The summary of ‘The Next Generation Robotics in Spine with Yossi Bar, CEO and Founder of LEM Surgical’

00:00:00

In this segment, the speaker introduces Yosi Bar, the founder and CEO of LM Surgical. They emphasize the history and significance of robotic spine surgery, mentioning how both Yosi and the speaker worked together at Mazor Robotics, a pioneer in this field. LM Surgical aims to revolutionize spine surgery further, moving beyond incremental improvements. Although currently in stealth mode, LM Surgical plans to reveal more details soon. Additionally, the speaker discusses the importance of effective digital sales strategies and introduces Alpha Sophia, a sales intelligence platform that provides comprehensive data on physicians, which is crucial for targeting early adopters and gaining commercial traction.

00:05:00

In this segment, the discussion focuses on the challenges and developments in the medical device industry, particularly surgical robotics. Yosi Bar, founder and CEO of LM Surgical, shares insights on the state of robotic spine surgery. He differentiates between two main categories of robotic systems: remote manipulators, where the surgeon has full control via a console, and hard tissue robots used in spine and brain surgery that require the robot to operate somewhat independently. He explains the complexities and high entry barriers in the spine surgery market and notes that despite many intelligent players, only a few are commercially active. New entrants, such as Striker with their meos system, highlight ongoing advancements in the field.

00:10:00

In this part of the video, the speakers discuss the current state and limitations of robotic spine surgery, specifically focusing on the use of robots for pedicle screw fixation and placement. They note that while this aspect of robotic assistance has been around for over a decade, it hasn’t significantly evolved beyond this single procedure. Despite this, even small improvements in accuracy (2-3%) in the large number of annual procedures (1.2 million in the US) can benefit thousands of patients. The conversation also highlights the need for further advancements in other aspects of spine surgery, such as interbody procedures, decompression, and osteotomy, for the technology to be fully embraced by surgeons. One speaker shares a personal background, noting an initial study in engineering before switching to philosophy, influencing their perspective on innovation in the field.

00:15:00

In this part of the video, the speaker discusses their journey and experiences in the medical robotics industry, highlighting their previous work with an Israeli robotic company and the challenges faced. They elaborate on the persistent feeling of not having achieved enough and the continuous quest for innovation in the field. The speaker then explains their transition back into the spine robotics industry after meeting intelligent and professional individuals in Switzerland, leading to the founding of LM Surgical three years ago. They touch upon the significance of having good partners and solid funding, which were crucial in establishing LM Surgical. Additionally, the speaker mentions the origin of the company’s name, derived from a novelist known for science fiction and futuristic themes. They also note the impressive accomplishment of raising over $30 million during the challenging market period between 2020 and 2023.

00:20:00

In this part of the video, the speaker discusses strategies for founders seeking to raise money, emphasizing the importance of having good partners who can assist not only with technology but also during the funding phase. The speaker highlights that during the initial year, having founders invest their private money can provide essential early-stage funding. Additionally, the speaker reflects on their own positive experience closing an oversubscribed Round B of funding in challenging times, attributing success to a solid ecosystem of partners and investors. They also share insights about rebranding their product from “Sapien” to “Dynamis” and the significance of operating in stealth mode for IP protection.

00:25:00

In this part of the video, the speaker discusses the upcoming release of a multi-arm robotic system designed for use in surgeries, highlighting its advantages over single-arm systems, especially in complex procedures like spine surgery. The system aims to enhance surgical capabilities and clinical outcomes. The conversation includes analogies to demonstrate the necessity of multi-arm systems, pointing out the difficulty of tying shoelaces with one arm compared to using multiple arms. The discussion then shifts to the potential role of automation in robotic spine surgery, addressing the need for providing substantial evidence of safety and efficacy to gain FDA approval. The speaker emphasizes that automation should aim to add clinical value, using the example of screw placement in spine surgery to illustrate the potential benefits of such technological advancements.

00:30:00

In this part of the video, the discussion revolves around the use of automation in surgical procedures, specifically in spine surgery. It highlights a scenario where a surgeon uses automation to place screws efficiently, reducing time but questioning the clinical value added. The speaker notes that while automation can aid in precision and efficiency, surgery inherently involves variability and cannot be fully automated like industrial processes.

The focus shifts to how augmented tools improve safety and capability for both surgeons and staff, allowing minimally invasive procedures to be performed with reduced risk. However, this brings challenges such as increased radiation exposure and physical strain on surgeons and staff. The speaker emphasizes the importance of enhancing clinical outcomes by integrating technology that supports safer and more efficient surgeries, rather than just automating tasks. The conversation underscores the trade-offs in minimally invasive surgery, aiming for better clinical results but acknowledging the intense physical and mental demands on medical professionals.

00:35:00

In this segment, the speakers discuss the psychology and disposition of early adopters in the robotics surgery field. One speaker emphasizes the importance of minimal intervention in surgeries, advocating for the least invasive procedures to achieve the best outcomes, yet cautions against too minimal interventions that could require revisions. They share a personal anecdote of choosing a minimally invasive surgeon for a family member, highlighting the significance of this mindset. Another speaker underscores the critical role of selecting the right early adopters for new technologies in the market, stressing that even with great technology and a strong team, failure can result from not identifying who the initial adopters will be. Early adopters who see the potential of a technology and assist in its development are essential for successful market adoption. The segment concludes with an acknowledgment of the effort and importance placed on surrounding oneself with experienced and professional supporters.

00:40:00

In this segment of the video, the discussion revolves around the challenges startups face, especially in gaining wide adoption beyond early adopters. The speaker emphasizes that while getting the first 10 users is crucial, sustaining momentum to attract a broader user base is significantly harder. They highlight the importance of finding a balance between catering to early adopters, who are typically more visionary, and achieving commercial acceptance from the general market. The conversation then shifts to the company’s goals for the current year, mentioning a forthcoming new website that will showcase their system more comprehensively. Additionally, the speaker notes a common issue in robotic systems, particularly in spine surgery, regarding their attachment to the table and the importance of improving fixation to enhance system accuracy and reliability.

00:45:00

In this part of the video, the discussion revolves around the complexities and challenges of spine surgery compared to other types of surgeries like brain or orthopedic surgeries. The main points highlighted include the difficulty of maintaining accuracy in spine surgery due to the movement of up to 30 individual fragile vertebrae, which makes it hard for robotic systems to track them effectively. The speaker emphasizes that while robotic systems have been successful in brain surgery by tracking rigid bone structures, spine surgery requires a significantly different approach. Additionally, the diversity in spine surgeries, such as various types of decompressions, fusions, and fixations, necessitates robust and adaptable robotic systems to handle this complexity. The need for improved navigation systems that can cope with the relative motion of vertebrae during spine surgery is also stressed as crucial to avoiding stagnation and enhancing surgical outcomes.

00:50:00

In this part of the video, the participants discuss the use of stationary cameras in medical procedures, emphasizing their implications and limitations. They also talk about the company’s presence at conferences like LSI USA and the importance of establishing relationships with key industry players for market adoption. They clarify that while they are not currently fundraising or presenting at exhibitions, they are focused on meeting important individuals in the field. The segment concludes with the host encouraging listeners to visit the company’s website and stay connected by subscribing and leaving reviews.