Trendlines report: 10 companies to watch Q1 2018

The report is published quarterly as an aid to understanding the assets of The Trendlines Group.

The 10 companies featured in this report have achieved significant developmental milestones, which may include investments, patent approvals, clinical or field trials, CE mark or FDA clearance, or sales in global markets. The report also includes an update about our Most Valuable Portfolio Company, Stimatix GI.

ApiFix • BioFishency • EdenShield • Fidmi Medical • Gordian Surgical • Leviticus Cardio • MemTech • Saturas • ST Stent • Vensica Medical

Note: References appear at the bottom of the page.


Minimally invasive scoliosis treatment device

ApiFix aims to disrupt the scoliosis device market with its minimally invasive, non-fusion spinal implant system for the correction of Adolescent Idiopathic Scoliosis (AIS). Worldwide, there are approximately 126,000 scoliosis procedures per year, of which 40,000 are AIS, representing a US$2.4 billion implant market. ApiFix estimates its total addressable market currently reaches US$1.15 billion.¹

Recent developments

  • Increased the number of surgical procedures to >200
  • Newly issued patent bringing total to 20 issued patents


  • CE mark
  • Sales in Europe, Canada, and Asia
  • 7 families of granted and pending patents
  • Offices in Boston, Massachusetts (U.S.) and Misgav, Israel


Advanced water treatment system for land-based aquaculture

BioFishency’s cost-effective, plug-and-play water treatment system enhances water quality, making it possible to double production in ponds and to reduce water use by up to 95% in tanks. Aquaculture is the fastest growing sector in animal protein production with a market value of US$135 billion in 2015²; 62% of food fish will come from aquaculture by 2030.³

Recent developments

  • Signed term sheet to raise US$1.5 million from a strategic and private investor
  • Q1 sales: ~US$800,000; 2017 sales of US$550,000
  • Signed term sheet with the Technion-Israel Institute of Technology to license a new technology that will enable growing fish in any temperature (cold, warm) and water type (fresh, sea); will significantly improve the traditional recirculating aquaculture systems (RAS); first application will be for the transportation of live fish, with the potential for increasing the number of fish and enabling longer transport periods


  • BioFishency’s units are already operating in China, Indonesia, Congo, Bangladesh, India, Singapore, Israel, and more
  • Distribution agreements: Bangladesh, India, Taiwan and China; cooperation with several strategic partners
  • IP: patent in National phase


Natural plant-based crop protection solutions

EdenShield’s natural nontoxic crop protection products leverage characteristics of plants that originate in Israel’s semidesert region to mask plant odor and significantly lower insect attraction, greatly reducing the need for pesticides. The current worldwide insect pesticides market — estimated at US$14 billion, with the greenhouse segment estimated to be at US$2 billion4 — is looking for cost-effective, environmentally friendly solutions that are synergetic with their existing products.

Recent developments

  • Sales: Achieved US$450,000 in 2017; US$2.5 million targeted for 2018
  • In Q1 2018, increased installations of EdenShield systems (GateKeeper and GreenFence) threefold in the United States, Mexico, Spain, Greece, and Israel
  • Raised additional US$2.2 million from strategic and financial investors for increasing production to meet sales growth and for development of a new application
  • Announced strategic partnership with Kibbutz Yotvata in southern Israel to facilitate an increase in production


  • License granted for EdenNET and EdenDIRECT for use in organic agriculture in the UK
  • Distributor agreements, including the United States and Mexico
  • Expanding farming operations to meet growing demand
  • IP: patent granted (U.S., June 2016, Australia, April 2017); published (Europe); final stages (Canada, India, Mexico, China); filed (Israel and Kenya)
  • License granted for EdenShield NET and Forte (Spain and Israel); final licensing stages (Turkey, England, United States)

Fidmi Medical

Novel feeding device for improved nutrition delivery

Fidmi Medical has developed a uniquely designed, low-profile, enteral feeding device that offers a secure, reliable, and discreet solution immediately post-surgery, and when needed, pain-free removal. Annually, there are approximately 1.3 million enteral device insertions worldwide, and an additional 3 million replacement procedures performed for blocked or dislodged tubes, representing sales of US$540 million. Estimates of the global market will exceed US$600 million by 2018.5

