I want to make this ratchet thingy electric somehow

This ratchet is used to tighten dental implants. The implants need 40 n.m to be tightened. I want to change it to an electric ratchet somehow, it needs to have 40 n.m of torque while remaining small. Is it possible? What are your suggestions on making this thing?

This ratchet is used to tighten dental implants. The implants need 40 n.m to be tightened. I want to change it to an electric ratchet somehow, it needs to have 40 n.m of torque while remaining small. Is it possible? What are your suggestions on making this thing?