Paul Mikus, PolarisAR - Mixed Reality for Surgical Planning & Guiding | LSI USA '24

Paul Mikus  0:05  
First, I want to thank LSI for the opportunity to present what a an amazing conference and an amazing opportunity. My name is Paul    Mikus. I'm the co founder and CEO of Polaris AR. And what I want to introduce you to today is our mixed reality surgical guidance technology. refer you to our Safe Harbor slide, but we'll skip that over so we don't have to read it. A little bit about Polaris, we're less than four years old. And in that four year period of time, we've been able to build a team, a technology, a product and get it FDA cleared. And we've done it in a space that we think is really about the next generation or the next decade of mixed reality guidance technology, where we've raised seven and a half million dollars to date over three small rounds. And we're in the process of raising five to seven right now in commercial phase launch for our first product that's just been FDA cleared in November of this previous year. The past decade has been a decade of robotics in orthopedics. And in particular, it's been a decade of robotics. In total joint arthroplasty, procedures, hip, knee shoulder replacement surgery. The reason why, from our perspective that has been that decade of robotics is because Robotics has been able to actually translate two dimensional preoperative plans into three dimensional action for the surgeon. So they've been able to take the plan and actually guide it into space for the surgery in a way that actually allows for something that it can translate into precision. That precision and that action, though comes at a cost. The cost is the size of the footprint of the technology, the complexity of the technology, and also the actual cost of the technology itself. So what Polaris aims to do is take what total giant robotic systems have done, and be able to achieve it in a mixed reality format. Think about it. If we can take the robot and replace it with a headset, we have a much simpler way of doing that. So I'm going to explain to you how we plan to do that. But what we do believe we're doing is ushering in a new era of mixed reality surgery. But in order for that error to begin, we really have to explain what we mean by mixed reality. So historically, mixed reality has been the WoW of the technology. Think about it holographic imaging, taking a preoperative plan and putting it out into space. So you can use it as a reference to what you're working on from a surgical standpoint. In fact, commercially, it's been a while as well, right? You can use it actually to see things in space. But when you look at the actual utility of holographic imaging, particularly in surgery, it's pretty limited. It's a novelty. What Polaris is in the process of doing is taking that novelty and making it a necessity. And the way we do that is we turn the holographic headset into a true spatial computing device. So what do we mean by that? This is Dr. Cooper here at Columbia University and what he's doing with his headset, he's able to take the headset and use it as a submillimeter measurement device, he's actually able to measure the anatomy real time intraoperatively. While he does that, that information is being fed into it real time dynamic intraoperative plan that he can adjust, he can actually adjust it different than how you would adjust a preoperative plan. Because once you take a preoperative plan, and start to use it intraoperatively, there's a divergence of the preoperative reality in the interoperative application. We're constantly adjusting. So we have an advantage by doing this digitally intra operatively dynamically in real time. The last thing we do is we are able to take that information because we created a three dimensional spatial map, and we guide the instrumentation just like a robot would to the exact spot, but without the need of a robot. That's the fun of Polaris is the ability to use a spatial computing tool without the need of bringing in a 900 pound instrument to do. We also free up the surgeon, we're able to bring back reduce the complexity and bring back the control in a procedure in a way where the surgeon is comfortable with that. There's this interchange of data and the surgeon operating in a way that we think is effective. One last note on this, Dr. Cooper is measuring the soft tissue here in this picture. He's measuring the impact of the joints and the ligaments so that he can balance that you can't get that from a preoperative plan. So in short, what we what our first product does for total knee arthroplasty is measure planning guide. We digitally measure the inter operative anatomy and then we take that information and we feed that into real time dynamic plan that the surgeon will adjust to plan the cuts before they buy the cuts, one of the things that surgeons love the most about our product is the ability to confirm before they cut, that confidence is super important in this procedure. The confirmation is then fed into the guidance part of the procedure in a way where they can actually test and then re measure the cut afterward, if they need to adjust the plan, the market opportunity for our product is pretty significant. So there's two segments first, in our first product launch in total knee arthroplasty, there's those that have robots and those that don't, well, 70% of the Market Plus doesn't have a robot or procedures being done don't have access to a robot. And so that's that's 70% of 900,000 procedures on a per annum basis, the 30% we call limited access to robots. So for example, you could be at a major teaching institution, there can be 10, orthopedic surgeons and to robots. And so on a daily basis, you may have limited access either way, both segments of the market could use access. And we think about this as democratization of the precision of the technology or the clinical value that's associated with robotics, but done in a mixed reality format, we have a cost advantage, we have three basic advantages, we have a footprint advantage over robotics, bringing spatial computing in to the three dimensional space, we have a cost advantage of footprint advantage. And then we have a portability advantage, we can take the headset and move it from or to or and from hospital to ASC. So those three advantages give us a significant opportunity. From a market standpoint. We're not a product company, we're not a total knee product company. We're a platform technology. What we've really solved is the ability to use mixed reality is a spatial computing too. And because we've solved that, we can apply to other total joint applications in hip and shoulder and other orthopedic applications in spine. The addressable market for our current first product is at $1,000 per case, nearly a billion dollars. And we'll double that TAM over the next 24 to 48 months as we start releasing new applications. We're mostly a software company, we use headsets that are off the shelf. So we're not building these really complicated, expensive technologies, relying on the budgets of you know, Microsoft Apple Magic Leap to build our hardware components. While we revive the software applications for new clinical opportunities. Our value proposition to the hospital and to the ASC is the same. It's lower cost transportability smaller size and smaller footprint. The last opportunity that I want you guys to walk away with is we're agnostic to implant. So most robotic technologies are tied to the specifics of a implant manufacturer. We break the tie from an enabling technology standpoint, and in a way that allows the hospital and the surgeon to get the best implant at the best price and not have to worry about that. And that's a real problem in all wars, where there's three or four different types of implants and one type of robot for one specific type of those implants. So you lose the precision of a robotic application, unless you are able to be agnostic to implant. Our timelines are we've we just announced? I think it was yesterday that we've begun the really early stages of commercial launch of our first product in total knee arthroplasty. So we've completed our first cases at Columbia University. Our plan and 24 is really reference centers that allow us to grow into standard of care. Right, so 24 is a learning year 25 scaling year, and 26 is really first sprint commercialization. You'll see in the later years, you can think about new products coming out every 18 to 24 months. We're excited about the opportunity to democratize precision surgery. And we're able to do that because we're able to take real time information and provide it in a way where it's accessible to the surgeon when they need it, how they need it, and in the place that they need it. And because of that we believe the next decade is the decade of mixed reality and surgical applications for precision. Thank you for the opportunity to present to you