Endiatx
Spearheading a New Era in Diagnostic and Interventional Medicine

Most of us were probably too young or not even born when Richard Fleischer's Sci-fi marvel, Fantastic Voyage, hit the screens in 1966. The movie was considered classic at the time, given its intriguing premise that unravels into a true banger of a plot. The story revolves around a microscopic submarine crew who ventures into the body of an injured scientist to repair damage to his brain. There's perhaps no argument that the story was way ahead of its time—even compared to the day and age we live in. Despite the technological advancements, the notion of shrinking people to fit in a blood cell seems far-fetched. But, the rapid advancements in nanotechnology and robotics today are carving the way for sub-microscopic robots to go beyond the realm of science fiction into reality.

Endiatx, a CA-based medical devices startup, is paving the way for this new era of diagnostic and interventional medicine. As a pioneer in the niche of pill-sized robots, Endiatx has developed an innovative robot pill, PillBot, that helps physicians virtually explore the human body in a non-invasive manner.

"Our ingestible PillBot can help doctors view and examine the digestive tract of their patients without the need for cables or complex procedures," says Torrey Smith, co-founder and CEO of Endiatx. "Patients can simply skip their breakfast, drink a few glasses of water, and swallow PillBot while doctors can have first-hand video of the GI tract on a tablet or iPad screen." By doing this, Endiatx provides doctors with the diagnostic power of an endoscope in the form of a pill. This next-gen medical device aims to improve patient experience—that generally takes a year of consulting doctors and getting gatekeeping experience—into a 20-minute zoom call from the comfort of their living room.

Bridging the Gap in the Industry

Just as PillBot reminds us of an imaginative and futuristic concept straight out of a sci-fi movie, the initial idea behind the solution was fed by Smith's affection towards science fiction. "As a kid, I was always fascinated by movies and cartoons that showed tiny robots moving inside the human body and books that depicted concept of sub-microscopic robotic surgeons curing medical conditions," says Smith. Growing up in a world of science fiction movies and books, Smith always believed that nanotechnology and robotic pills were the future of medicine. Passionate to pioneer the global efforts of developing groundbreaking technologies, he began his adventurous journey early on.

Though an aerospace engineer by profession, Smith has been involved in designing innovative healthcare solutions for more than 12 years and has participated in three successful company exits in the medical device industry. It was during that time, Given Imaging, the creators of PillCam sold their first-of-its-kind passive pill camera to Covidien for almost $1 billion. This move caught Smith's attention. More importantly, it raised several ambiguities concerning the operational efficiency of passive electronic pill cameras developed decades ago. Identifying this opportunity in the medical device industry—both on the cost and functional fronts—Smith decided to develop PillBot with his friends, Dan Moyer, James Erd, and Alex Luebke—who today serve as Endiatx's CTO Emeritus, principal R&D engineer, and Chairman & CTO respectively.

"A Moving Eyeball in the Stomach"

With PillBot, team Endiatx aims to disrupt the gastroenterology space by eliminating the use of widely used but uncomfortably invasive colonoscopy procedures to diagnose conditions in the GI tract. Though ingestible passive pills—considered a value-added alternative for traditional endoscopy—have been around for a while, they lack therapeutic capabilities, the ability to obtain biopsies quickly, and active control over the movement of the capsule. Designed to address these challenges, PillBot features a novel built-in propulsion system—four micro pump jets—that helps doctors navigate it around the stomach like a drone quadcopter. So, unlike an ingestible passive pill, it enables physicians to actively control the device and have real-time remote access to the entire GI tract, beginning with the stomach.

PillBot can enable a doctor to actively explore the stomach and yield high fidelity video while being controlled via a tablet over secure video call.

