Firoza Kothari is a Co-Founder & CTO of Anatomiz3D Medtech Private Limited and also a Forbes 30 Under 30 winner. After completing B.Tech Biotechnology engineering she worked with a Diagnostics company and within 6 months Firoza decided to print her own world and decided to start a business concerned with 3D printing in medical applications.

In an exclusive interview conducted by Abhimanyu Chavan, Director at Manufactur3D Magazine for CXO Insights Series, FIROZA KOTHARI, Co-Founder & CTO of Anatomiz3D, speaks about her journey into 3D printing, leading the race in 3D printing in medical applications in India and achieving many firsts along the way. The Forbes 30 Under 30 winner also talks about the AM industry, how PoCs are the way forward and what makes Anatomiz3D tick.

Manufactur3D: Tell us about yourself and what led you to co-founding a MedTech Startup?

FIROZA KOTHARI: After completing my bachelors in Biotechnology, I wasn’t exactly sure what I wanted to do. I enjoyed the concepts of biotech but knowing myself, I knew I wouldn’t enjoy lab work for long. So, I joined a Pathological Equipment’s distributor company as a sales executive, soon realising that it wasn’t exactly my long-term interest either. Then I got an opportunity to explore 3D Printing in Medical applications (Healthcare) through Sohrab Kothari and Sagar Shah, Co-Founders of Sahas Softech. I joined them and we began our pilot studies, which meant working on different types of cases and varying anatomies, every time. Being able to have such a direct impact on the lives of patients was extremely rewarding, and it kept us on our toes.

Gaining success in a few cases and some direction through the unsuccessful ones, we decided to make this our focused application area with dedicated resources, and that’s how Anatomiz3D was born.

M3D: How has been the journey of your Startup and what are some of the most striking accomplishments you have achieved?

FK: To be honest, the journey has been quite a rollercoaster. Many of the products and applications we know today were quite new to the 3D Printing industry in India in 2015, with much more yet to be discovered for the first time. This was a little frightening, especially since patient lives were at stake, but it was what kept us motivated to do the right thing. The doctors were very supportive which encouraged us to take the leap of faith and explore new avenues.

We performed numerous firsts for India, including Paediatric Cardiology, Kidney Tumour, Partial Amputee Prosthetic Upper Limb, Tongue Tumour, and others, and contributed to numerous research papers as a result. We also won a few start-up competitions and received seed funding at the end of 2018. I also received the title of Forbes 30 Under 30, Asia, Healthcare and Science in 2020.

After having worked on increasing awareness, we introduced and launched for the first time in India, Industry-Clinical Facility partnerships led Point of Care centres, where we set up and operate fully functional 3D Printing labs, including manpower and hardware, inside healthcare premises.

M3D: You started Anatomiz3D in 2016, since then how has the Indian AM industry evolved? What do you think is better today than it was in 2016?

FK: When I entered the industry, only a handful of people knew about 3D printing, and an even smaller number knew exactly how it can be applied in various industries. Everyone was in the exploration stage. Over the years, I have seen AM go through its hype curve, with people becoming well aware about the advantages and bottlenecks of the technology, about where it can and can’t be used, and applying it in their process in the most optimised way. Even industry players have now started acknowledging the limitations and this has helped the community come up with novel solutions, allowing further progress of the technology.

M3D: What do you think is the size of the Healthcare 3D printing industry of India? What are the major challenges in the adoption of 3D printing in the healthcare sector in India?

FK: As per our market research, based on multiple sources such as our own presence in the market, experience over the years, other industry stakeholders and correlating that with research papers, the Indian healthcare market for AM as of today is about US$1.25B a year in services alone, with a growth rate of 15-20 per cent each year.

Everyone has the right to high-quality, cost-effective, and timely healthcare. This year-on-year growth is expected if current challenges are overcome by software advancements, resulting in less design time, faster and affordable 3D printers, the availability of high-quality materials, as well as an overall increase in awareness of the utility of personalization in healthcare.

M3D: How does an in-house 3D printing lab help the hospitals/doctors, the patients and even you as a solution provider?

FK: To fully utilise 3D printing in medical applications, it is critical that it occurs at the point of care within a hospital, where all clinicians can use it in their daily practice. This enables the technology to be easily applied for more routine personalised patient care.

Advantages of in-house 3D printing labs in hospitals

• Allows 3D printing to be used on a regular basis in clinical practice.
• Generates real-time clinical feedback.
• Reduces lead time and cost compared to outsourcing of such services.
• Enables clinicians to freely innovate and realize new ideas and products.
• Reduced OT time – leading to more surgeries and reduced waiting time.
• Improved surgical outcomes – raising the standard of healthcare.
• Adds to a hospital’s brand value of being an advanced healthcare centre.
• As a solution provider, it helps us add to our knowledge by executing varied types of cases, solving day to day surgeon problems by providing unique solutions and overall increasing the volumes.

