John Ma, Ronovo Surgical - Spotlight Interview | LSI USA ‘23

Ronovo Surgical is a Shanghai-based surgical robotics company. The company has been in stealth mode since 2019 and plan to unveil their expertise in robotic technologies focused on soft tissue surgery.
John Ma
John Ma
CEO, Ronovo Surgical




Nick Talamantes  0:00  

Hi John, thank you so much for joining me at LSI this year.


John Ma  0:17  

Thank you, my pleasure.


Nick Talamantes  0:18  

why don't you tell me a little bit about Ronovo Surgical,


John Ma  0:21  

Ronovo Surgical was founded about three years ago. And fast forward to today we have 140 employees, almost all based in China, focusing in functions like r&d and clinical. And we have a platform called the Carina, which is a soft tissue surgical robot. And we are advancing very quickly into human clinical trials.


Nick Talamantes  0:44  

Why don't you tell me a little bit about the carina system? It's my understanding it's a modular robot. What does that entail? And how does that maybe compare to what other soft tissue robotic systems are doing today?


John Ma  0:56  

Yeah, that's a good question, because that really goes back to where we found it about three years ago. Because as you know, China's huge market we do about 10 million procedures a year, and with 10,000 hospitals, over 100,000 surgeons, but over the past 16 years, really, that the surgical robotics up to today is only a very tiny fraction of the 10 million procedures about 0.9%. And what's more important is that in two most important specialties, general surgery and the gynecology, the percentage is even lower penetration is very, very low. When you looking deeper into their situation, what you really find is, the current commercially available system is not really perfect for specialties, like a general surgery and gynecology. So what the company was founded is try to broaden the adoption and the penetration in these two specialties. And modular system as we are the first to introduce in China, we believe that this can allow us to penetrate into these two specialties.


Nick Talamantes  2:08  

It's fascinating. So I believe you're referring then to the Da Vinci robot is Da Vinci already in China, is it being used?


John Ma  2:16  

Yes, Da Vinci has been in China for 16 years, the first surgery was performed in 2007. In cardiology, over the years, it has grown tremendously. I was very fortunate to be part of that. And as I mentioned before, that when you look at the clinical feedbacks from the field, which you heard that the most is a surgeon often tells you that when they require multi quadrant access, there's the robotic arms crash very often. And you will find out also very importantly, 90% of the soldier only use three arms are the four. So that makes me wonder how you provide better access of surgical space for the surgeons, when they particularly will be needing, you know, multicultural. And so that's all prompted our initial innovative thinking of being modular, we have more to the VA modular system as well as you know that, that when we developed over the last few years,


Nick Talamantes  3:15  

so you're initially focused on the soft tissue applications, general surgery, what maybe if we look a little further into the future, where can Kareena also be used? Is there any limitations to it?


John Ma  3:28  

I think that most of the surgical robotics, whether it's a soft tissue and hot tissue that they all have, for some come in something in common. They also have different clinical applications. What we initially focus is a very large market, it's about 10 million procedures in soft tissue. Having said that, I think there are many clinical applications we'll have, we'll find that its usage of some of the core of our technology. And right now we're only focusing on soft tissue, which to me, it's a 10 million procedures a year,


Nick Talamantes  4:04  

Right. So you guys have grown very rapidly, I would say for a startup in such a short relatively short period of time. Where are you guys at in terms of bringing Carina to market?


John Ma  4:16  

Sure, we really accelerated processing validated our original design intent. So last year, we performed the 22 animal and the cadaver trials. This year alone that we are you know, in the first quarter we are up to 26. So really, this is picking up a lot of PACE moving towards human clinical trial. So next quarter, we will kick off a human clinical trial in two specialties, which is urology and gynecology.


Nick Talamantes  4:49  

Coming back to the modular design. I'm just intrigued to know a little bit more about it. Does that entail multiple arms? Is that what's making it modular? What's the modular component really all about?


