The Memo: Lazzaro Medical Building a Robotic Solution for Airway Collapse

Under the direction of Co-Founder Robert Israel, Lazzaro Medical is developing a minimally invasive, robotic-assisted solution for tracheobronchomalacia (TBM), a structural airway collapse disorder that leaves patients struggling to breathe. Built around the company’s LM Scaffold System™, the platform is designed to transform a complex, highly specialized surgical repair into a more standardized robotic procedure that thoracic surgeons around the world can perform. With nearly $8 million raised to date, strategic backing from leading health systems, and plans to begin a human feasibility study this year, the company is working to bring a long-overlooked respiratory disease into a new era of treatment.

Origin Story

The foundation of Lazzaro Medical began with a long-standing friendship and a shared appreciation for innovation.

Israel and Dr. Richard Lazzaro first met as students at Union College, where the two quickly became close friends. They graduated together in the 1980s and remained connected over the years as their careers took very different paths. While Lazzaro went on to become one of the world’s leading robotic thoracic surgeons, Israel built a career as a serial entrepreneur across industries, including apparel, food, and consumer products.

Years later, the two reconnected and began discussing the groundbreaking surgical work Lazzaro had been performing to treat airway collapse. Using robotic-assisted surgery and standard surgical mesh, Lazzaro had developed a way to repair the trachea by reinforcing the weakened airway structure and restoring its shape.

Israel immediately saw the significance.

“I was blown away by what he was doing and the lives he was saving,” he said.

In the procedure, surgeons place mesh along the outside of the trachea and suture the airway membrane to the mesh, pulling it outward to restore the airway structure.

Recognizing that the procedure itself was transformative but technically difficult to perform, Israel partnered with Lazzaro to develop a purpose-built scaffold designed to make the surgery easier, faster, and accessible to more surgeons.

The Current Landscape

TBM remains one of the most underdiagnosed airway disorders in medicine.

The disease occurs when the cartilage that supports the trachea deteriorates, allowing the airway to collapse during breathing. Patients often experience persistent coughing, shortness of breath, and repeated respiratory infections. Because symptoms frequently resemble COPD or other respiratory conditions, TBM is often misdiagnosed or missed entirely.

Estimates suggest the condition may affect up to 10% of the U.S. population. Among patients with COPD, roughly half may also suffer from TBM.

Despite the prevalence, treatment options have historically been limited. The traditional surgical repair requires an invasive open procedure that many patients are not healthy enough to undergo due to the significant risk of complications or death.

“For many people with this condition, they’re told to get their affairs in order and that there’s nothing that can be done,” Israel said. 

Robotic-assisted surgery has begun to change that reality. By repairing the airway structure through minimally invasive techniques, surgeons can restore normal breathing in patients who previously had no viable treatment option.

"Patients who undergo successful minimally invasive, robotic-assisted surgical repair often describe the procedure as life-changing,” Israel said. “They report breathing more comfortably, becoming active again, and returning to parts of daily life they had been missing for months or even years. Our work is focused on standardizing and democratizing that approach."

Inside the Innovation

The LM Scaffold System was designed to simplify one of the most technically demanding steps in TBM repair.

Traditional surgical mesh requires surgeons to manually position and suture the material around the trachea, a process that can take up to six hours and requires extensive surgical expertise.

“Our scaffold is designed specifically for this surgery,” Israel said. “It creates a structure that makes suturing the airway much easier.”

The scaffold includes strategically placed openings that allow surgeons to access the airway membrane more directly during robotic surgery. 

By simplifying the suturing process, the LM Scaffold System could significantly reduce procedure times and expand the number of surgeons capable of performing the repair.

“Right now, only a handful of surgeons in the world can do this procedure,” Israel said. “Our goal is to make it possible for all robotic surgeons to perform the procedure.”

The system is also designed to integrate seamlessly with robotic surgery platforms already widely used in hospitals. 

“The procedure is done robotically today using the da Vinci system,” Israel said. “Our technology works within that robotic ecosystem and makes the surgery much more accessible.”

Progress and Milestones

Lazzaro Medical has spent the past eight years advancing the LM Scaffold System through development and preclinical testing.

The company has raised nearly $8 million to date through convertible notes, SAFE agreements, and non-dilutive grants. Strategic investors include Mayo Clinic, Northwell Health, and Intuitive, while surgeons from Cleveland Clinic serve as key advisors.

Preclinical development has included successful canine and cadaver studies, along with extensive V&V testing. 

With the LM Scaffold System ready for production, the company is preparing to submit its IDE and begin a feasibility study later this year, with Mayo Clinic likely serving as the primary clinical site.

The company is currently raising a small bridge round to complete their feasibility study, followed by a larger Series A raise to support a pivotal clinical trial.

For Israel, the opportunity extends far beyond the company itself.

“We believe there are about four million people in the U.S. alone who could benefit from this surgery,” he said. “This is a massive opportunity to help patients who today have almost no treatment options.”

With the LM Scaffold System preparing to enter human trials for the first time, Lazzaro Medical is approaching a pivotal moment in its development.

“Our product is about to go into humans for the first time,” Israel said. “It’s a huge milestone for the company, and we believe it has the potential to change millions of lives.”