Bob Cathcart, AiM Medical Robotics - Studio Interview | LSI Europe ‘22

Transcription

Nick Talamantes  0:00  

Bob, thank you so much for joining me here at LSI Europe.

Bob Cathcart  0:02  

Thank you. Glad to be here.

Nick Talamantes  0:03  

Tell me a little bit about aim medical robotics.

Bob Cathcart  0:06  

Yeah, so AiM AiM, the company was formed about two and a half years ago when we licensed this amazing technology from Worcester Polytechnic Institute, outside of Boston, the inventors of our robotic technology been working on this for the past 10 years, they were funded by the NIH, in the range of $15 million. So tremendous amount of energy and effort has gone into making what we think is a kind of a game changing technology for our initial case, which is neurosurgery, but other platform areas as well

Nick Talamantes  0:40  

Tell me why is it game changing?

Bob Cathcart  0:42  

Well, for years, physicians have told researchers and others, hey, could you get to help us get into the EMR? Can you help us use MRI as our imaging modality for our procedures? It's better on soft tissue for sure. So seeing things in the brain, it's, it's the, it's the imaging of choice, of imaging modality of choice. It's also safer if you're if you're using CT or giving ionizing radiation to the patient, and to the surgeon, which is not good for either. But the MR is a difficult space to work in, because it's a giant magnet, essentially. So they said, Can you build something that will help us operate in them or MR space, and that's what we're doing with our robot. So our researchers are the inventor of the technology has been able to build a robot, essentially, that can work in the MRI space. So you think, well, robots are big, they're made of metal, and all those kinds of things. And that's not the case at all, he's been able to figure out how to build a small compact robot that can fit in the MRI scanner with the patient, and allow them to use an excellent imaging modality of the MR

Nick Talamantes  1:50  

Your robot works with MRI to provide real time visualization of the brain. 

Bob Cathcart  1:56  

Absolutely. 

Nick Talamantes  1:56  

What else can I do?

Bob Cathcart  1:59  

Well, so if you think about a patient in the MRI scanner, if you've ever been in an MRI, it's a big tube. So the physician is not going to be they're trying to reach in to treat that patient to manipulate instruments. So our second generation will, robot will be able to manipulate instruments for the physician at the command of the hands of the physician while the patient is in the MRI scanner. So that procedure can be done more accurately, with a higher level of precision driven by the robot, and faster, more efficiently, so that the surgeon ultimately will have that control, we'll be looking at images from the MR can sale, and then tell that robot exactly what to do, and how to do it safely. So we think there's this huge benefit not only for the patient be able to treat these patients better, but also in terms of the health economics of the procedure to do it faster, more efficiently, turn those rooms over and be able to treat more patients.

Nick Talamantes  2:57  

Real Time MRI is sort of the holy grail of neurosurgery. But there are a lot of challenges involved with it. As you said, mentioned, the giant magnet is a starter, how have you guys addressed those challenges and solve them?

Bob Cathcart  3:10  

Yeah, so it's really kind of the secret sauce of what we do. So they're the what what our researchers have found out that you have to use particular types of motors that are unique for that MR environment, you using particular types of materials, so non metallic materials, you also want to be able to create electrical systems that have very low level noises and in protected and shielded, you want to be able to do that in a way so that you can have this entire unit in that MR Field and not interact with, with the imaging and after a lot of years and NIH money our team has been able to figure that out. Where others haven't.

Nick Talamantes  3:48  

Why don't you tell me a bit about the sort of initial indications or procedures you're going to be implementing this technology and in the neuro suite?

