Bruce Lichorowic Presents Galen Robotics at LSI Europe '23

The company is a digital-Surgery-as-a-Service (DSaaS) combining the power of a new microsurgery platform with a system of big data analytics and machine learning to provide advanced surgical assistance in performing delicate or intricate procedures.
Bruce Lichorowic
Bruce Lichorowic
CEO, Galen Robotics



Bruce Lichorowic  0:05  
I'm with Galen Robotics. We're out of Johns Hopkins, I was asked to commercialize a commercial robot coming out of the robotics lab back four years ago. So this comes with 35 patents are already assigned to it. At the same time, we just received our de novo grant 60 days ago. And we just received our first two orders 32 days ago for the robot for Harvard Medical and Johns Hopkins. We have agreements with Stryker j&j and Integra to hold tools that they own. This is my, I'm really proud of this. I mean, we went through hell and gone to get this, but this was a, this was a, this was tough to get this de novo through, we're one of 30, this year that got granted, given the failure rates of first time de novo is is 68%, we consider ourselves fortunate to get this. So what we do, we hold any instrument the surgeon already owns. So what we're doing is providing power steering, to existing tools that are already in the OR. And with that, we can offer a high level of precision, high level of accuracy and stability. And this is really what a lot of the surgeons really want is this, I want to have my tools have power steering or some surgical assist. So when you look at it, what we can do is quickly replace any tool that can attach to a single arm robot. And then from there, we can put a drill, we can do a laser, we can do any type of end effector that that the surgeon already owns. So these things are really quickly done. All surgeon driven. This was not done in a lab. And hopefully there was a technology looking for a solution. This really came from what surgeons were looking for. So this is what it all ends up to be. You take the same tool that doctor asked us here using. And for example, we asked 100 surgeons to touch the red dot. This is basically heartbeat, and tremor. And they'll never say they have heartbeats or they'll say they have a heartbeat will never say a tremor. But you hook up the robot to their tool all of a sudden touch the red dot again and this gives them quickly what they can do that they couldn't do before. Another drill that we have done at Hopkins, especially for the spine surgeons. They practice on raw eggs to carve the top of a raw egg off. Five minutes to do this to carve the egg off. We can do it in 90 seconds with a sensor built and that's a Stryker S1 drill that we're holding there. That's okay. Where do we play? Our indication is ENT laryngology to start it was the easiest to get the things through, we just wanted to get the platform through. And then from this point on every upgrade or anything we do to move the indications is software driven. So we add software to the robot and other tools. So again, this is third hand surgery reduces fatigue. next horizon for us will be neuro. Of course we're out of Hopkins is kind of where neuro started. So what we would hold there are the endoscopes any type of power arrangement, but especially the drill for craniotomy and things like that. So we already have all this in play in our labs in is working. And you can kind of see there's a number of different value props versus the actual indication itself. Next would be the spine we didn't see this coming. Nick, Theodore, he's at Hopkins, he's part of when he was part of Globus when his contract cleared off, at Globus he gave me a call and said there's a huge market out there in the limb neck, the market decompressions, where surgeons by hand, will carve away the bony tissue away from the nerve root. Again, a half a million surgeries in the US alone on this no robotic assist at all. Go back to the egg drill. This is where that egg drill would apply to this particular indication. Then finally, we didn't see this at all was cardiac. Coming from an MIS procedure, holding longer instruments holding endoscope steady. Offering a third hand. We see a lot of cardiac guys that are asking, Can your robot hold our stuff. So before we even did the deal with Hopkins to sign their agreement, I wanted to make sure it wasn't going to run into a bus. And I ran into a bus before in high tech. And that was called Cisco and it was not a pleasant experience. So what I wanted to do was to stay out of Intuitives way or any of the big strategics way I didn't want to go up against any of that. But when you look at the market and you look at robotics in general, where they're not playing is obviously neurosurgery, ENT, cardio and we call it soft spine. Now conventional spine, yes, you got Mainzer you got anything else here for for implant replacements and things like that, and also hip and knee and then you've got Intuitive for lapro. David, I very have done this before. This is my team. So far that we've got my board is Dr. Bob Froelich at a Deutsch, Bob Langer out of Maderna. Tom Crimal out of Stanford where he's now with Sante ventures, Henry Brams, head of Chief of Neurosurgery at Hopkins and Earl from Medtronic. My advisors are Intuitive. We share a dozen patents with them. We have the patents we own with Intuitive. And we have Maurice and Bill and and Nick and Marty. And then my surgical Advisory Board are kind of KOLs of the world. With Hopkins and Stanford and heart and UCSF and all them are represented here. So we didn't expect to get cleared until here. We didn't expect average. We didn't it'd be October. By the time we got fixed. We put our we've put our application in last July. So it was 400. And some odd days is average for de novo. We got clear and we kind of went oh my god, no, no What. So right away, we started to scrambling to figure out what's next. So when you look at all the entire market, it's a huge Tam. I don't like TAM's because they're kind of nebulous. I like more the SAM the actual addressable market, you can go after. When you combine all that that's, that's where it comes in. These are our collaborators, these are the people and surgeons that have helped us laid hands on the robot gave us and gave us input. These are our first installs. This is where we're headed. The first three, already got his order, his orders coming in, or it's coming in or came in. And we're working with Stanford on there. So we're moving right along on that. So where does all this lead? I can. We'll do ENT. First, as I said, neuro and spine. We know how the cost of these robots are we cost about 100k. Now, but we get down to 65,000 per. What's big here is that we're working with a lot of AI with Hopkins and a lot of AI development that's already in play there. For virtual fixtures, the big the big buzzword is digital twin, you take an original CT scan and you impress a digital twin on top of that you make the maneuvering, you put it line it back up, and then you can apply that into the robot in the future and the robot can tell the surgeon were not to go. So we're kind of going in that direction. This is how we would sell it as a service. We see this going on as a service. And this is what gets us through the vacuum at relatively quick course we can do a CapX, there's our financials, how we see this thing ramping, we're kind of controlling our ramp, and they're not to get too crazy. And these are our, our milestones. And these are things that I can go into detail, whoever's interested. So we did our $20 million Series B, with the de novo coming in so quick, Maryland called us up and say congratulations, you know, we moved from San Jose to Baltimore, they offered a $2 million match. On our first two in put together so we are putting together a bridge for B, mostly to buy parts. Now we think we can increase our forecast for next year. So that's what the convertible note is. And then we'll do a 30 probably even a bigger Series B next year. So that's the plan. If you look at our space, you know, five of the six have all been a billion dollar plus exits or IPOs. Our comp is Prosep. So we kind of know where pro step was when they came in. So we're kind of lining up with them. We share a board member with Tom combo with them. And then you can also see how it would look on the return and ROI on this. That's it. Thank you very much

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