At first glance, a first-time visitor to the Hospital for Sick Children, or “SickKids” as it’s more commonly known, could be forgiven for thinking that they were in a plush shopping centre rather than a major specialist paediatric hospital. Indeed, it has all the trappings of coffee bars, food outlets and such forth. The downtown Toronto–based hospital is a sprawling campus of old and new buildings, colourful furniture and equipment, and boasts one of only three medical centres in the city equipped with a helipad.
Centre for Image-Guided Innovation & Therapeutic Innovation
Somehow, the combination seems to work because the hospital has grown rapidly to become Canada’s largest centre for child health research. Supporting this strategy has been the Centre for Image-Guided Innovation & Therapeutic Innovation (CIGITI), which was set up at SickKids in 2009 and, as part of a public/private partnership is developing three technologies with paediatric and foetal applications:, namely minimally–invasive endoscopic manipulators, a natural orifice anastomotic device and MR–guided high–intensity focused ultrasound.
In the case of the KidsArm technology development, the public contribution comes in the form of research and clinical expertise (SickKids) and government–based funding, whilst the private sector contribution encompasses contributing robotics (MDA Corporation), imaging (Philips Healthcare) and simulation (L–3 Communications MAPPS) technology.
The ambition for KidsArm can hardly be described as modest. The goal is for the technology to effectively to secure a position as a world leader in robotic surgery and imaging. Billed as the first robotic surgical arm for paediatric imaging, the device allows surgeons to navigate to a specific treatment area without impacting upon structures such as blood vessels. It could also be used to perform procedures such as the suturing of vessels and tissues at a rate of at least ten times faster than a surgeon.
The surgical platform is intended for use across all key surgical specialities, including cardiac, foetal, neurosurgery/general surgery and neurosurgical areas. The device also has the benefit of producing virtual reality–based models that can be used in planning and teaching.
As with all high–profile technological breakthroughs, CIGITI has not got a clear field in terms of competitors, which include the likes of Intuitive Surgical, which has emerged in recent times as a leader in robotic technology through its DaVinci system. Still, confidence in the KidsArm’s attributes is strong and in a presentation to analysts, CIGITI isn’t afraid of holding back on a direct head-on comparison with Intuitive Surgical.
First up, CIGITI says the KidsArm is markedly smaller and lighter than that from Intuitive, and that its device will be much cheaper and adaptable than its rival. As the kid’s device is specifically targeted for paediatric use, it can also be used for any procedures that require minimal inversion. In contrast, Intuitive’s technology stands accused of being too large for paediatric use and limited to urological applications. Other technology standouts for KidsArm include built–in telesurgery and imaging guidance initially focused on MRI.
Unlike Intuitive, the development of CIGITI’s technology is still at the relatively embryonic stage, although a clinical working model is expected to emerge within two years. Backed by C$10 million in funding awarded by the Canadian government in 2010, Phase I of the programme, which started in 2009, has been focused on the development of technological innovations such as in the areas of advanced complex surgical delivery, multi–modality fusion and real–time image guidance and creation of surgical simulation models.
Whilst this process is still continuing throughout 2012, Phase II of the programme, which started in 2011 and will last two years, involves a critical analysis of the KidsArm technology. This includes a review of minimally–invasive surgery (MIS) vs robotic surgery, a look at fusion and real–time image guidance and improving the accuracy of the surgical system and simulation modules. The analysis will also be carried out at high–frequency imaging for foetal intervention procedures. All this work, if it continues to impress, is likely to lead to commercial and clinical opportunities for the technology from 2014 onwards.
So why is a hospital taking such an active role in product development when its primary role is providing healthcare provision? Aside from the revenue earning potential of creating IP assets that can be licensed or used for start–up companies, the collaboration stands to general high–end manufacturing jobs, healthcare and research opportunities and substantially improve the education available to school students and rising all the way up to medical staff, both in Canada and the province of Ontario.
For SickKids, such efforts help to improve patient care and the quality of healthcare provided by the institution by introducing novel image–guided tools into the paediatric setting. So far, in just two years, SickKids/CIGITI has created a number of positions across all levels of academia, filed for three patents covering surgical tools (including one for KidsArm), secured C$25.8 million in research funding, signed a licensing agreement with Medical Modeling relating to patient–specific cranial facial models and templates and forged tentative links with venture capitalists.