John Ma  5:01  

Yeah, I think, first of all, we have to look at the commercially available system out there in the market. It's a single pedestal design and with multiple arms attached to that, you always have a surgeon Council in, you know, controlling the movement of the robotic arms, you know, sort of remotely and modular design, which means that you will have each cart with a surgical arm, and that they spread around the in the operating table. So, which you can envision it gives a surgeon better access from both sides of the operating table. So again, it's a one arm for each surgical cart.


Nick Talamantes  5:43  

Okay, so do those different carts then have different functionalities? Or do they all kind of have the same capabilities?


John Ma  5:50  

Yeah, that's a very good question. Actually, we are getting to the core of the technology, our purpose is going to standardize the cart, which means that each card can attach to the vision system, or the robotic instrument. So it's a standardization and which also helps us to make a better use. I mean, imagine the hospital will have a standardized the cart. And they can keep inventory that which helps them to make a better use if a when is in need of repair or maintenance. And also it helps us to reduce the overall cost of the capital costs of the system.


Nick Talamantes  6:27  

Another thing I found fascinating about the Carina system is that you guys have your own advanced visualization technology. Correct? Could you tell me a little bit more about that?


John Ma  6:37  

Yeah, I think that the vision system is always a critical part of the surgical robotics, and it helps the surgeon to see better enlarge the view. And to that end, we have two different configurations for the vision system. One is that we can adapt to the existing vision systems, you know, like this vision system used for laparoscopic surgery. And we have our own in house three dimension high definition with ICG capability vision system that we use in the Carina system as well. So really, that configurability will allow us to work with a variety of a choice that the surgeons preference for different procedures


Nick Talamantes  7:21  

is that visualization also adding in other capabilities, such as artificial intelligence, or maybe augmented reality to reduce the cognitive load of what the surgeon has maybe augment their capabilities and expand them beyond what they're traditionally used to?


John Ma  7:38  

Yeah, this is a great direction, because initially, we are focusing on what we call the functional imaging. And what that means is we are seeing more than anatomical information that we are bringing therapeutical information intra operatively. So that that helps the surgeon to make clinical decisions during surgery. ICG is a good example of that. And the two that enter we will continue our efforts into the area that you have just mentioned. Whether this is augmented reality, or VR, there are a number of options available to us. But right now, we are focusing on functional imaging.


Nick Talamantes  8:16  

It's fascinating, I imagine that having this combine this in house imaging capabilities that you're developing, in addition to your own robotics platform makes it a much easier product to accept when you're bringing it in and pitching it to your prospective customers. 


John Ma  8:32  



Nick Talamantes  8:33  

I know that Johnson and Johnson recently shuttered their efforts in the soft tissue space with their verb program. I imagine that is in large part due to the competition from Intuitive and from Medtronic. How are you guys feeling about going toe to toe with these two?


John Ma  8:51  

Oh, I'm not worried about Intuitive Surgical or other companies out there. I think, a different perspective. If I may, first of all I worked at Intuitive Surgical, this is a great company. There are a lot of great people great technology. I have really enjoyed my time there. This is a great learning for me. Make no mistake. But in addition to that, I think this is industry there has been in monopoly for over 20 years. And I just find the tremendous fun to work, the possibility of innovation. And there's more fun to work with the engineers and the clinicians, and the innovation. And I think there's a lot more fun. There's a potential that we can perhaps disrupt that, that monopoly and in the finding value in the hands of surging and the patients.


Nick Talamantes  9:41  

That's exciting. I'm looking forward to you guys entering the market when you guys are ready. What brings you to LSI this year?


John Ma  9:48  

I think, first of all, just this is my first event and I heard that there are a few hundreds of attendees and in the many respectful companies and investment fund I think my first objective is just learning and to make friends to get know people. And also, I think obviously we start out fundraising for this time and like to see if there's an opportunity that there's interesting Ronovo Surgical that I can find the opportunity to introduce the company, the technology on our team.


Nick Talamantes  10:20  

You know, based off of the limited research I've done, I'd say there's a lot of interest and excitement around Ronovo Surgical so I think that this meeting is going to be a fantastic experience for you. 


John Ma  10:29  

I hope so as well. 


Nick Talamantes  10:30  

John, thank you so much for joining me in the studio. Thank you.


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