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Kurt Azarbarzin Presents EndoQuest Robotics at LSI USA ‘23

EndoQuest Robotics is developing the Endoluminal Surgical (ELS) system, a flexible endoluminal robotic surgical system.
Kurt Azarbarzin
Kurt Azarbarzin
CEO, EndoQuest Robotics


Kurt Azarbarzin  0:05  

Good morning. My name is Kurt Azarbarzin and I'm the CEO of EndoQuest Robotics. I've been fortunate enough to be part of the surgery and middle invasive surgery space for the last 40 years. I know I don't look at I started when I was 10 maybe. But, you know, saying all that I was always asking myself what if, as an engineer, and open surgery was an amazing innovation, but there's issues with open surgery. So I was fortunate enough to be part of the stapling surgical stapling platform that was developed by US Surgical in the early 80s. Laparoscopy came around again, I was very fortunate to be part of that in late 80s and early 90s developed a lot of instrumentation to allow laparoscopic surgery to happen. People don't realize that without industry, these procedures wouldn't be happening. We were there with surgeons Hand in Hand figuring out how we do a laparoscopic close discectomy. So again, very fortunate in the last 15 years, I've been part of the robotic evolution my company Sergi quest, build their business on robotics get 95% of our revenue $50 million in revenue in 40 countries was based on robotic surgery, we sold that technology to Conmed. But then I became the CEO of VIRB Robotics, which was a joint venture between Johnson and Johnson and Google a dream job, having two giants coming together to develop a platform. And we sold that JV to Johnson and Johnson. And then I became the CEO of an awesome company called and EndoQuest Robotics, which is focused on endoluminal robotics. So continuing on the what if question on all of our minds that have been part of this endeavor is what if you didn't have to make incisions? What if you could do surgery through natural orifices, and I believe me if if this audience was full of surgeons, every one of them would be asking that question, because that is a dream of ours go with the diseases without an incision treated early, effectively with lessons less invasiveness, allow the surgeons to go home for patients to go home fasters and just improve quality outcomes. So I put this slide on because it's very rare, where you see these type of improvements in all categories. There's no questions, patients would benefit from not having a scar, there's no question that physicians would rather have a procedure that only takes a third of the time, a much less invasive, and edge and much more effective. From the provider and trade payer standpoint. When was the last time you would have all the pieces of the equation come together from a standpoint of faster recovery, faster procedure, better outcomes? So we really are excited about this dream of mine. And what if and I hope I don't have to ask that question anymore. Because I think this is final What if answered for me. What is EndoQuest Robotic, it is a robot you're gonna see a lot of people come today and yesterday and talk about robots. To me, my in my eyes robot is something like an intuitive, you have a physician console, you have a patient card or a robot, and then you have a tower. We make these devices ourselves. As a matter of fact, what you see here is our second generation product, which is going to be used for clinical study. We make it in Boston, we have three facilities, one in Boston, one in Houston and a large facility in South Korea. And, and truly, what I would say is that it is enabling that word enabling is used a lot in our in our space. To me, enabling is allowing for you to do something you weren't able to do before. So we do this through what we call an over tube. So you first insert the over tube inside, in trans trans generally a trans orally trans vaginally, and then once you get to the lesion, then you you dock that on the robot. And then from there, you have instrumentation that will be inserted with a camera that's flexible. So all the dimensions are there. It's very, you know, I would say the small footprint from standpoint of size. From a market standpoint, sky's the limit. There's not a single time where I've come down a podium conversation or presentation and different surgeons from different specialties would approach me and say, Well, can I use it in thoracic space between the ribs? You know, Can I can I use it in urology, doing bladder, you know, going doing prostate through bladder? I mean, you can imagine the minds are going crazy when they can finally have a platform can allow them to do certain things that they weren't able to do before. We are focused on four areas trans anal trans oral, trans vaginal, and then transit available. For us, those are low hanging fruit. These are things that we're very familiar with, there's an unmet need. And the numbers are out, you know, huge in big, big, big procedural numbers and big, big marketing numbers. So for us, it's just the beginning again, this, I truly