Welcome to this public session of the Science, Innovation and Technology Committee. First, as is our practice nowadays, we welcome this week’s innovator, Sebastien Ourselin. Sebastien has been brought to us by George Freeman MP, so I ask George to introduce him.

Fantastic.

Thank you very much, George. Thank you, ladies and gentlemen, for giving me the opportunity to present today. I am Seb, a professor of healthcare engineering. I have been working at King’s over the last seven years to build what we have named the St Thomas’ MedTech Hub, which you can see here beyond your curtains on the other side of the river. It is basically the largest concentration that we have in the UK of medtech research facilities embedded in an acute NHS trust. It is not only delivering R&D, but offering clinical services and already transforming the lives of many of our patients on site and beyond. I want to start by explaining this with two exemplars. You have one in your hand, and I will go into detail about it in a few minutes. I want you to picture in your mind what a surgical robot looks like. I am sure that if you think about surgical robotics, you will think about a very large piece of equipment of the likes of either a Da Vinci, as shown on the left of the slide, or the fantastic company in the UK, now the largest medtech in Europe, Cambridge Medical Robotics. Those robots have a very large footprint. They are used for general surgery. There is clearly a very huge push right now to get more of those surgical robots on the market for the patient because they benefit accuracy and reduce the time of hospitalisation. But what about the other type of robots? How will we use them in different conditions? I want to highlight hearing loss. Hearing loss is a global crisis; over 430 million people are affected. Just in the UK, one in three adults are suffering from some deafness, hearing loss or tinnitus. Half of the population over 55 has some kind of hearing loss. This is clearly a major crisis, and we have the treatment to be able to tackle this global epidemic. The challenge is how to inject the treatment. One of the most common treatments for hearing loss is to inject steroids into the inner ear, in the intratympanic area. You do this manually, as you see on the left-hand side of the picture. You go to see an ENT surgeon; you must see a specialist after you have been diagnosed, and the earlier the better, to be able to get treatment. Some people have been waiting for weeks to see an ENT surgeon, and they therefore have permanent hearing loss. In this condition, you need to inject the steroid in the right place, without creating further comorbidity. On the right-hand side of the picture, we talk about the revolution of gene therapy for hereditary hearing loss. We are talking about people who have congenital hearing loss, and people who are actually not able to hear at all. Some of them will have a cochlear implant, but there are other ways, such as to inject the drugs specifically into the cochlea. To do this cell treatment, you need to be very precise. Two advances have been happening over the last year, which I am presenting here. Two companies are creating those stem cells. The challenge is how you can demonstrate the accuracy and the efficacy. If you have a treatment that is dependent on the quality of the precision with which you inject these drugs, you are going to increase the noise in your clinical trial, which eventually could make it fail but, more importantly, will make it more expensive and more difficult to bring across the community at scale. It is a major challenge to bring this drug to the right place in the inner ear, only in the cochlea. If you think about robotics, you might think, “Well, we could bring a robot to do that.” That is how people have been looking at it. “Those big robots exist. Why don’t we bring them into this problem?” The challenge is using a multimillion-pound solution for a very tiny confined area. What about developing a different type of robot? This is an area that we call endoluminal robotics. What you have in your hand is a green bit that you could consider a smart trocar. If you play with the syringe, you will see that I can change it with some of those bubbles you see in the inner ear. By doing this, I can confine the syringe. If you can pass this through—

What you have in the green is a small robot, a small trocar that you put in the inner ear. With those small bubbles, as you will see on the video, you can exactly position the trocar in the inner ear. You have a small camera—the black dots in front of the green bits—and then you can put your needle in it. You can do your injection either of steroids or, eventually, of your regenerative therapy. Basically, you convert a massive robotic solution into a tiny robotic solution, which is patient-specific, and which can be single-use. We are talking about a few pounds to build this system to put in the inner ear. Of course, there is always electronic, AI and computer vision to add to it, but this is a very safe and efficient solution, built in the UK, which is targeting a global market and could eventually be a valuable tool for over 430 million patients per year. It is patented. It is a fantastic collaboration between two major NHS trusts and two major universities in London. It has been co-funded by UKRI. I applaud the funding that we get from NIHR i4i, which is critical non-dilutive funding. For companies, creation is critical. This is going through a spin-out between UCL and King’s as we speak, and it will be launched next year. The second example I want to present is around tumour tissue resections. If you are unfortunate enough to have cancer, and you have a tumour, which is in roughly one in three patients, and it is diagnosed early, one of the most effective ways of treating it is through a resection. How do you resect a tumour? The challenge is that sometimes you do not see the boundary of the tumour. In 20% of cases you have complications, and in 30% you leave significant tumour. Leaving tumour behind means that you could have a recurrence. It means that you have not treated the cancer; you have just delayed it. How do you make sure that you remove the tumour? The claims that I am making are now widely published. It is a big social issue in all cancers. We know how to diagnose early now, but how can we treat efficiently through resection? First, we decided to focus on colorectal surgery, which is the third most common cancer. One of the big challenges of colorectal surgery is what we call anastomotic leakage—a complicated word just to talk about suturing. What we need to do is to identify the part of the colon that you want to resect and then stitch it. Once you have stitched it, you hope that there is no leak. If there is a leak, you have a major challenge which can be deadly, and eventually you need open surgery to correct the leakage. This costs over £100 million in the UK and over $1 billion in the US every year. It costs more than five extra days of hospitalisation for the patients, and there is a 35% mortality rate. The way that people are doing it is to use a dye. You need to switch off the light and use an infrared camera. You can only see it when you inject the dye. As soon as you have injected, the dye starts to dilute. We can try to see how we can use white light—how we can use standard, visible light, not only red, green and blue but all the spectrum—to extract a new biomarker. It is a combination of artificial intelligence and new compute available to do that in real time. The camera in your hand is something we have built. It was funded by venture capital over the last year. We raised over £9 million, including £6.5 million from VCs. We had fantastic support again from NIHR i4i. It is manufactured next door. It has been UKCA-marked since last year. We have already had patients benefiting from this technology in St Thomas’ hospital. We start a clinical trial with three sites across the UK in three months, and we are going for FDA approval by June. Why is this important? Look at the video. What you see on the left-hand side is natural light. This is in the kidney of a pig: it is from an animal study that we did, which was really important to demonstrate the value. What you see here is that we climb the main artery, and in real time you can see the kidney becoming all purple. Why is it going all purple? Because there is a limited amount of oxygenation going to the tissue. I can demonstrate to you that we can measure in real time what we call StO2 tissue perfusion—blood oxygenation in the tissue—which could revolutionise transplantations. Sometimes we do not even know, when we transplant a liver, if the liver is still alive. This is going to be really important in surgery right now.

Thank you very much.

I am on nine minutes. Can I have one minute more?

Okay—one more minute.

I would like to explain why it is important to have the infrastructure to do this. These technologies will never happen without being co-located with a hospital and without having a venture builder, an accelerator, support for scale economies and support for a go-to-market strategy. It is not only about innovation from R&D. It is innovation in the way we deliver it at scale. In less than a year and a half it has become a product. It is thanks to the co-location and the infrastructure that we have in place at St Thomas’ with the NHS trust and the co-partnership with industry that we are able to build such infrastructure, as well as delivering it at scale and marketing it. Thank you.

Thank you very much for setting out that excellent example of partnership between the NHS and research, and the benefits that it can bring to the NHS.