Todd Usen, Activ Surgical - Pioneering Digital Surgery Imaging | LSI Europe '22

Transcription

Todd Usen  0:06  

Imagine you're your mom, your daughter, your sister, has a serious surgery coming up. You know, you have a couple of months before you have to set this up. So you've scoured the earth, in the United States, at least we scour the United States and in Europe will scour Europe to find the best physicians to do this procedure, you find the world class leading physician that's done 5000 of these procedures that you need. All set, you meet with the physician, they meet with your mom, your spouse, your loved one, whoever that is, it's getting surgery. And you're all set to go. Night Before surgery, you get a call from the doctor says, everything's great. Look, your mom will be set tomorrow in the operating room. We're ready to go. But I won't be there because I just caught COVID. But I have a wonderful fellow that I've been training that is ready, and I think they're ready to jump up there and do this first case of their career on your mom. How you feeling? Why should it be that because I've done 5000 cases. And another doctor that's done 200 cases 100 cases one case doesn't have the same information. Why does a 17 year old driver have a rear view camera and a sideview? mirror that to keep the lets you know someone's in a blind spot just like a 50 year old driver does? Why does your seat vibrate when you leave the lane so you can get back in. But in surgery, it's all intuition and how long you've been practicing? Well, that's what Activ Surgical is about. We want to provide intelligent information to doctors across the world to democratize surgery. Dr. Peter Kim, the second person on this list founded the technology and our company. In 2016, he completed the world's first fully autonomous robotic procedure of soft tissue. Now we're not building robots. But this was this led to a company and I was brought in. I'm not a traditional startup. I'm not a founder. I'm not this young, brilliant engineer. I'm neither young, brilliant nor an engineer. I was brought in coming from big company, I had the pleasure of being the president of Olympus, and all the medical divisions. Before that I was the president Smith and Nephew in all of orthopedics. And I cut my teeth in Boston Scientific my last role I lead the United States in our neurovascular business. So I was brought brought up in big companies and understood I think how to commercialize and take a technology. But because you can bring in a world class team and I always start any presentation with team, people are always first and we'll get to technology second. But having a team of people that understand the medical landscape, understanding this work that Dr. Kim had started, but then our CTO Tom Caleb has continued with his team, and allowing physicians to get the information that they need, whenever they need it in real time. Here's why I came the third leading cause of death in the world. Our preventable medical errors are the third leading cause of death in the world of preventable medical errors. 26% of those are preventable surgical errors. That means a patient's going to the operating room. They might be getting their gallbladder out there might have an appendectomy they might be having a colon procedure and esophagus procedure. They're not terminal. They weren't terminal, yet, anywhere from five to 22% of these patients are coming back because of complications of situational awareness, things that weren't available to the physician or the physician couldn't see not because they're not good enough or weren't trained well enough, but because they couldn't see certain things. So there's a real problem here. What's the answer? Set of building a robot? The thought was if I was going to build a robot I can I need to raise a couple billion dollars. And my hope is maybe I get a couple percentage market share points in a few years, maybe 10. Why don't I look at 94% of the minimally invasive world are still done laparoscopically and 6% are done robotically. And we're robot fans. By the way. I want a technology that works on all scopes aren't the scopes, lapper scopes, and robots to make sure physicians can do the cases they need to with intelligent information. And with the press of a button, they can see things that I'll share with you in one second, such as blood flow perfusion, key critical structures, veins versus artery and get continual data and AI back to their screens in real time. So these physicians can identify things like when I leave my lane, when I'm driving instead of my seat vibrating, we'll tell you. Today, first principle of surgery is knowing where blood flow is. Anything that ends in the word ectomy, this is as clinical as I get. We're cutting something out, we're selling it back together. number one cause of readmission is an asymptotic leak because that's an as the most when you're so two parts together, the number one cause of an anastomotic leak isn't adequate blood flow. Today, or for the last 70 years, they've been using a technology on the left, called ICG. Great, you inject dye, wherever this flow the dye will attach itself to. And then we bring in capital equipment, we visualize any area, this area, and anywhere that it's green, there's blood flow. But if you notice, we've clamped the vessel in this particular case, but magically, it's still green. Because what the cameras are all seeing is the dye it's not seeing blood flow. So we've stopped the bleeding in this particular case yet to the physician, it's fully still bleeding. But doctors know this, we didn't come out with trying to teach doctors to not use ICG, we believe in ICG two. But with active site, when you clamp the vessel, you'll know exactly this is an overlay view and I'm going to show you a contrast