M3D: What are the 3D printing solutions you offer at Anatomiz3D? What is your unique proposition to hospitals/doctors?

FK: Anatomiz3D is a one-stop shop for customised medical product design and manufacturing. We create anatomical models, pre-surgical guides, customised implants & implant moulds, and other items from CT and MRI scans of patients using 3D modelling and 3D printing technology. As the first company in India to introduce and master soft tissue modelling for 3D printing, we have a case library of over 1700 cases covering all specialties. We have developed multiple patent pending in-house products as well as quick COVID-19 patient and healthcare worker protection products. With our experience and exposure, we have also contributed to the global community by publishing various white papers and expanded internationally with offices in Australia and Canada.

We are consultants, trainers and partners to individuals, service providers, OEMs, Hospitals, Educational Institutes and other stakeholders in the industry who are in or want to explore the medical field. With our POC module (Point of Care Centers) we also support or even establish an entire process flow for 3D printing labs, along with providing back-end support for end to end solutions. We have set-up such labs at leading Hospitals, Institutes and Diagnostic Chains such as Apollo Hospitals, Max Hospitals, NM Medical Center, and more. 

In the education and training space, we have curated a vast list of models from our library of complex defect anatomy and normal anatomy, which can also be very useful for training of specific techniques in workshops to ensure repeatability. We have also developed the first ever course in the world on Medical Imaging, 3D Modelling and 3D Printing.

M3D: What can you tell us about designing for medical 3D printing? How does it differ from regular product designing and what are some of the most important considerations here?

FK: Designing for healthcare from Patient CT/MRI scans requires knowledge of the entire workflow, starting from image acquisition, region of interest, area of defect, surgical correction expected, CAD, 3D Printing & post-processing based on the product application. It starts with being able to read the scans and being able to differentiate the area of defect, followed by extracting the patient information accurately, by identifying the correct margins, so that the eventual product designs such as implants and cutting guides are a perfect fit. Patient anatomy should have all the structures required for precise decision making, which could involve bones, blood vessels, nerves, muscles and other soft tissues.

Commercially available software has made significant advances over the years, and AI has greatly reduced the time required, but nothing can replace what the human eye can capture. Once we’ve accurately segmented the patient 3D Model, we need to understand what the surgeon will do on the operating table and back calculate from there, keeping in mind all the additional structures that may or may not be included in the 3D Model, hurdles that a surgeon may face during the actual surgery, which structures are acceptable to penetrate through and which are not, and so on. This allows for proper product usability and experience for the surgeon. The design should then be finished using the DFAM principles appropriate for the 3D Printer and material used.

M3D: Is it correct to say that in healthcare 3D printing, model/part designing and material selection is more important than the choice of 3D printer? If yes, why so?

FK: Partially, yes. As explained above, designing is a very crucial part of the entire process, which is also the case for other industries, but the only catch here is that you get just one chance per patient. Hence, it’s extremely important to get it right the first time. When it comes to materials, it’s important to choose the right properties which would fulfil the application, rather than just the make of the 3D printer. For e.g., if we need to 3D print a cutting guide which is going to be used on the patient bare bone, we need to ensure that the material is biocompatible and sterilisable by autoclaving/ETO. Whether we choose a biocompatible resin or powder, is a very trivial component.  However, it goes without saying that the 3D printers should be tested for part accuracy and tolerances.

M3D: Considering the strict guidelines in healthcare, what sort of 3D printers and materials do you rely upon to deliver printing solutions?

FK: We use a combination of 3D printers depending on the final application, such as SLA, SLS, CJP, DMLS, FDM, DLP, etc. For any product which requires contact with the human body, we strictly use biocompatible polymers and metals.

M3D: What is the usual order fulfilment process? What all steps are involved and what are some of the timelines from the first interaction with a client to delivery?

FK: Above is outlined the usual process of designing and manufacturing a patient specific product. Depending on the type of scan and doctor availability, we generally provide our products from as little at 7 hours for simple bone models to about 7 working days in case of complex cases or implants.

M3D: What is the goal at Anatomiz3D? What is the holy grail you are after?

FK: The vision of Anatomiz3D is to be an extensive ‘patient-specific’ solution provider to the healthcare industry, utilizing Design, 3D Printing and Bioprinting technologies, inventing and nurturing the research along the way and reducing the need of organ donors someday.

M3D: What do you think about our ‘CXO Insights’ initiative?

FK: I believe it is very important for a growing niche industry like AM to have a platform to communicate and collaborate, and Manufactur3D is doing a wonderful job of giving us the opportunity to showcase the technology’s strengths, create awareness and voice our challenges.

In our CXO Insights section, Director at Manufactur3D Magazine Abhimanyu Chavan interviews leading CXOs from the global Additive Manufacturing community who share their insights on the technology, the developments in the 3D printing industry, and also on India’s 3D printing industry in particular.

https://manufactur3dmag.com