Jeffery Alvarez, Moon Surgical - Spotlight Interview | LSI Europe ‘23


Jeffery Alvarez

Jeffery Alvarez

Chief Strategy Officer, Moon Surgical
Read Biography
Moon Surgical is developing a surgical robot to assist with laparoscopic surgeries. The system will feature a modular platform, computer vision, and haptics to augment the capabilities of surgeons.



Nick Talamantes  0:16  
I'm here at LSI Euro 23, in Barcelona with Jeffrey Alvarez of Moon surgical. Jeff, thank you so much for joining me in the studio.

Jeffery Alvarez  0:23  
Thanks for having me.

Nick Talamantes  0:24  
What brings you to LSI this year?

Jeffery Alvarez  0:28  
LSI is a fantastic event because it's it's very intimate. There's a lot of authentic connections that are happening at the meeting tables in the hallways, the presentations are always wonderful, all the different companies that are here, and the panels are well constructed. I find a lot of value in coming here and having those exchanges with other entrepreneurs, meeting different investors and of course, other other larger strategics.

Nick Talamantes  0:58  
What are you looking to achieve with these conversations that you're having here at LSI that will help you and what your team is doing it Moon Surgical?

Jeffery Alvarez  1:09  
I think there's two two aspects to that. One is other entrepreneurs, there's, as an entrepreneur, you can feel very alone, there's a lot of uncertainty in your world, you're trying to figure out how to navigate things. And I find having conversations with entrepreneurs and helping to, to figure out the pathway through all these challenges and hurdles ahead, is always very rewarding. I've experienced that myself, and a lot of my own startups that have been a part of, and sharing those experiences is always a wonderful thing. It also helps me reflect on my experiences and say, oh, yeah, that's why we made that decision. And in hindsight, you usually gain a lot from from those those reflections. 

Nick Talamantes  2:02  
I really appreciate that about what these events can do. And I love hearing that from other entrepreneurs. What some advice you can give to some of the other players in this space?

Jeffery Alvarez  2:15  
I think the first is step back and think about what is the problem you're really trying to solve. Are you trying to solve being a competitor to an existing platform that's on the market? Are you trying to solve enabling surgeries that aren't roboticized to be roboticized, or robotic supported? Are you trying to solve enabling a clinician to do a procedure that they've never been able to do before? Make sure that you're stepping back and understanding that problem at the right level so that you're tackling it in the right way. And why I say that is is if you look at the market, that the market the landscape where these procedures are happening overall, in soft tissue surgery, surgery is rapidly changing. Many of these procedures are being pushed to outpatient surgery departments, either hospital based outpatient surgery departments or joint venture ambulatory surgery centers, and making sure that whatever you're designing whatever, you're building, whatever you're selling works in these environments, because they're very different than your big academic hospital institutions. 

Nick Talamantes  3:29  
Absolutely. You know, that's, that's a really interesting point about understanding the job to be done. Yeah, you guys at Moon Surgical are particularly focused on addressing healthcare shortages.

Jeffery Alvarez  3:42  
So the Maestro System does help adjust labor resources in the operating room. We don't think it necessarily gets rid of one and you know, is a robot that replaces a person in the hospital and allows that person to be deployed somewhere else, right? If we think about an operating room, the the assistant that is usually there holding a laparoscope and a retractor which might be holding up let's say a liver, they're there for 40 50 minutes just holding these things so that the surgeon can sit there and kind of operate on the tissues, and it's taxing physically taxing on that person. And it can be very frustrating because it surgeons getting frustrated because the image is wobbly or the camera is not the right spot. So why do you have such a skilled person just holding something in a way that probably reduces the career because it's it's not ergonomic? And so our Maestro System comes in it holds those things in that person's place, but it also allows the surgeon have control of them in a way that's much more improved than the experience that they have today. Now I offsetting that person, it's, it's really interesting because what do they go do, they can go now and prep the next patient for the next surgery, they can go and check on the patient from the last surgery and make sure that they're recovering. okay. These are the things that our healthcare providers should be focused on. Right, not holding stuff in the operating room, they should be making sure patients are okay. And I think that's what Maestro's really enabling.

Nick Talamantes  5:25  
You've also talked before about how Maestro is enabling new types of surgical instruments to be brought in? You know, I believe I heard you mentioned that endoscopic instruments or laparoscopic instruments have to be a certain weight, because you have traditionally somebody holding it. Are you guys at Moon surgical talking to other developers of medtech technologies about maybe developing new instruments that are compatible and made specifically for use with the metro system? Yeah,

Jeffery Alvarez  5:56  
Absolutely. There's a lot of conversations that we've been having with both startups and large players in the industry about what are the possibilities with higher capability instruments, right, that have increased weight, increased form factor, but enable things like hyperspectral imaging or, you know, other unique laparoscopic capabilities. That's one of the benefits of LSI, by the way, is being able to come and have those conversations and in these types of settings. 

Nick Talamantes  6:29  
So coming back to the redistribution of personnel, is there are you guys considering maybe adding additional technologies such as voice control or additional arms to the system that will enable you to free up further resources in the AOR? 