Bob Cathcart  3:57  

Yeah, sure. So there's really two main indications for for neurosurgery, the one is the placement of electrodes for deep brain stimulation. So patients that have Parkinson's disease disease, where their drugs they become resistant to their drugs, and so their their symptoms are getting worse and worse. And so they'll become candidates for surgery. And so electrodes are placed deep in the brain, and that helps to control their their tremors and other aspects of the disease. But again, they're doing they're placing those electrodes very deep in the brain. They're trying to get to that spot without causing any other trauma. So they're doing that through very fine holes, that they're drilling in the skull and then advancing instruments. So our ability to help them place those electrodes exactly where they need to be in the brain, without them interfering or damaging healthy tissue is one of our big indications. And today, there's a fairly significant number of patients who have go for that treatment and and the leads are misplaced there. they're in the wrong location and all they have to miss by half a centimeter or so and the treatment isn't working. So we want to make sure they hit those targets the first time, every time and doing that under Mr. guidances is the best way to do that. The other is for brain cancer. So there are certain brain cancers that where if the brain the cancer hasn't spread widely throughout the brain, and you have smaller lesions or smaller tumors, there's an opportunity to go in and ablate or kill those tumors with with some type of energy source. And so the ability to very accurately not only locate that tumor, but when you destroy the tumor, you want to make sure you're only destroying the tumor tissue, and you're not hurting the healthy tissue on the margins. And again, you're talking about millimeters, and even sub millimeters of accuracy to do that, and doing that under MR guidances that people say is the best way to do it. And that's where we're trying to help search our surgeons to

Nick Talamantes  6:00  

So your real time guidance, a GPS for the brain. Is there a Navigation component to your technology as well? Yeah, sure.

So you have this, the procedure li the the physician will take a preoperative scan, it might be a CT or an MRI. And they'll use that scan to map out or create a map to initiate the procedure. But once they're in the MR, they can update that map, just like Waze does today in your car, or Google Maps does in your car. So if there are changes that have occurred inside the brain, the EMR can pick that up. So there's the constant communication between the MR scanner, the planning, navigation software, and then the robots. So think of it as kind of a closed loop, constant updating of the information that the MR is able to provide, and then be able to enter in a physician being able to appreciate changes that have occurred and then instructing the robot to move and reposition itself accordingly. So constant constant, closed loop feedback is a key element of what we're trying to do.

Yeah, it's my understanding that there are a disparate number of different technologies being used to image navigate, and then advanced treatment in the brain. And you guys are combining it all into one solution. 

Bob Cathcart  7:20  

That's, uh, you've said it better than I do. It's a great way to think about it. And I worked for a company called Hanson medical. And we were doing robotics where we were helping surgeons and interventional cardiologists, and radiologists, drive catheters in the bloodstream. So they insert a catheter in the groin, and they'd run it all the way up in to the brain are down the leg for procedures and things. The robot was a spectacular piece of equipment could do amazing things with catheters, but it was 170 pounds. And it was fixed to the side of the operating room table. It got in the way the nurses didn't like us hospital administrators didn't like us. So when I saw this equipment, our robot which is very small, very lightweight, it has to fit inside the bore of an MR scanner, we said let's make that portable. So it can move from the MR here one day to the operating room here the next day. And I think the end users, physicians, nursing staff will appreciate but hospital administrators really appreciate it. Because they'll get a bigger return on investment from the purchase of a single robot that can move into different different environments within the hospital. 

Nick Talamantes  8:32  

That's amazing. I want to talk about what sort of next after neurosurgery but before we do that, tell me a little bit about the market opportunity for your initial indications.

Bob Cathcart  8:42  

Yeah, so there's, again, the biggest indications we're going for right now are for brain tumor biopsies. So finding the tumor, identifying the tumor, and then the bleeding the tumor, as well as deep brain stimulation. If you combine those numbers, both in the US and around the world, there's probably in the range of 300,000 particular procedures. And there are other procedures that we've heard our physicians or nurses and physicians talking about. Some of the kind of cutting edge work going on today revolves around the implant of stem cells and gene therapy and cellular therapies that they're directing, again, through these small burr hole incisions directly in the brain, those are those types of therapies are in phase two and phase three clinical studies. But they want to do that all under Mr. guidance as well, because they want to see where those where those cells are going to in the brain as they place them. So there are are this kind of ongoing market and procedures but we see this as an enabling technology for for more advanced on new procedures that happening in the neurosurgery space.

