Dominic Griffiths Presents Alesi Surgical at LSI Europe '23

Alesi Surgical's Ultravision system utilizes the process of electrostatic precipitation to eliminate surgical smoke that accumulates during laparoscopic surgery.
Dominic Griffiths
Dominic Griffiths
CEO, Alesi Surgical


Dominic Griffiths  0:00  
Good morning, everyone. So when we finish this presentation, there will have been over two and a half 1000 surgical procedures performed. That's five every second. And each one requires a surgeon to perform the procedure accurately and efficiently. So imagine this you get a gallbladder infection is very common. You're admitted to hospital to have it removed. The good news is you can have it removed laparoscopically. So through keyhole surgery, the bad news is this is the view your surgeon may have to battle through. Or would you prefer that one? We would. And that's why we created Ultravision. So it lets you search it was created from a leading UK surgical training center with the vision to become a leader in surgical smoke management. Surgical smokers produced by every one of the electrosurgery tools using over 150 million procedures a year. And through our first generation product, we generated clinical data and advocacy and over 40,000 procedures. Through our r&d, we're looking to disrupt larger market segments with a combined $12 billion a year. And as you'd imagined, we're heavily protected by intellectual property. We continue to exploit our IP to the securing additional non dilutive funding. And the reason I'm here like many others, is we're looking to raise growth capital. So from the outset, we were looking to solve four problems. The first I've spoken about the issue of visibility, hence the name Ultravision. The second is the fact that surgical smoke content can contain back bacteria, viruses and chemicals that represent both the short and long term health and safety hazard for our professionals. The third is that is that laparoscopic surgery requires carbon dioxide. Typically our abdomens hold about three liters of this gas, it's dry, it's cold, it's acidic, it's not great for you. But it's not uncommon to have over two 300 liters of this gas continually flush through your abdomen during surgery, hardly minimally invasive. And that contributes to complicated patient outcomes in terms of post surgical recovery time, and post surgical pain. And the final point is that obviously, managing this smoke creates workflow disruptions and inefficiency at a time when healthcare systems around the world can least afford it. So Ultravision solves these problems better than any other products on the market. In terms of visibility, ultra vision clears the smoke from an atmosphere so quickly that you can barely detect it. And what remains is very rapidly eliminated compared to the competition. In terms of smoke management, Ultravision is 23 times better at minimizing the amount of smoke that goes into an operating room during surgery. And also works at particle sizes that are 15 times smaller than the competition down to seven nanometers, which is about the 10th the size of a virus particle. In terms of co2, we're the only technology that can minimize the pressure, the flow and the volume of co2 that patients exposed to. And we have an increased cohort of surgeons who are seeing the benefits for their patients of adopting this co2 sparing approach. And finally, by eliminating these workflow issues, we're able to optimize the efficiency of surgery. So some surgeons estimate that we save over 20 minutes per laparoscopic procedure. So for example, in robotic surgery, cleaning the camera is an absolute pain. And using ultravision largely eliminates this problem. So how does it work? Well, every other technology basically relies on a process of mechanical filtration, where there's smoke containing gases force through a physical filter. These have been described as inefficient, bulky, awkward, cumbersome and noisy. And whilst their use is increasing due to legislation around the world, they're by no means popular. Ultravision, on the other hand, works by process of electrical filtration or electrostatic precipitation. We have a low cost generator, which is attached to the patient via a standard patient return electrode. And that establishes the patient as one side of the electrical circuit. The other side of electrical circuit is introduced via what we call the ion wonder cable. It's an electro which is introduced into the abdomen. So when the generator is switched on, it creates a very continuous flow of low energy, negatively charged gas ions or a cold plasma. This results in the rapid precipitation of the smoke as it's created. It's unique, it's efficient, it's ergonomic, and it's silent. And the result of this is we've been generating strong global clinical advocacy across the largest procedural segments. So we've been focusing on general surgery and Gynecology, and across all elements of the value proposition. This has resulted in five clinical publications, a dozen white papers, all of which attests to the potential of the technology. We've compiled the Medical Advisory Board and sort of key opinion leader input to help drive up our r&d efforts. In addition to this, we've also positioned ourselves at the forefront of driving legislation. We're the only small business that's associated with the ARN Smoke Policy Council in the US. And you can see from this image here in 2018, two states we're legislating in the US for surgery Smoke management, that number is now up to 23. So an 11 fold increase, and obviously COVID has accelerated this, this legislation. So our growth strategy is to disrupt four major surgical categories. You can see here, the value of those combined over $12 billion, and a 1% market share represents around $120 million gain or loss in revenue. You can see the usual suspects in here as the dominant strategics, all of whom have increasingly commoditized portfolios, where a compelling differentiator will help drive a competitive advantage in particularly in contract business with GPOs and IDNs and we believe we can be that differentiator. How are we doing that? Well, what I've shown you so far is the standalone version, the version one, and we've used that to demonstrate regulatory acceptance, product market fit, appropriate pricing, securing adopters, and clinical advocacy, and of course, identifying improvements through our r&d efforts. And the result of that is that the surgeons have demanded greater integration of the technology. And there's two elements to that. One is on the capital side, where the new technology Ultravision Two will be physically communicating with electrosurgical generator in such a way that allows to synchronize, increase and optimize the power delivery to the to the patient. And on the front end, what we're doing is integrating our technology into the tools that perform the procedures themselves. So this is currently with the FDA and fingers crossed in about 30 days we'll be receiving clearance. So in terms of the tools, our first tool is the laparoscopic l hook. It's the most commonly used surgical tool in laparoscopic surgery, we estimate around 5 million procedures a year. And you can see here but the surgeon is able to get all of the benefits of the technology are spoken about. with absolutely no change to his or her clinical practice, there's essentially plug and play. For successful development of this tool has led on to the development of open surgery device where essentially we've mounted our emitters onto the top of a relatively standard diathermy device. There are 10 times more of these used every year. And as you can see from this slide where where liver surgery is being performed, it effectively eliminates the production of the aerosol in use. We've both qualified that quantified it and we're very confident that it addresses both the performance and the ergonomic issues that are hindering the adoption of the competitive devices. So the commercialization of the technology in Smoke has also led to the off label use of our technology in the treatment of metastatic peritoneal cancer. So for those of you don't know metastatic peritoneal cancer is relatively common, occurs in over half of the patients that experienced primary tumors in their abdominal organs each year. And as you can see, it's a dispersed disease, where the treatment frankly is somewhat barbaric. As a result, the outcomes are terrible, worse than lung and liver metastases. And surgeons around the world are increasingly using an aerosol based approach where they have chemotherapy, introduced as an aerosol. And they've been starting to use our technology to help distribute that aerosol within the peritoneal cavity. We now have five clinical papers that we weren't involved in and reporting 440 procedures where the technology has been safely used and proven to be effective. But of course, we can optimize it, it was never delivered for that purpose. And we were lucky enough to secure a two and a half million European grant that's helping to develop an optimized generator, and consumable for this application. So our plans are clear, and we have the team to deliver it, both the operating team also our non execs are experienced in globalizing medtech. And we have supporting investors that all add value to the board. We've raised $25 million so far from five leading European VCs, and our fundraising for $10 million is currently underway. The funds will be used primarily to launch and commercialize our ultravision to technology I presented you today, but also expand the product range. So if like us, you would rather your surgeon had a great view when they're operating whilst protecting the health and safety of their colleagues, optimizing patient outcomes, and also help maximize the efficiency of the AOR we'd love to speak to you. Thank you


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