view, you can see the color difference, you know exactly where the blood flow is happening. Now watch when we release the clamp in real time, you'll see in real time blood flow come right back. That is after you saw a vessel back together. And you want to know if there's adequate blood flow and you're not still looking at the remnants from the previous ICG injection before you cut, you're going to see this. That's one. Second is we want to make sure our doctors know exactly where they are. And we can identify key critical structure at all times. So while they're doing the procedure, this one in the picture in picture happens to be a contrast view. We are letting the physicians know where there's adequate blood flow where there's not where there's a potential anass demotic leak, where there's key critical structure, etc, etc. And the physician always is grounded understanding where they are because they have their laparoscopic view. They have their contrast view and they can switch back and forth. They have an overlay view, which is another picture that I showed as well, it's up to the physician, we want them to know all the time exactly where they are. We want to be the ways of surgery, there's an accident up ahead, there's traffic up ahead go a different way, there's a landmine up ahead that you want to avoid. You don't want to hit this vessel, we're going to tell you where that vessel is, whether you're a fellow that's done one case, or whether you're a senior surgeon that's done 100 cases, 500 cases, 5000 cases. Today, Activ Surgical, we're FDA cleared, we're in our commercial limited market release, I'm not here to raise money, which is which is nice. The technology is is being launched right now in the United States in some of the largest ideas, and I'll share that in a second. And we're starting. As you can see, on the left, we're starting with the laparoscopic and robotic procedures about 40% of our procedures have been robotic procedures and the prostatectomies were identifying the neurovascular bundle or landmark artery so the physicians can stay in the lane, and they can do a prostatectomy without sacrificing the nerves. That's a really important thing that something that they haven't been able to do in the past. At the same time, we're focused on colorectal, working with the thoracic surgeons on esophagectomy. He's working on bariatric surgeons for revision bariatric procedures that have high levels of readmission because of an estimate of leaks. We continue, we have an unmet need, whether it's like I said we're in the in esophagectomy colas, discectomy prostatectomy, right colectomy we're in all these procedures, we can visualize ICG too, with our system. So instead of having to bring in a new system and a new scope and tower, you can visualize ICG with Activ or you can press a button for perfusion and get all the information that you need there as well. Here's the key thing. Every operating room in the world has Stryker, Stuart's, Olympus towers, we walk in and can attach to the mall. We're not selling our capital equipment we're going to walk in, we're going to put ourselves right in your scope, we're going to press a button, you're going to see this information, you go back to using your scope, you're going to get all the information you need from there. Activ site, what I just showed you active insights, the last piece that I'll share with you, every case that we do we collect the identified surgical video goes up to the cloud. It's annotated by surgeons around the world, that annotation comes back to anyone that uses one of these devices attached to their scope. They're going to continually get a loop of continual feedback of information such as critical structure identification, quantification, vein Varus, artery ureter identification, nerve identification, all this information right on the screen for the physicians so they can make intelligent decisions and the proper information. This is the data cycle we're already doing number one, and number four, we get to two and three. That's the data annotation and the work that we're doing and we understand from surgical plan segmentation, and what have we understand the process and surgery so we can provide physicians the information they need on anytime in the operating theater. This is where we are right now. We're at 14 of the largest IDN's in America for simple reason. We want to make sure we get into these hospitals and once we're in the first hospital, we have a license to hunting the rest of those hospitals. Many of them have 40 or 50 systems of 40 or 50 hospitals in their system. I'm gonna move fast because I'm right thing at a time and you get to see that little, little little later. A great partnership. What we're doing today to close out and why Activ Surgical, the med tech industry, medical device companies, the tech industry is companies like Nvidia, who's a Partner of us they just announced Activ Surgical is one of the three companies that they're working with their GTC. They just announced it the other day. Kimberly Powell is their head of healthcare and their CEO, Jensen, if you look it up, and Nvidia, just active surgical as part of their opening his opening keynote speech of what they're doing with medical technology, to do our inferencing models, and working with our systems to make sure that we can get the right information to our doctors, med device, tech, hospitals, all separate, Activ Surgical can hopefully bring them all together into the operating room and we can work together like that. This is who we are. We've been blessed to raise $92 million. So far. We're working, we're commercial, and we're going into our global launch into into Europe next year. We're in the United States right now. I want to thank you for your time and enjoy the rest of the conference.