Jeffery Alvarez  6:44  
Yeah, absolutely. Moon Surgical, we have a very fleshed out roadmap of possibilities of things that we can add on to our system. We're very creative and passionate individuals. And we look at these things as excellent possibilities. But we also counterbalance that with, you know, does it compromise are the values that we need to bring to the customer, which is we need to make sure that our system doesn't interrupt the operative workflow. It doesn't disrupt, you know, the training of the system, which needs to be simple and fast. So adding more and more components to our system can add more friction, and we have to be very judicious about which elements we choose to do.

Nick Talamantes  7:39  
Is that largely based on customer feedback, then which elements you may be need to be focusing on?

Jeffery Alvarez  7:44  
Yeah, absolutely. We spent a lot of time in the operating room, watching surgeons, we spent a lot of time talking to surgeons, we even spent a lot of time interacting with all the other stakeholders, right? hospital administrators, nurses, biomed departments, and understanding their perspective and their needs in the value chain. And that allows us to develop a product offering that creates value for each one of these individuals. And that's also very important in today's world.

Nick Talamantes  8:14  
You guys recently closed a fairly large round. How much was it? 

Jeffery Alvarez  8:19  
It was 55 million. 

Nick Talamantes  8:21  
Yeah, that's incredible. On in addition to around back in June of last year, I believe that was 30 million?

Jeffery Alvarez  8:26  
Yeah, 34 million.

Nick Talamantes  8:30  
You guys have been incredibly successful, which is brilliant to see FDA clearance in the last year as well. You've brought on NVIDIA as a shareholder. What has that brought to the maestro platform?

Jeffery Alvarez  8:45  
Yeah, it's an excellent question. We're really excited to have our partnership with Nvidia. They're a wonderful company and have some amazing technology. Through this partnership, we're working with them to spec and develop the hollow skin product line. And this is a very high powered computing system that sits in our device and allows us to do edge computing at an incredible rate. And it powers all of our data computations for AI algorithms. Now, this is really exciting because when you look at the maestro system, it's uniquely positioned in the operating room. It truly is at the heart of the operating room right by the bedside. You know it can see the patient it can see the table it can see the surgeon it can see what's around the surgeon whether you know the lap tower is here, the anesthesia card is there. And we can bring all of that information in and help guide improvements that'll that'll drive efficiency improvements in the operating room. 

Nick Talamantes  9:52  
With this Nvidia AI technology, you're going to be able to reduce the cognitive burden of surgeons in the operating room. Could you talk a little bit more about those advantages. 

Jeffery Alvarez  10:00  
Yeah so I think that's that's part of it, there's a couple aspects. One of the areas that we're really interested in using AI is really outside of the procedure, right? What goes on before the procedure and after, because these are areas where they can be very detrimental to the turnover time of the operating room. And in these facilities that we're looking at, you really need to be fast and efficient, right. These are these are really surgical factories that are looking at six to seven procedures a day. And using AI, we can start to automate a lot of this turnover, right, a lot of the setup of the system are taped down on the system, to start to really speed those things up and help help the operating room get through more procedures. Now inter operatively, we absolutely can look at things that would help that surgeon reduces cognitive burden, but really just give him or her more confidence in what they're doing. Because if we can, if we can not necessarily provide the data for them to make an interpretation, but provide them the insights to say, Yes, I need to proceed with doing this or No, I need to stop. That's what the power of AI really is with our system.

Nick Talamantes  11:17  
Would that tie into all the different force sensing mechanisms that the maestro platform has built into it? Now the AI can go in and say you're approaching this too forcefully. Let's slow down. Let's take it from a different angle.

Jeffery Alvarez  11:28  
Yeah, these are all things that we're exploring, right? Our arms are very high resolution for sensors. And so we understand exactly the forces and motions that are a surgeon is putting on the laparoscopic instruments and ultimately the tissue they're connected to. So one of the most challenging things to learn in surgery is figuring out just how much force you're supposed to be putting on things like the fundus of the gallbladder before kind of rips open. And these are things that we can start to train using our system because we can provide that feedback and say, Hey, so and so surgeon, this is their force profile on when they stop and we can coach that through, you know, the tactile elements of our system.

Nick Talamantes  12:16  
Speaking of Nvidia and strategic partnerships, I am aware that you guys are also working with J&J, another major player in the robotics space. What's that partnership? Like?

Jeffery Alvarez  12:25  
Yeah, JJ is a wonderful company. Obviously, they're, they really know the space. Well, they acquired Oreus and Orris in 2019. You know, they've been focusing and putting a lot of resources into their Altaba program, which is their multiport soft tissue robotic system. And, you know, when when they saw our system, they quickly recognized that it's not necessarily a competitive product, I think, to to these multiport soft tissue systems, but quite in fact, complimentary because it goes after a very different market, in in, you know, operating rooms that these other systems wouldn't necessarily be in.

Nick Talamantes  13:07  
Jeff, thank you so much for joining me in the studio. It's been a pleasure speaking with you. Thanks for having me.

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