SINGAPORE –Creative Medtech Solutions (CMS) ,dedicated to the development and application of intelligent medical platforms and surgical robots. The company has started this research cooperation with the Institute of Information and Communications Research (I2R) affiliated to the Singapore Science and Technology Research Agency (A * STAR). That in our collaborative research efforts with I2R, we can combine I2R’s strengths in image processing with our own capabilities and strengths in Ultrasound and Robotics to provide a solution that achieves 3 objectives.
1. Achieve Higher Accuracy, Reduce Procedure Time, and with Zero Radiation
2. Ensure precise, repeatable procedures for operators of all levels of experience
3. Instil confidence and reliability in using a robotic platform for percutaneous puncture in place of free-handed punctures.
l Project introduction of ultrasound guided surgical navigation system:
Percutaneous abdomen interventions are widely used for medical diagnosis and treatment, such as procedures for biopsy, nephrolithotomy, and tumor ablation. One of the common procedures is the nephrolithotomy, by removing the large kidney stones from percutaneous through a small incision. The procedures may have complications as the invasive approach by insertion a big needle into the body, without direct visible field of view available. Complications of such a procedure include bleeding, injuries to the organ or other surrounding organs (colon, lungs), incomplete treatment (stone removal or lesion ablation), infection and sepsis. Same problems can be faced by clinicians and patients for biopsy and liver tumor ablation.
Kidney stones are very common worldwide. From National Kidney Foundation, the prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. This increase was seen in both men and women. The lifetime risk of kidney stones is about 19% in men and 9% in women. Average cost of the treatment is US$11,730 and the procedure takes more than 2 hrs in average. (US Natl Kidney Foundation; J Endourol. 2019 / 2016)
The learning curve for nephrolithotomy is steep, which takes more than 60 procedures to achieve the performance at senior level. One of the challenges is to gain percutaneous renal access. A survey reported that only 11% US practicing urologists routinely obtained their own access . The success rates of the access are 73.4% to 92.8% for multiple to solitary stones .
ultrasound and fluoroscopy are the two common ways used for the guidance. But Most are still using fluoroscopy intra-operatively . Current ultrasound system is still not optimal, only 4% by guidance. The objective of this project is to develop a CT-Ultrasound fusion system to enhance the safety and accuracy for ultrasound guidance for interventional needle insertion.
l The benefit of such a system will enable an easy and accurate puncture access with reduction in:
· failure rate
· procedure time
· estimated blood loss
· infection rate
 VG Bird et al, Practice patterns in the treatment of large renal stones, J Endourology, 2003, Aug, 17(6), 355-363.
 J Tan et al, Renal access through the inferior calyx is associated with higher risk of severe bleeding after percutaneous nephrolithotomy, Arch Med Sci, Apr 25, 2015, 11(2), 340-345.
Annex One—February 14 ,2020 between the Singapore Institute (left) and CREATIVE MEDTECH’s CEO Dr.Xiao Gao,Ph.D., (right) signing ceremony
Annex Two: Taking pictures with both partners