Nick Talamantes  9:47  

So let's talk the next couple of years after you guys have tackled deep brain stimulation and brain cancer, no small, you know, challenge there, are you going to stick to neurosurgery are there other Are neurosurgery indications you're exploring considering?

Bob Cathcart  10:03  

Well, I think that the the the MR capability, that visualization, what you get out of the imaging of the MRs is is where we're focused today. And we'll be able to capture a good bit of that market, we get interest from lots of folks for going outside of neurosurgery. And my board likes to tell me to stay focused on neurosurgery. Don't listen to those people yet. But it's clear there are opportunities like prostate, the treatment of prostate, which is where a lot of this work initiated, because again, it's a very small target, it moves around, it's hard to get to using the say ultrasound as an as an image guidance modality. So prostate is an application, doing biopsies for liver and kidney cancer and then ablating those cancers is another space that that we have interest in. And whether we take that on ourselves, or we eventually partner with somebody in that space that could get help us advance that technology. We certainly have our eyes on that we think this can be once we've proven it in brain surgery that this can be a platform device for for other other areas of therapy. And when people see that you can do it in the MR. We think there'll be a lot of interest from moving other procedures there.

Nick Talamantes  11:22  

Tell me a little bit about what stage you guys are at right now. Are you clinical are you doing in human testing?

Bob Cathcart  11:30  

Yeah, so we've we've the I mentioned earlier, though, how the inventors had raised or had been granted over 15 million those dollars of NIH grants, they were able to build prototypes in the academic environment that have actually been used on humans, there was a 30 patient IRB study done at the Brigham and Women's Hospital in Boston for prostate. The inventors have also had two NCI sponsored animal studies for brain for blading brain tissue that they've done. So those prototypes have been used in that clinical environment. We are we are essentially taking those prototypes and reconfiguring rebuilding them under design control, and all the guidance that the FDA provides us and building them out for commercial use. So we have we have built our first prototype of the commercial system. And we're essentially doing our benchtop testing with that right now. We will continue to advance that design. And we'll probably be doing animal studies with that the next year,

Nick Talamantes  12:33  

The support of the NIH sounds like has helped you guys a lot. But are you currently seeking additional fundraising?

Bob Cathcart  12:40  

Yeah. So we're here at this great meeting, thanks to the folks that LSI and we're, we've raised about three and a half million dollars in a seed round, which we closed at the end of 2021. And we're right now we're looking to raise another $15 million in our A round. So we've been meeting with venture capital firms here, and there are lots of folks already that are well aware of what we're doing the LSI meetings have been a great avenue for us to, to get the word out. And we enjoy coming and being a part of it. And it's been it's been a great experience for us.

Nick Talamantes  13:11  

Could you talk a little bit about sort of the territorial or regional strategy? Where do you guys see yourselves first going to market? 

Bob Cathcart  13:18  

Yeah, so we'll essentially be probably first in the United States, but we clearly want to be in in Europe as well. So our testing process are everything that we do will be kind of a parallel path of trying to get into the US and and into Europe as well.

Nick Talamantes  13:37  

That's great, 

Bob Cathcart  13:38  

Depending upon the FDA and what they asked us to do. If we need to do clinical trials for the FDA, we will certainly do them there's some indication that we might not have to based on other predicate devices that are in the market today. But as soon as we have a system available that can be used in humans will be will be testing that somewhere around the world.

Nick Talamantes  14:01  

It's safe to say that you have a truly disruptive technology and Bob I want to thank you so much for coming by and talking to me a bit about it.

Bob Cathcart  14:07  

I appreciate it. Appreciate the opportunity to do that. And again very much enjoy what you guys do at LSI.

Nick Talamantes 14:12

Thank you