The Memo: Spiro Robotics Pioneering the Future of Tracheal Intubation

More than 30 million OR, ICU, and ED intubations are performed annually in the U.S. alone, and over 6 million are estimated to be difficult. Difficult intubations are often managed poorly, which can result in varying degrees of airway trauma, airway obstruction, hypoxia (lack of oxygen), and even brain damage and death. 

The patients’ injuries further increase with the number of intubation attempts. Hospitals lose over $20B annually due to procedural complications, canceled surgeries, patient readmissions, and lawsuits.

Highly variable operator performance, lack of appropriate equipment, and other human and environmental factors contribute to the problem. There is a clear unmet need for new tracheal intubation technologies that will improve intubation success rate, ease, and speed of the procedure, and will reduce patient trauma.

Spiro Robotics is transforming difficult airway management with Spiro-VISTA™, a groundbreaking technology designed to provide precise intubation control and improve procedural efficiency and safety

Spiro-VISTA™ integrates advanced video technologies in a single handheld device, which is intuitive and easy to use. It provides broad and detailed view of the airway anatomy, allows navigation through complex airways with robotic precision, and enhanced operator support for both routine and high-risk cases.

Origin Story

Spiro Robotics was founded to address the unmet clinical need for a more reliable, precise solution for difficult intubations. The idea took shape during the COVID-19 pandemic when anesthesiologists and critical care providers struggled with airway management in high-risk patients.

Dr. Vladimir Nekhendzy, a professor of anesthesia at Stanford, had long recognized the limitations of traditional intubation methods, particularly in patients with complex airways. 

His experience—combined with the challenges of intubation during the pandemic—drove him to develop a new intubation platform that could integrate cutting-edge airway visualization with precision-controlled flexible endoscopy. 

Drawing from advancements in computer vision and soft robotics, Dr. Nekhendzy set out to create a technology that would make all intubations more predictable and reproducible.

Dimitri Sokolov, an experienced medical device engineer, joined Spiro Robotics early on to help translate this vision into a market-ready solution. Leveraging his background in R&D and commercialization, Sokolov led the development of Spiro-VISTA from concept to initial clinical validation, ensuring that the device met both clinical and regulatory requirements.  

“I was introduced to the idea in October 2020,” Sokolov recalled. “I had a three-month-old baby at the time, so I wasn’t ready to commit full-time. But I was fascinated by the potential of this technology and started helping part-time.” By March 2021, Sokolov had joined the company full-time, driving the development of Spiro Robotics’ flagship device from early concept to initial clinical trial.

The Current Landscape

Tracheal intubation is a high-risk, high-stakes procedure requiring advanced techniques and specialized expertise.

“When an airway is difficult, failure rates can reach as high as 42% in high-risk patient populations,” Sokolov explained. “Major complications leading to severe hypoxia, brain damage, and even death continue to happen when intubation is delayed or unsuccessful.”

Difficult airways are more common in patients with obesity, obstructive sleep apnea, head and neck cancers, patients with limited cervical spine mobility, and other patient populations presenting for elective surgery. Additionally, emergency intubations in the ICU and emergency department settings are particularly prone to failure. Current techniques rely on direct or video laryngoscopy, but these methods often fail in the most challenging cases, leading to prolonged attempts and increased complications.

Spiro Robotics aims to eliminate the variability and risks associated with difficult intubations by developing a technology-enabled approach designed to enhance accuracy, consistency, and safety.

Inside the Innovation

Spiro Robotics’ Spiro-VISTA is a handheld device designed to simplify and improve intubation, even in the most challenging cases.

“Our goal is to make all intubations easy,” said Sokolov. The system is designed to provide:

• Dual-camera full airway visualization, for airway assessment.with real-time feedback to the operator.
• A servo-controlled flexible endoscope for precise airway maneuverability allowing to navigate complex patient anatomy.
• A predictable, reproducible solution that aims to reduce costs.
• A disposable system to reduce the risk of cross-contamination and facilitate ease of use.

Designed as a scalable platform, Spiro-VISTA™ also has the potential to incorporate future advancements in computer-assisted guidance and precision targeting for difficult tracheal intubations.

In our recently concluded clinical study, the expected intubation failure and complicate rates using standard video laryngoscopy were 20-33% and 12% respectively” said Sokolov. “With Spiro-VISTA™, we have had zero failures and zero complications—and the doctors wanted to keep using it.”

Progress and Milestones

Spiro Robotics is advancing toward commercialization, thanks to its ability to attract top talent from Silicon Valley to its team.

The company successfully completed its first-in-human clinical study of 30 patients with highly complex airways in Lithuania, achieving a 100% success rate without adverse effects or complications. “The response from clinicians was overwhelming—many asked if they could keep the device,” Sokolov explained.

Spiro Robotics is advancing toward commercialization thanks to their ability to recruit highly talented people in Silicon Valley to be part of their team. The company is preparing for its FDA submission in Q3 2025, with the goal of obtaining regulatory clearance by Q4 2025 and launching a limited commercial rollout in early 2026. With $9 million raised to date, Spiro Robotics is now raising a $15 to $20 million Series A round to support regulatory clearance and early commercialization efforts.

“We have several smaller investors lined up but are seeking a lead investor in the $5-15 million range,” Sokolov shared. “LSI USA will be an important venue for connecting with potential partners as we move into this next phase.”

With a growing clinical foundation, growing investor interest, and a groundbreaking tracheal intubation solution, Spiro Robotics is poised to redefine airway management and improve patient outcomes worldwide.

Currently, Spiro-VISTA™ is not available in the United States.

Beyond the initial market launch, the company is also exploring strategic collaborations with the U.S. Air Force, which has expressed strong interest in the technology for hospital and patient transport applications.

Join Us at LSI USA ‘25

Sokolov has been selected to present at LSI USA ‘25 this March 17-21 in front of hundreds of global medical technology companies. Join us in welcoming Sokolov to the event in Dana Point, CA, where he will share the latest updates on Spiro Robotics’ technology and development.