Greg Roche, Distalmotion - Making Robotic Surgery More Accessible | LSI USA '24

Greg Roche  0:03  
Good morning, everyone. Great to see everybody. I just told someone in the audience, this is the first meeting. I've been on time to all week. So I'm excited about that 121 days in the role, but it's been fast and furious. And I'm just going to go briefly here in the next nine minutes over where we are, from a distal motion perspective. So you can see empowering robotic surgery with Dexter, what does that mean? You know, I was thinking about this last night, and we had a panel discussion about segmentation of robotics, and right product for right side of care for right procedure. One of the things that I love about Dexter is Dexter has removed the barriers for high volume, low acuity cases that can be done in outpatient surgical centers, but also has the ability to flex upwards into the higher acuity more complex cases as well. And we have a slide on kind of what we've done in Europe. Today, just full disclosure, we do not have FDA approval, as of yet. But we've had CEE for several years. And we can talk about our learnings there. So when you look at the marketplace, what I see is very similar form factors, large form factors that are that are designed around complex cancer complex cases, predominantly in urology and colorectal procedures. And really now we have this influx of of fellows and residents coming out of training now demanding or needing robotics to empower these these procedures. So we're going to talk a lot about how we're going to do that just briefly on the company. I wouldn't call it a startup any longer. We've been around since 2012. You can see first clinical cases in Europe, we're in 2021 in Lausanne, Chavez right next to our headquarters. We're seeing Mark for urology, gynecology and general surgery. And we'll we'll pursue that also in the United States. We had our first installation in 2022, although I would tell you that wasn't our launch. If anyone knows robotics, there's a period of time where you have what I would call technical development. So fast iteration to ensure software is in the right place. So we spent about a year doing that we also spent a year doing clinical development. So port placement, where do things go, and we'll talk about some of the learnings there. I actually included last night that I joined as one of the key milestones, but that's not true. What is true is 1000 cases so far, in Europe, the slides a little dated across 3035 different types of procedures. So we really are finding out where we can win in proving out that motto and getting ready for our US launch. And then the last thing we talked about yesterday, we've had the ability to say no to a lot of things. So this platform is open. You can use your own visualization, your own stapling your own advanced energy, we decided to focus clearly on the robot and making something complex, very, very simple to integrate into use and to train on. And example this is we just partnered with proximity for telepresence data infrastructure, cloud based services. And frankly, we believe we can use these types of technologies to go from a high touch model, which exists in robot robotics today, you know, a rep or clinical rep almost in every room, to starting to virtualize some of this, these protocols as well, and allowing for us to do more with less. So here's the system, you know, our key marketing themes underneath empowering robotics, accessibility, simplicity, and excellence. And I'll go through a little bit of this with a few videos. So small form factor, and I would put us in a unique category. So I think all of those that have trailed the market leader have have matched the form factor, it might it might be single chassis and might have a modular design, but at the end of the day, there's very limited access to the patient, the surgeons in a non sterile environment. This this is very small, very modular, you can see we believe it can be used in outpatient ASC environment, and minor procedure rooms. Again, very nimble, very flexible. I always use the example when I was putting the simulator in my office in Cleveland, I took it off the truck, I was able to maneuver it into a standard doorframe. So that just tells you how easy it is to move around. Or integration. The way that I describe this and just my experience with other technologies. This integrates into the workflow of the surgeon rather than the surgeon trying to integrate into the workflow of the robot. So a lot of the same laparoscopic principles apply relative to port placement and how you integrate. And we think again, from a learning and education perspective, and most importantly, an adoption perspective that's essential for technology to be successful. And then obviously, we've talked a lot about economics. I think when you when you think about The high acuity robots again, they're trying to master a lot of different disciplines and they have incredible feature sets. But that really is a limiter when you start to, in an economic format, try to get them, you know, able to be used for the inguinal hernia as the hysterectomy is, it's more of an anvil verb, you know, for a nail type of strategy. And we think we unlock that, you know, to enable and empower people to use physicians to use a robot on these procedures that they're desperately looking to do. So you can see here, this is the console, it's open, the surgeon is scrubbed in, that actually can go up and down. So if you think of a standing desk, the surgeon can sit or stand doing the surgery. So we've focused a lot on economics, that's the the two, the two pieces in the middle here, you'll see the surgeon console being wheeled in, and how small it is the arms are actually inverted. So if you think about a lot of the designs, that that don't come from a single chassis, the arms are actually out like this taking up a lot of real estate, you can see how much how much patient access kind of below the belly line there that you have with this system. So simple. Again, I'm going to keep repeating this but incredibly difficult to make something this complex this simple. We believe from an adoption perspective, a utilization perspective, you know, when you're onboarding, this is very, very easy to do. Again, the other thing that we've seen from a training perspective is a surgeon can lean on laparoscopic principles early in the beginning. And as they get comfortable, they can do the surgery fully robotically. So they always have the ability to go back and do something they're comfortable with until until they master the system. And then one thing that's also unique for us and again, I think very important is we talked to the presentation just before, I learned a lot about logistics of outpatient, ASC. And it's very difficult, especially when you have multiple sets of instruments trying to maneuver there, we have we have a single use instruments that we only have five instruments, we believe we can do every surgery with those five complemented by you know, a best in class energy device or stapler. And again, just a quick video showing kind of ease of use here, this is just you know, getting set up for the surgery, docking, simple, simple docking procedure. And in often running in under three minutes. And you can see from a port placement perspective, incredibly easy. The arms go down using the simple button interface after you align with that, that magnetic trocar. And you see them inserting the instruments and off they go. So excellence, you know, Dexter, obviously, that it's rooted in dexterity, so we're still giving the benefit of wristed instruments, you know, focused on you know, really a deep rooted Swiss engineering. So this this really was, we we spent a lot of time focusing on what we thought was really important and what we could master the sterile console. Again, I think there's multiple multiple advantages from teaching and education and fellowship or residency programs, but also just having direct access to the patient, open platform, you don't have to give up what you've already invested in. So again, preferred stapling device preferred energy device preferred visualization system, you can use all of those. And then we're going to really, I think, try to challenge the status quo relative to training and virtualize a lot of that. And in fact, when we do installations, we send in a simulator did do accreditation with the console that they purchased. And off they go. So this is, to me the proof point, this is what we've done in the EU. And you can see we've done over 30 plus different types of procedures, we feel very confident with what we can do with the system. And like I said, it's made to empower lower acuity cases, but also do the complex. We just did a seven hour Whipple a couple of weeks ago. So it definitely can do high acuity, but that's not our focus. And that is it. So you know, again, I think, for me, just the message here would be I think it's time for segmentation in the marketplace, right technology for right procedure, right site of care. And I appreciate all your time. Thank you very much.