Transforming the healthcare industry with soft robotics
According to a recent market report, the global medical robotics industry is forecast to be worth US$11.4 billion by 2020 – increasing at a compound annual growth rate of 22 per cent from 2015.
At least one institution is riding the wave. The National University of Singapore (NUS) is proving to be a leading force in the evolution of healthcare robotics. The institution is studying the mechanisms of nature to develop new medical technology that will fulfil a range of unmet clinical needs in the healthcare industry.
“Singapore currently stands high among the countries with leading research institutions for bio-inspired research,” says Dr Raye Yeow, head of the NUS Evolution Innovation Laboratory and assistant professor at the NUS Department of Biomedical Engineering.
“The vision of the Evolution Innovation Laboratory is to develop innovative technologies inspired by nature.” Dr Yeow and his team are using such insights to develop a range of new innovations in soft surgical robotics, soft rehabilitation robotics and wearable sensors.
These three rapidly developing fields are set to improve healthcare outcomes in Singapore and around the world, while also offering exciting opportunities for private businesses to assist in the commercialisation process.
Soft surgical robotics
Tissue damage during surgery is a common cause of surgical negligence lawsuits and can result in damage to veins, nerves and other underlying structures in affected patients. This creates additional need for rehabilitation services and puts further pressure on Singapore’s healthcare system even as the government increases health spending from $4.7 billion in 2012 to $11 billion in 2016. Innovations in soft surgical robotics aim to remove such risks of soft tissue damage during surgery.
Dr Yeow and his team have used soft surgical robotic technology to develop a soft chamber-gripper device that can be used to grip nerves without inflicting damage like traditional forceps can.
“This device is highly customisable to suit different surgical requirements and prevents tissue trauma during surgical manipulation,” points out Dr Yeow. “It has an integrated air chamber that, when compressed, transfers pressurised air into the gripper component to trigger a soft gripping action.”
Dr Yeow and his team are currently putting the soft nerve grippers through clinical trials to prove the utility of the innovation before it can enter the market.
“Once we have the pre-clinical and clinical trial data in place to de-risk this technology, we hope to attract medical technology companies to license this technology and help commercialise the use of the device for various surgical procedures,” he says.
Soft rehabilitation robotics
Singapore is also facing the challenge of supporting an aging population. In 2015, the old-age support ratio fell from 6.0 to 5.7 residents aged 20 to 64 for each resident aged 65 years and above. With fewer younger residents to support Singapore’s senior citizens, soft rehabilitation robotics could offer one way to address the challenge of senior citizen care.
Soft rehabilitation robotics aims to provide safe and comfortable wearable robotic systems that can help stroke patients, 75 per cent of whom are above 65 years of age, with their rehabilitation process and assist them with common daily tasks.
During the innovation process, Dr Yeow and his team studied the movement biomechanics of coral tentacles and developed soft actuators that can contract, extend and bend like coral tentacles. Such actuators are used in medical devices such as wearable robotic glove ExoGlove to help define movement with the use of pressurised air.
“Two of our flagship innovations are the robotic glove and the robotic sock,” says Dr Yeow. “The robotic glove helps stroke patients in performing hand therapy exercises and assists them with common manipulation actions such as grasping and pinching.”
“The robotic sock helps prolonged bedridden patients with robot-assisted ankle-foot exercises to improve venous flow and ankle mobility, thereby preventing the development of ankle contracture and deep vein thrombosis.”
Both projects are funded by the Ministry of Education, Singapore Millennium Foundation and Agency for Science, Technology and Research (A*STAR), and are currently undergoing clinical trials.
“We have spun off an NUS startup company, Roceso Technologies, which will commercialise and bring these products to the market,” reveals Dr Yeow. “We will likely work with local and overseas distributors to help us access the different customer clusters around the world.”
Wearable sensors allow healthcare professionals to remotely capture key information about a patient’s condition, such as their mental state, movement quality and strength. Collected data is then wirelessly transmitted to the cloud for the clinical team to assess the patient anytime, anywhere.
In developing the sensors, Dr Yeow and his team took inspiration from recent electronencephalographic (EEG) data that has been shown to be useful in detecting anxiety levels in patients suffering from social anxiety.
“We’ve developed brainwave sensors that can detect the user's anxiety state,” he explains. “This will be useful for patients with clinical anxiety conditions, where clinicians can continuously monitor the patient's condition in real time and provide interventions when necessary.”
This innovation carries significant weight in the fight against Singapore’s rising suicide rate. An average of about 400 Singaporeans commit suicide every year, with around 1,000 cases of attempted suicide reported annually. Early intervention through the use of wearable sensors could be key to reducing this concerning trend.
The sensors are low-cost yet reliable, and may have other potential applications beyond the medical field. For example, Dr Yeow and his team are using these brainwave sensors to monitor the anxiety state of local air rifle shooters, in collaboration with the Singapore Sports Institute.
They have also developed soft bend sensors that can be embedded into any orthotic devices (such as an ankle brace or elbow sleeve) to capture the desired joint angle when the user performs a therapy exercise at home.
Soft sensors hold vast potential to transform the healthcare industry and improve a wide range of patient outcomes in Singapore and around the world.
Solving real-life problems with robotics
As the latest innovations begin to emerge from clinical trials, researchers such as Dr Yeow will increasingly look to private business and multinational healthcare companies to help assist the commercialisation process. Licensing partnerships and relationships with local and overseas distributors and retailers will then be explored to bring the next generation of medical technology to market.
And that’s good news for patients in Singapore and around the world as evolving technology promises to solve real-life problems such as reducing soft tissue damage during surgery, improving the rehabilitation of stroke patients, and providing early intervention for patients with clinical anxiety conditions.
Edited by Kritika Srinivasan and Goh Wei Ting