Recent developments

  • Preparing CE mark submission
  • Developing a low-profile PEG device for children


  • Opened clinical sites in Israel; performed 7 procedures
  • Submitted FDA 510(k)
  • 3 patents pending (all in National phase; U.S. EU, China)
  • Raised US$2 million investment from B. Braun Melsungen AG; funds to be used to complete clinical trials and prepare for market entry

Gordian Surgical

Integrated port closure system

Gordian Surgical has developed and is currently marketing the TroClose1200™, the only integrated port closure system available worldwide. The product enables the surgeon to insert surgical instruments into the abdominal cavity, and then close the port site in a simple, secure, and safe manner when the procedure is completed. The global trocar and closure markets are estimated at a combined US$1.45 billion yearly revenue.6

Recent developments

  • Beginning next investment round
  • Increased usage of the Gordian TroClose™ 1200 to >300 in more than 100 hospitals (including surgical procedures in urology robotics, general surgery robotics, bariatric, gynecology, hernia repair)
  • Direct sales began in the United States beginning Q2 2018


  • Raised >$5.5 million to date (including grants)
  • FDA clearance and CE mark
  • IP: 3 U.S. patents; one provisional and one in National phase
  • Regulatory clearance in Israel, performed surgeries
  • Regulatory clearance in Mexico, initiated distribution
  • 6 distribution agreements

Leviticus Cardio

Wireless energy system for LVADs

Leviticus Cardio is developing a wireless solution to provide the energy needs of left ventricular assist devices (LVADs), eliminating the need for a driveline, a potential entry point for infection. According to Grand View Research, the global LVAD market was valued at US$763 million in 2014 and is set to grow to US$1.98 billion by 2022, driven by increased prevalence of cardiovascular disease, advances in technology, and favorable reimbursement, among other factors.7

Recent developments and status

  • Animal trial with successful 60+ day follow-up
  • Fully operational system
  • Raised US$8.7 million to date
  • IP: 12 issued patents and two pending (U.S.)
  • High visibility among LVAD players
  • ISO 13485


Game-changing membranes for water treatment

MemTech’s ultrafiltration membranes have more than 2x higher flux capacity (at similar quality) compared to leading commercial membranes, and are sold for wastewater treatment, pretreatment, drinking water treatment, and nanofiltration. The global membrane wastewater treatment technology market is estimated to reach US$12 billion by 2020 with annual growth of 10.2%.8

Recent developments

  • Sent first Membrane Bioreactor product unit to Latin America
  • Began a project for the home purification market with a Chinese partner


  • Increasing sales of membrane products; initial sales of integrated filtration system; expanding partner relationships and product offerings
  • Growing list of industry partners and of customers include Mekorot (Israel’s national water company) and SEB Alliance
  • IP: 1 issued patent; 2 patents pending (U.S.)


Advanced decision support system for optimal irrigation

The Saturas Decision Support System (DSS) for automatic irrigation is based on its miniature Stem Water Potential (SWP) sensor. Embedded in the trunks of trees, vines, and plants, Saturas’ sensors receive direct feedback/input from the tree or vine to provide online, accurate information for optimized irrigation. Current solutions for measuring water status lack accuracy and are labor-intensive or costly.

Recent developments

  • Completed an investment round of US$4 million from investors Hubei Forbon Technology Co. Ltd., a leader in the field of fertilizer additives for agriculture in China and worldwide; Ramat Magshimim, a collective farm in Israel; and Miguel Torres Winery SA, one of the largest wineries in Spain and owner of vineyards in California and Chile; existing investors in Saturas also participated (Gefen Capital, Trendlines, the Israel Farmers’ Union, and Shlomo Nechama)
  • Completed successful field trials in commercial almond, citrus, and apple orchards in Spain and Israel during irrigation season 2017
  • Developed a miniature version designed for vineyards/grape vines; December 2017: new version successfully embedded into plants/vines for wine grapes
  • Updated user interface model – developed and in use


