From Industrial to Medical Endoscopes

The lobby of Adronic Inspection Instruments’ facility is decorated with the company’s many SGS Taiwan and GMP quality certifications.

Company CEO John Tseng says it has relied on a process of continual innovation to transition from making 120-meter-long endoscopes, used to inspect tunnels, to medical endoscopes as small as 0.8 millimeters in dia­meter, used to examine human nasolacrimal canals, ureters, and brain tumors.

Adronic Inspection Instruments’ industrial videoscopes make it easier for engineers to inspect the engines of fighter jets such as Russia’s MiG-29. (courtesy of Adronic Inspection Instruments)

Honing one’s tools

When Tseng was living in Germany in 2007, a neighbor who owned an industrial endoscope maker suggested that enabling industrial endoscopes to make videos would make them easier for older workers to use. Tseng thought it was a good idea and began working on it.

He subsequently developed an industrial endoscope with a lens that could be aimed, and that could record video. Designed to inspect the combustion chambers of automotive engines and determine whether fuel had fully combusted, the device won Tseng customers in the auto industry, including firms like Audi, Porsche, and Bosch. He even received an order involving Russian MiG warplanes, which resulted in him developing an endoscope designed to examine the interiors of their engines to check for evidence of maintenance.

Adronic spent a decade developing and producing more than 30,000 endoscopes of different shapes and sizes, tailor-made to meet needs as unusual and specific as examining the interiors of exhaust pipes and fuel tanks of military tanks and submarines. The company also produced radiation- and water-resistant endoscopes used to check for pipe wear at nuclear power plants, ensuring that small defects would not lead to immeasurable harm.

Adronic CEO John Tseng has steered the company into the development of medical endoscopes to help Taiwan win a piece of the international market.

A fated transformation

In 2012, Tseng’s mother was diagnosed with Stage III nasopharyngeal carcinoma. Her death six months later caused Tseng to reflect: “My industrial endoscopes are capable of looking inside jet engines to check for fractures in the turbine blades caused by impacts from small stones. They can penetrate into the pitch-black engine compartments of submarines to see whether fuel has fully combusted. Why can’t I make a medical endoscope to spot malignant tumors?”

Not wanting to be a bother to others, Tseng’s mother had treated her symptoms with analgesics for a long time before seeing a doctor. As a result, her cancer was already at stage three when it was finally discovered. Tseng, who in those days was still working abroad, couldn’t help but wonder whether his mother’s outcome would have been different if the cancer had been found sooner, or if the doctors had been able to clearly image the tumor at the time of her surgery and chemotherapy.

Coincidentally, Chang Gung Medical Technology, part of the Chang Gung Medical Foundation, happened to commission Adronic to develop a medical endoscope in 2012. The move initiated a six-year-long R&D process that absorbed all of the company’s earnings from its indus­trial endoscope business.

A series of awards and quality certifications earned along the way reinforced Tseng’s conviction that he was on the right track. The company’s 3.5-inch medical endo­scopes, which are portable enough to be easily used for urgent surgeries in remote locations, earned Taiwan Excel­lence Awards in both 2016 and 2019, and in the future will be used in conjunction with 5G technology for telemedicine applications. Meanwhile, the company earned certification as a medical endoscope maintenance center for the Asia region (excluding Japan) in 2017.

The Industrial Development Bureau of the Ministry of Economic Affairs gave Adronic a grant of NT$7 million in June 2020 to assist its development of endoscopes and supporting systems. (photo by Lin Min-hsuan)

Spotting brain tumors

Adronic’s medical endoscopes were initially used in research and education. For example, faculty members from National Cheng Kung University’s College of Medi­cine asked Adronic to develop hysteroscopes, ­biliary endo­scopes, and laryngoscopes for academic applica­tions in hopes of making progress towards resolving problems in clinical settings.

But it wasn’t until doctors at Chang Gung Memorial Hospital used an Adronic endoscope to image and excise a brain tumor in a two-month-old baby that Tseng fully appreciated the device’s power. When the tumor was subsequently examined and reconfirmed to be malignant, the surgical team was even more relieved to have removed it.

Tseng recorded the entire event, and explains that doctors can’t tell with their naked eyes which tissue is cancerous. For this microendoscopic surgery, they injected the baby with a photosensitizing imaging agent called 5-ALA that makes cancers appear pink, then used the Adronic system’s photo­dynamic detector to spot the tumor and remove it.

Endoscopes can identify tumors’ locations, but surgeons still need other tools to remove them. Observing this difficulty, Adronic realized it could take its own corporate trans­formation farther by developing tools to assist in the removal of brain ­tumors. 

In 2019, Tseng began working on magnetic endoscopes, which are better able to identify the precise location they are imaging, and expects to complete develop­ment in 2022. The company has already developed disposable endoscopes, which eliminate the risk of spreading infections from one patient to another.

“When I first went into medical endoscopes, I did it with the ordinary, simple-­minded idea of helping people. But fate turned my efforts into something more, and I ended up designing endoscopes capable of spotting brain tumors.” With the govern­ment now steering medical equipment makers towards the development of micro and AI-­assisted devices, medical endoscopes may well become another leading light in Taiwan’s medical devices industry.

Tseng says that his eight years researching and developing medical endoscopes that have helped hospitals complete innumerable successful surgeries have provided him with a much better understanding of healthcare. “If my mother’s cancer were discovered now, I could use endoscopy to find the tumor. With that information to guide surgery and proton therapy, she would have had a different outcome.”                            

Adronic displays its many quality certifications from Taiwan, North America and Europe on a wall inside its facility.

Adronic is continually improving its tools for assisting in removing brain tumors. The products are now in their seventh generation.

Adronic’s endoscopic photodynamic detector works with a photosensitizing imaging agent that makes cancerous cells appear pink, helping doctors identify tumors and remove them completely. (courtesy of Adronic Inspection Instruments)

Adronic’s endoscopic photodynamic detector works with a photosensitizing imaging agent that makes cancerous cells appear pink, helping doctors identify tumors and remove them completely. (courtesy of Adronic Inspection Instruments)

Adronic’s endoscopic photodynamic detector works with a photosensitizing imaging agent that makes cancerous cells appear pink, helping doctors identify tumors and remove them completely. (courtesy of Adronic Inspection Instruments)

Adronic is working in partnership with medical centers to develop new techniques and products tailored to clinical needs.