"PillBot can enable a doctor to actively explore the stomach and yield high fidelity video while being controlled via a tablet over secure video call. It eliminates the need to wear a specialized belt or lay down on an expensive piece of capital equipment," adds Smith. Unlike traditional endoscopy, liquid preparation (typically polyethylene glycol) is not required. Patients will simply skip breakfast and drink water to provide a clear fluid environment in which PillBot can operate. While undergoing this sedation-free, wireless, non-invasive, and cost-effective process, patients do not have to stay back at the hospital to recover. The solution is designed to eliminate risks of perforation, abrasion, infection, patient-doctor physical contact, multiple hospital visits, and millions of dollars in capital equipment. Not just that, it allows patients to be part of their medical journey by seeing what PillBot sees, talking to doctors in real-time, and providing the imagery that appears on their phone in a safe, HIPAA-compliant way.

Carving the Way for "PillBot" Diagnostics

Team Endiatx prides itself on having the potential to take a simple napkin sketch to the final stages of R&D in two and a half years. What led to this remarkable success is its dedicated team of industry experts that encompasses several prominent doctors in the gastroenterology space. "We are honored to have the top three gastroenterology institutions in the world represented in our team," says Smith. The chief of GI at Mayo Clinic, Dr. Vivek Kumbhari, who also served at Johns Hopkins and Dr. Bu' Hussain Hayee, the chief of gastroenterology at King's College London, are part of Endiatx's team. This, combined with recent fundraising developments, is helping the company create clinically relevant, effective PillBot and enter early-stage Institutional Review Board (IRB) trials. Team Endiatx is hopeful that their innovative technology will successfully clear the FDA trial by the end of 2023.

So far, Endiatx has completed 23 inhuman trials and a demonstration for MIT. The company has successfully performed a live swallow demo at the 2021 IFAH conference. Smith swallowed the robot live on stage, controlled by Luebke, and displayed the video from the robot to the big screen in real-time.

Additionally, team Endiatx has run weightless testing in the cockpit of an airplane on a ballistic trajectory to validate PillBot's propulsion systems.
Most importantly, they performed a cadaver study at Mayo Clinic labs with Dr. Kumbhari, allowing them to see—first hand—live videos of PillBot moving around inside the GI tract using the Xbox controller.

"The feedback from the global medical community has been very exciting. For the first time in the history, a micro-robot has been operated inside the human body autonomously—without any wires, cords, or connections. It is an easier, faster, and better alternative to the traditional methodologies," informs Smith. Dedicated to ensuring that doctors and patients are getting easy access to this revolution, the team is really hard at work. They are now putting their best foot forward to address standard issues on electronics, optics, propulsion, and battery, to name a few, to enhance its potential for hard telemedicine and make it the right alternative for the traditional upper endoscopy.


The Future of Medical Care Delivery

"At Endiatx, we always strive to design and develop cheap, disposable, single-use sub-microscopic robots to make inspection of deadly diseases easy, fast, and cost-effective," says Smith. Several like-minded organizations are constantly approaching Endiatx, enabling the company to blur the lines between medical devices and pharmaceuticals. By developing this new category of micro-robotics, the company plans to bring medical device manufacturers, healthcare institutions, and other stakeholders in the industry together. This will reduce the overall healthcare cost for patients and provide timely access to the right care and advanced procedures.

As PillBot becomes a reliable form to diagnose conditions inside the body, team Endiatx plans to enhance it with surgical tools, needles, claws, clippers, and snippets. This way, the company intends to extend its usability in drug delivery, bleed cauterization, sample collection, microsurgery, and removal of polyps. "We want to use the tiny robot platform as the foundation of a new standard of care in medicine," adds Smith. Endiatx is also creating a product roadmap that goes beyond the GI tract. The company's long-term goal is to develop rice-grain-sized, nuclear-powered brain surgeon robots that can swarm a tumor without causing the risk of potential collateral damage associated with an open-skull surgery. Instead of patients undergoing traditional invasive procedures, these tiny robot surgeons can work around the periphery and perform operations like shutting the blood flow, injecting radiation enhancers, and then actually cauterizing, snipping, and destroying the tumor.

"We intend to provide doctors with the tools that they've only dreamed about. Our goal is to become the SpaceX of the medical device industry by bringing some of the world's leading talents to create a standard of care that truly makes things better for people," concludes Smith.