  • Proven technology with Saturas’ sensors successfully operating in lemon, clementine, almond, and apple trees for more than a year
  • Installed ~350 sensors in 3 experimental farms and 10 commercials farms in Israel and in Spain
  • New field trials in California in May 2018 in vineyards and in almond and walnut trees
  • Established strategic cooperation with Netafim and NaanDanJain (the leading drip irrigation companies in the world) in Israel, Spain, and California for field trials; these industry leaders are also potential distributors of the system

ST Stent (STS Medical)

Removable sinus stent for use after Functional Endoscopic Sinus Surgery (FESS)

ST Stent ST Stent has developed a removable stent for use after FESS to keep the sinus cavity open for almost a month, long enough for the sinus tissue to recover post-surgery. The stent improves patient outcomes and prevents post-surgical complications, thus reducing the probability of revision surgery. Today, about 30% of sinus surgeries fail due to scarring and recurring inflammation that closes the nasal openings and requires revision surgery.9 According to Intersect ENT, the estimated sinus stent market opportunity exceeds $3 billion in the United States.10

Recent developments

  • Raised >US$1.1 million
  • Performed clinical trials (30 patients)
  • Preparing manufacturing capabilities for first approved product for American and Israeli market
  • Preparing first U.S. clinical cases (Lenox Hill Hospital, NY)
  • Preparing for sales in Israel


  • FDA clearance (December 2017)
  • Successful first in human trials, including stent removal after four weeks, with three-month follow-up; excellent therapeutic results
  • One issued patent (U.S.); two pending (Canada, Europe, Japan, China)


Ultrasound-assisted drug-delivery for overactive bladder

Vensica Medical is developing VensiCare to treat overactive bladder (OAB) with ultrasound delivering Botox® into the bladder wall painlessly, without needles. The procedure can be performed in the doctor’s office or clinic, without anesthesia. OAB is the most common bladder disorder. There are an estimated 39 million OAB patients in the United States alone.11


  • Raised US$2 million investment from Cogentix Medical, part of structured acquisition
  • Successful preclinical trials
  • Filed PCT (international patent application)


[1] U.S. National Center for Health Statistics; OECD Health Data 2015; Statistique annuelle des établissements de santé and CNAMTS (Evolution des actes techniques en secteur liberal); Statistisches Bundesamt; Conjunto Mínimo Básico de Datos – Hospitalización and Ambulatorio; UK Hospital Episode Statistics databases for Admitted Patient Care and Outpatients; Life Science Intelligence Surgical Procedure Volume database.

[2] The State of the World’s Fisheries and Aquaculture 2016. Food and Agriculture Organization of the United Nations.

[3] “FISH TO 2030 Prospects for Fisheries and Aquaculture.” December 2013. The World Bank.

[4] Global Markets for Biopesticides, January 2017. BCC Research.

[5] Enteral Feeding Devices Market: Global Industry Size, Market Share, Trends, Analysis, 2012-2018. Transparency Market Research.

[6] Endoscopic Access Site Closure Devices Market, General and Pelvic Endoscopic Surgery Devices Market, chapter 8. Medical Market and Technology Reports, MeddeviceTracker.

[7] Congestive Heart Failure (CHF) Treatment Devices Market Analysis by Product (Ventricular Assist Devices, Counter Pulsation Devices, Implantable Cardioverter Defibrillators, Pacemakers, Cardiac Resynchronization Therapy) and Segment Forecasts to 2024. October 2016. Grand View Research.

[8] Frost Perspectives: Augmentation of Membrane Filtration Technology Market. June 2016. Frost & Sullivan.

[9]  RSNA RadioGraphics, Failed Endoscopic Sinus Surgery: Spectrum of CT Findings in the Frontal Recess, 2009.

[10] Centers for Disease Control and Prevention. National Center for Health Statistics, Chronic Sinusitis, 2015.

[11] The Burden of Overactive Bladder on US Public Health; Curr Bladder Dysfunct Rep, 2016 March, W. Stuart Reynolds, Jay Fowke, Roger Dmochowski. The Total Economic Burden of Overactive Bladder in the United States: A Disease-Specific Approach;