a medical imaging device. It allows surgeons to take high-resolution digital X-ray images from different angles in real time.
“ANT-X can be used in a wide range of procedures in disciplines such as orthopaedics, neurology (in the spine discoplasty procedure), and urology (for a kidney stone removal procedure known as Percutaneous Nephrolithotomy or PCNL),” adds Goh.
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In PNCL, a small incision is made in the patient’s flank area before a tube goes through the incision into the kidney under X-ray guidance. A small telescope is then passed through the tube to visualise the kidney stone, break it up and remove it from the body. With ANT-X, urologists can confidently perform image-guided access with speed and precision during PNCL, which was previously challenging without assistance.
ANT-X was granted the FDA 510(k) clearance by the US Food and Drug Administration (FDA) in June 2023. With this FDA approval, more clinicians can carry out PCNL procedures safely and effectively for more patients. “With the advancement of PCNL techniques such as mini PCNL and ultra-mini PCNL, more patients can be discharged on the same day without stents, tubing, or any remaining stones. Recent trends show an increase in PCNL targeting stones up to 2cm, while mini PCNL has been proven to minimise adverse events. The adoption of ANT-X reduces the complexity of such procedures,” says Goh.
Smart lesion targeting system for CT scanners
NDR Medical Technology offers ANT-C, a smart lesion-targeting system that can help with pulmonology (dealing with respiratory tract diseases) and hepatology (which looks at issues affecting the liver, gallbladder, biliary tree and pancreas).
“ANT-C greatly enhances patient safety and effectiveness in procedures. Doctors can achieve higher accuracy in needle placement. Radiation exposure is reduced as well. This has reduced complications, led to shorter hospital stays, and improved surgical outcomes. These developments lead to significant advancements in healthcare and better patient experiences, enabling clinicians to provide optimal care,” says Goh.
He adds that ANT-C is undergoing a 60-patient trial for biopsy and ablation with an interventional radiologist in Japan. There have been 12 successful robotic-assisted CT-guided biopsy and drainage procedures performed so far.
Growth path
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NDR Medical Technology operates with 20 employees in Singapore and Malaysia, spread across four offices. It holds a joint venture with Microport in China and a Japanese subsidiary headed by a prominent key opinion leader (KOL). Its international collaborations include partnerships with about 20 KOLs and customers worldwide, like Nagoya City University in Japan, Singapore General Hospital, and University Malaya Medical Centre.
Goh says securing capital and accessing clinical facilities have been the company’s main challenge since forming in 2014. “We have partnered with clinical sites worldwide, extending our focus beyond Singapore. With the niche nature of the medical robotics market, we intend to expand into key markets where investors are receptive to deep technology ventures. By strategically targeting such markets, we aim to capitalise on investor interest and drive growth in their business.”
He also cites SGInnovate as a vital backer of the company’s expansion. This support covered funding and essential business guidance, enabling them to acquire resources for development, execute strategies and broaden operations.
Goh adds: “Their guidance and expertise in business have proven instrumental, allowing us to leverage their industry knowledge to our advantage. SGInnovate’s investment and talent support has been particularly impactful, opening doors to new opportunities and partnerships. Their mentorship and networking opportunities have been vital to our company’s growth and success.”
NDR Medical Technology will continue expanding into the US market, focusing on urology. “We will focus on the US because of the current landscape of the healthcare industry there. We aim to apply for FDA 510(k) approval for our product ANT-C by the end of this year. Furthermore, we have plans to broaden the application of both ANT-X and ANT-C to include additional indications. We are exploring its potential use in spine discoplasty for ANT-X, while ANT-C shows potential for liver-related indications,” he says.
The company is actively working on integrating a wider range of imaging modalities, including Cone-Beam CT, into its products. For instance, integrating ANT-X with Cone-Beam CT will enable 3D images to be fused and provide a better vision for selecting an entry point.
To support these initiatives, it seeks to secure Series B funding to finalise the funding round by the end of this year. This investment will give them the needed resources to drive expansion plans forward.
