Carevature | Dennis Farrell, President & CEO

Dennis Farrell  0:00  
Good morning. My name is Dennis Farrell. I'm the president and CEO of Carevature medical. And I'm grateful to be here with you today excited to share with you our development of a first of its kind, spinal decompression robot.

So where's the opportunity here? If we start with the current state of the spinal industry, the industry is hyper-focused on implants, biologic biologics, fusion and reconstruction of the spine, and there's very little to no attention being directed to what brought the patient into clinic in the first place. And how do I treat that pathology in a minimally invasive, predictable, safe and cost efficient manner, we see a tremendous opportunity to digitize and interconnect, what today is a very fragmented and analog process. And the starting point is the spinal anatomy is very, very complex. Unfortunately, as we all age, we form bone spurs. And they tend to form on the underside of healthy bone. And one of the inherent challenges of spine surgery is removing this bone spur that's underneath healthy structural bone. And in fact, this is what really gave birth to the spinal industry as we know it today. You see if you don't need to worry about getting underneath. And if you have no capability to get underneath and safely remove that bone spur, it's okay, you take the healthy stabilizing bone that's in the way, you introduce an instability and you put it all back together again with screws and rods. And this is how the spinal industry was formed. Now, there have been a number of evolutions and improvements in terms of more minimally invasive techniques, and percutaneous implants and smaller surgical corridors. But the fundamental challenge of reaching and removing pathology that's underneath healthy bone, if anything, is more difficult through a smaller surgical corridor.

So I mentioned earlier, this is a fragmented and analog process. And this is how it works. A surgeon typically works off of plain X ray or MRI films to correlate what they see in terms of bone spur pathology, to the patient's symptoms. And in the operating room. That imaging study is literally hung up on a Lightboard. And the surgeon goes back and forth between the lightboard and the anatomy trying to go after that bone spur and remove it without creating too much collateral damage. It's a very challenging process. There are some surgeons are good at this, unfortunately, a lot are not. And therein lies the opportunity. I think this really illustrates it all in terms of the opportunity to build value. The success rates of spine surgery are unacceptably low, they're extremely low, and there are a lot of patients. So in there's a tremendous amount of spend on back and neck pain in the United States. But despite all of the innovations, minimally invasive techniques and so forth, the outcomes have really not changed. And this is where Carevature focus to improve the outcomes, make spine surgery more predictable, reproducible and cost efficient. So what do we mean by interconnecting these various elements of spine care, we'd like to call this spine 3.0. And it's a chaotic platform where the surgeon is using their skills and training through a technological interface to see in real time down to the bottom of the surgeon surgical corridor and be able to

in real time control precision end effectors that remove this pathology that is so difficult to remove. So interconnection means digitally marking the pathology that correlates to the symptoms. This shows up with augmented reality. So enabling technologies. real time visualization on the left hand side, you can see this process of controlling a precision end effector that allows the surgeon to remove that bone spur. So wrapping all this up into a compact surgical cobot that is compatible with the ASC environment and finally solves this issue. Now, what's the key to Cobotics, cobotics is not a new idea. It's a new idea in spine. But DaVinci was the first and surgeons use their skills and training through a console to control precision end effectors. And the absolute key to cobotics is the end effectors themselves you have to design end factors that are capable of removing

pathology in the target anatomy, while preserving healthy structures. This is the Hominis robot from Memic another Israeli startup and Hominis develop these precision end effectors that go through a trans vaginal approach for minimally invasive hysterectomy. And the key is these humanoid like arms allow the surgeon to see in real time, the pathology, remove it and respect the nearby visceral tissue. So the key for a cobotics platform is sorting out the end effector part of it in spine orthopedics, what you need for an end effectors you need high speed and high torque this has been the gating factor to cobotics in our industry, you need high speed and high torque to remove a bone spur. And you need to be able to deliver that around a tightly radius curve to reach underneath healthy structures preserve the stabilizing anatomy while getting to the heart of the issue. And this is the foundation of Carevature's end effector technology, we have FDA clearance on our family of fixed angle, end effectors. These have been used safely and reproducibly in over 2000 cases almost 2500 Now in all regions of the spine and all types of surgery. So this is a massive market 1.1 million patients. And the common denominator is how do you treat this pathology in a minimally disruptive, reproducible, and safe way. And Carevature end effectors will do that. We have a large and growing family of intellectual property. We have 18 issued patents now, with several more on the way for manual application of this cobotics end effector technology as well as navigated and cobotic implementation. High speed and high torque and cobotic application is extensible to several billion dollar markets. This idea of reaching and removing pathology that's outside the line of sight is extensible to reconstructive orthopedics, cranial neurosurgery, ENTt. So we're starting in spine, we're startup but it can be extended.

Where are we from a proof of concept point of view. As I said, we've done almost 2500 cases with the precision end effector technology. We have had 12 labs in the last 11 months with some of the most renowned and well respected spine surgeons from around the world. These are have all been wet labs, where we've been able to prove that real time visualization and search and control can be used to safely and reproducibly perform spinal decompression. If you haven't seen our investor video, which is on the LSI app, if you have any interest in this, I would encourage you to look at that it captures surgeon commentary on the game changing nature of this. The economic forces are real. I mentioned safety, predictability, reproducibility. The cost component of this in today's environment cannot be underestimated the ability to improve these outcomes and do so with preservation of resources in mind. And as we know the growth of IDN and payer provider networks, value based contracts all will make that even more of a tailwind.

We are closed in A round. This was a largely friends and family round. We're here to open our B round, which will be a $14 million round. And we'd love to speak to anyone that has an interest in that this about the proceeds which will be directed to regulatory clearance for the phase one robot integration of these enabling technologies. We have an exceptional team. I'm joined here by Matt Link, who is the former president and evasive serves as our chairman of the board, Yosi Weitzman founded the company. In a recent recruit Yaron Levinson from Memic the Hominis robot we saw earlier, he co developed that he joined the team. So within the four walls we have everything we need to execute this exciting journey. And that includes the external team as well some of the most well renowned surgeons in the field of spine surgery. And again, if you have a chance to see the investor video, these gentlemen share their thoughts. So with that, I'd like to thank you. Happy St. Patrick's Day to my Irish brothers and sisters, and have a great conference.