From Frank Pantridge’s invention of the defibrillator to pHion Therapeutics’ recent breakthroughs in drug delivery systems, Northern Ireland’s contribution to healthcare innovation has been remarkable over the years. Today, Belfast-based firm Axial3D’s new patient-specific solutions are continuing that tradition as they begin to transform surgery around the world.

Founded by Daniel Crawford, Axial3D create patent protected software that revolutionises the surgeon’s work, saving time and money and reducing patient risk. By automatically translating existing 2D CT and MRI scans into 3D, the surgeon is given a far more detailed picture of what he needs to plan and execute an operation or use the precise implant a patient may need.

Axial3D CEO Roger Johnston saw the potential of this world - leading innovation from early conversations with Daniel Crawford. Roger’s own background in the technology sector goes back over three decades following his graduation from Belfast’s Queen’s University. A proud advocate for Northern Ireland around the world, his passion has been growing early and mid-stage companies to success.

From the outset, Roger was struck by the potential of the idea Daniel Crawford presented to him over four years ago.

“I thought it was an amazing idea and one that didn’t exist anywhere around the globe. I decided to invest in the company and, when Dan was ready to scale the company commercially, he asked me become CEO. That was September 2019 and I have loved every second working here since.”

To understand the full potential of Axial3D's 3D technology, imagine you are a surgeon planning for a complex operation with existing 2D CT or MRI scans. In 2D, it isn’t possible to see the specific details of a patient’s condition and so the surgeon can’t be sure exactly what kind of operation is needed.

Without the detailed information of what they will find, a surgeon is likely to go into an operation with several contingency plans. Only when the patient is opened up will they be able to choose the appropriate action. However, in order to cover those possibilities, they will need to have brought extra tools and extra people into theatre.

The operation will take significantly more time and the patient will be exposed to greater risk of blood loss, infection and trauma. The recovery time may also go up and with it the attendant risks to the patient.

“2D imaging doesn’t allow the precision of understanding you need to plan complex surgery”, Roger says. “Our modelling and imaging corrects that.”

The statistics tell their own story. “In half of cases, surgeons tell us, they change their plan for surgery when they use our models. On average they save 62 mins in surgery, while on average a patient spends 18 per cent less time recovering in hospital.”

The 3D modelling and imaging works across the range of surgery, typically in complex orthopaedic, cardiology and neurosurgery operations, although oncology procedures are becoming more common.

“We’re the only company doing this globally and at a cost that makes it accessible to pretty much everyone around the world.”

The way it works is simple. Once the 3D file of the scan is produced, it can be viewed on a phone, iPad or virtual reality headset or be printed out on a 3D printer (Axial3D can provide this service for surgeons). 

“An orthopaedic surgeon can print it off in hard resin, a cardiovascular surgeon, used to working with a soft touch sensation, on flexible resin. That means they can even practise the operation in advance on what will be an exact replica of, say, someone’s heart or spine.”

Its potential for improving the implanting of medical devices is equally important. Using Axial3D’s imaging in tandem with 3D printing, an exact, bespoke, patient specific implant can be produced with no implications for extra cost. 

As 3D imaging begins its journey to the mainstream, Axial3D are reaching out to their two main markets, surgeons and medical device companies. “Our software is at the core of this new technology, and all of the market leading device companies are moving to patient specific implants. They are very big customers and a huge potential market for us.”

At the same time Axial3D are in constant touch with surgeons around the world, particularly in the US, encouraging them to try their modelling to appreciate its benefits.

To further their work, Axial3D has received vital funding from the UK Government and Invest NI, especially during the Covid pandemic. “They have been amazing. We were fortunate to be accepted for the Future Fund from the British Business Bank and the Covid-19 Equity Investment Fund, from Invest NI. They were both fantastic and expedited the funding with all the urgency the Covid situation demanded.”

Roger believes the astonishing degree of innovation emerging from Northern Ireland is the result of an innovation eco system that is fast maturing after three decades of growth. “At the start there were very few true global innovators here and perhaps we were a little naive. Now we’ve had three generations of people who understand what it is to be an entrepreneur. As well as that, our educators are better at educating our students, there is more funding available and we have more successful role models who focus on technology that has true global potential.”

“I’m in awe of the quality of many of the young leadership entrepreneurs coming through. They are truly incredible. When I was their age we had perhaps ten companies that would be off the charts. Now it’s a hundred!”