believe this platform has no limitation. So we are, we are going to be starting our study beginning of next year. It's a trans anal study with 60 patients with 30 Day follow up. We've done number of patients outside of us with very good data. And our hope is to be able to get a de novo 510 K sometime in 2025. So this is a procedure, we're going to walk you through a video of a procedure of an ESD done simulation of an ESD. But here we get to use the endoluminal robotic system by EndoQuest. The Interquest robotics open physician console contains a graphics user interface or GUI, which provides useful information to the physician during a procedure and the upper left. The over to roll blacks and translation is displayed. On the middle left in the middle right panels, instrument details, position and status or display that includes user feedback information on foot pedals, finger clutches, and hand control devices. And the top part of the lower left we see the video scope, flex and translation. And in the lower left in the lower right, we see a three dimensional representation of the system instruments in space. Right now I have two instruments set up I have a grasper in my left hand and I have a hook in my right hand. And we're going to start out by just identifying a pretend lesion. And what we really want to do is demonstrate some of the features that you know the robotic platform gives us and some of the precision that we can get. With dissection with the robot, go ahead and insert go and push into the tissue keep going and just inject a little bit. It looks like I've got a lift on all sides of the demarcated area. So we'll stick with this go ahead retrack. One of the beautiful things that we can do with two hands is we can really achieve good tension and counter tension here I'm just going to kind of lift upward. The entire goal of the ESD is to get an R zero resection. And this is coming along quite nice. Next thing we're going to do is we're going to get the specimen out putting a rock net through that instrument channel and then I'll pass it to the RAF net and we'll pull it out now this is a needle driver on my left side and the needle driver on my right side is gripping that suture actually quite nicely grips it hard enough that I can really handle the needle quite well. But it's delicate enough that I can handle the mucosal tissue without doing any damage. Now one thing that we've learned with basic surgical technique is that it really is important to get it just right technique matters in here by picking up a suture. So the last piece when you see a suture inside the lumen, and ability to throw a knot and ability to be able to close the lesion that that is like eye opening for any surgeon any specialty, so I just want to make sure you guys had a chance to see it. We talked about a timeline, very detailed robots. Difficult with FDA, the V and V process and all the work you got to do to get it there. It's it's it's probably the hardest thing I've ever done. This is my second time at it. So hopefully we are successful. We planning to do studies in four centers, Harvard Medical School with Chris Thompson, Mayo Clinic, Cleveland Clinic, and are ready to go. Those four sites are already ready to go and we've been well trained. For me, it's about partnerships. We have a relationship at Harvard Medical School, and air CAD in France developing upper GI procedures, which is our next target. You got to start doing that as you're developing your current platform. So that's been really going well. We have robots in both facilities where they're working with us on procedure development. We also signed two agreements recently, one with Veramed with our simulation and training. I believe in robotics. The only way you're going to be successful is through training and simulation, because you do new procedures, you need to train them on a new system, you need to have those tools to be able to be successful, and then Proximie, which will give us the multi purpose digital war as a tool. I couldn't do it without my scientific advisory board. I'm blessed to have the gods of surgery. And as part of it, I don't think was ever been where you have five people with this type of background come together as Scientific Advisory Board and that speaking volumes about what we're doing and why they're so excited about it. Have an amazing team, all with robotic background. I will tell you, if you're running a robotic company, you need to have people that have run robots before without it, you're going to take a lot longer. But I've been blessed to have an amazing team that's been delivering robotic platforms for many years. And then again, we were had nobody else is doing endoluminal surgery, robotically. You know, it is the future of IS. We have amazing technology platform huge market. We have a freedom to operate right to use. IP is king in this space, you know it and we have to make sure that we have that. And then finally, again, when would you have all four stakeholders addressed in any platform? Thank you


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