Adam Sachs, founder and CEO of Vicarious Surgical, was captivated by the concept of microscopists operating inside a scientist’s heads as a kid. He said that human beings are not the right size to do surgery on humans. We can create miniature robot avatars of humans but not shrinking them. We can make tiny robotic versions.”
He and his Vicarious Surgical cofounders – Sammy Khalifa, chief technology officer, and Dr. Barry Greene, chief medical officer – have been doing this for the past ten years. They have created an innovative robot that pairs with a VR headset for abdominal surgery. This robot is expected to be available to the market by 2023. The robot’s two arms and the camera can enter the patient’s abdomen through an incision less than one inch. Once there, they can move in all directions. Although it is difficult to reduce a surgical robot’s size, the Vicarious trio hopes this will make abdominal surgery more accessible, safer, more efficient, and less complicated than other options.
While it’s not sci-fi like the movie in which doctors are injected directly into patients” bloodstreams, Vicarious is futuristic enough to attract A-list investors such as Bill Gates, Eric Schmidt, Vinod Khola, and Jerry Yang. It was also awarded the FDA breakthrough designation–the first surgical robot–which makes it eligible to be reviewed in priority.
Paul Hermes, who managedMedtronic’ss robotics program, is now an advisor at Vicarious.” Putting your elbow down within the body cavity is very important and being able to reach back and work towards the abdominal walls is impressive” he says.”Robotic surgery is going to improve,” says Paul Hermes.
Through a merger with DonaldTang’ss SPAC, the company will go public. Becton Dickinson (which makes surgical mesh for hernia repair) will become an investor. The deal, worth $1.1 billion, will raise $115m. It projects $1 billion in annual revenue by 2027.
Sachs, 30, said that”we’re going to the markets where existing surgery robots have struggled” Sachs, 30 says that there are many copycats out to target the incumbent. They all face the same problems. Our architecture is unique.”
Intuitive Surgical has been the dominant force in robotic surgery since it introduced the da Vinci robot, a four-armed robot with sticklike instruments. IntuitiveSurgical’ss market capital is $115 million. J&J, Medtronic, and others are trying to make robotic surgery the norm. The expected price of the Vicarious robot is approximately $1.2million, about half the cost of existing topline robotics. This could also be a factor.
Sachs started his machine design education at home in Boston. His father, Ely Sachs, is a professor at MIT of mechanical engineering and is known as the”elder statesman” of 3-D printing. Sachs” mother is an architect. Khalifa (31) was his freshman year of engineering at MIT. They became fast friends, and they spent their spare time working in the school’s machine shop to make actuators. These mechanical components power the joints of a robot. Sachs states, “We’d try them, we’d discover they didn’t function, and so we’d repeat that over and over.”
While Sachs, Khalifa, and Khalifa were still attending college, they began to work with Greene, a bariatric doctor and friend ofSachs’ss family, on a medical device that would eventually become the robot. After a brief stint with Apple, Sachs launched Vicarious in 2014 with $400,000 of seed financing led by Michael Rothenberg (the Venture Capitalist later charged with fraud by The Department of Justice). Khalifa joined Vicarious in 2015 after quitting his job.
Sachs stated that the most challenging part was working out the actuators. It was challenging to reduce them down enough to have nine of them, which is three times the number used for surgical robots. The 28 sensors on each arm helped to decouple them so that each joint could be moved independently.
Howie Choset from Carnegie Mellon Robotics compares the technical challenge of packing too many things into one piece of luggage and trying to get those items to do something. Worse, he said, is that the actuators get weaker the smaller they become. He states,” You want to get the most actuation into as tiny a package possible. Still, it’s already challenging to pack as much as possible” It is incredible that Sachs did this” Vicarious’ss first market, hernia surgery, is vast. There are more than 2,000,000 procedures per year in the U.S. for this condition. Ventral hernias along the midline, which is located at the abdomen wall, account for 500,000 systems. They are also highly complicated. Although attaching the mesh to an abdominal wall is a standard procedure, this can cause recurrence up to 20% of the time and require a more complex fix. The advanced technique of tucking mesh against the rectus Abdominis muscle reduces the likelihood of recurrence. It’s time-consuming and can take as long as four hours with robots.
Sachs said that Vicarious had the FDA breakthrough designation and could perform this procedure in less than half the time. Vicarious” robotic arms insert mesh into the ventral hernia and then sew it up. Patients are less likely to experience complications, and hospitals can save money by performing shorter surgeries.
Vicarious plans to expand its reach into other abdominal surgeries such as gallbladder and gallbladder procedures. This would create a potential market for 39 million surgeries. Robotics is only 3% of these. Sachs, whose $112 million stakes is in Vicarious, estimates that it will need just a fraction to build a large business.
Tang, the SPAC investor, stated that”the field has been pretty stagnant oveperiodd of time and there is an accepted wisdom which isn’t accurate” You have to get this into the hands of people to prove it’s possible. It’s not impossible.”