Video Transcription
Pedro Costa 00:00
Pedro, Hi everyone. I'm Pedro. I'm here representing Interventional Systems. We are a manufacturer of OEM B to B surgical robotic solutions for minimally invasive and percutaneous procedures. And like most of the robots you'll find in the market that focus on a niche or an application, we actually want to partner with implant manufacturers, needle manufacturers, and others that are not digitally native but want to offer the benefits of robotics and surgical navigation to their customers, either because they don't have the skill set, the time, money, or even the willingness to focus on something that's so far out of their markets. Our flagship product is the Micro Mate device. The Micro Mate is a table-mounted, easy-to-use, affordable robotic device for percutaneous and MIS procedures. As I've mentioned, it makes use of intraoperative imaging and interoperative planning to plan one or more trajectories and also help deliver the tools inside the body. You can control it with a joystick on the bedside. So it's the only percutaneous robot that allows you to do bedside corrections and avoid rib punctures. And among our success stories, of course, are our commercialization in the interventional oncology space, but more notably, our partnership with Medtronic to whom we license the cranial neurosurgery robot called Auto Guide Alpha Tech Spine, another publicly traded company that is working in the spine space. However, I'm here today to talk to you about a different field, the urology field. I'm sure that all of you have experienced or know somebody that has or has had kidney stones. It affects 10% of Americans of all ages, 7% of the European population of all ages, and most of the cases are painful enough to force people to seek emergency room care. These are reoccurring. Half of the people that are treated come back within five years with a new stone because debris are left, and each debris is a new stone former. The best way to treat kidney stones is actually being more invasive on them. The percutaneous treatment of kidney stones is a surgical treatment called percutaneous nephrolithotomy. To avoid this mouthful, I'll say PCNL from now on, and it ensures 90% stone-free rates or higher. This means that the only way for you to have a chance to come out stone-free in one single case is to do a PCNL. Yes, it's more invasive, but it's a much more lucrative procedure to the hospital. It's better for the patient because it's the one that has fewer complications afterward. It's the one that generates less waste, and it's the only one that treats stones above a certain size. So it's one of those niches that there's no alternative surgical solution for it, and the existing incumbent solutions that are less invasive cannot solve it. Despite being such a fantastic procedure, only 7% of cases are done with PCNL. And the main reason for this is because the most critical path and step of the procedure is obtaining safe and accurate kidney access. You don't want to puncture the collecting system, but you want to make sure you go with the right angle, in the right location, in the right calyx because you also want to minimize soft tissue trauma once you maneuver endoscopes later on. Most urologists do not feel comfortable doing this. It's very hard for them to do it under fluoroscopy; they take seven minutes plus under radiation to try to get the right puncture, and they need hundreds of cases to get acceptable results. So this kind of forces them to outsource this task. 17% of urologists in the world obtain their own access. The earlier 83% outsource this to interventional radiologists. This causes scheduling issues because the patient needs to come the day before when this could have been a single-day procedure for small stones, and they get standard; the access is done and the procedure is the next day. The outcomes are not proven to be superior because a radiologist wants to have access, but they don't care about how you are going to approach different calyces or maneuver the endoscope, and it has been proven to cost north of $4,000 per procedure. This is especially relevant if you look at the US, for example, where 85% of the cases are done in an ambulatory setting. How can an ambulatory stone center owned by private physicians that do not have a radiologist offer this to customers? So what we have is that patients do not get the best care they should, and physicians are also feeling comfortable doing the procedure that should get the best stone-free rates. So we saw an opportunity here, and we funded a spin-off called Lark Robotics. The focus of Lark Robotics is to leverage the work we've been doing over the past 14 years and focus on solving this problem. It's a niche, but it's a valuable niche. The endpoint is urologists, who are used to using robotics such as Da Vinci. They have the budget, they have the political power, and they have the need to solve this procedure. We want to make use of our released technology for 3D navigation and live fluoroscopy and are currently taking advantage of one thing that exists in every OR room, which is a C-arm; every room has one. So what we are building is a 2D fluoro navigation solution that makes use of only two shots, and based on two shots, we use these stereo navigation principles to create a 3D path that a robot can execute and help you get the access. We are developing this together with the Advent Health Celebration and Antero Clinic, so two big urology centers in the US and Europe, and in some territories like China, India, and Southern Europe, ultrasound is still the main way of access. We also have patented technology that allows us to make use of a flexible holding arm to obtain safe access. We essentially look at this opportunity because we think we can empower surgeons in solving three things that are critical for them. One of them is the workflow. The owner of the patients is the urologist. They want to be able to obtain the access intraoperatively. They want to be able to do the procedures themselves. It saves them time. It saves them costs. They can adjust the surgical planning much more effectively intraoperatively, and this is something we can provide. Robots are inherently accurate, but they also want to be sure that there are other outcomes, both for them and the patients. We are the only percutaneous robot in the market that is FDA validated from clinical cases, not from bench testing, sub-millimetric targeting accuracy under live fluoroscopy for two reasons. One, our robot fits inside the gantry, so you can use live imaging. So it's like you are usually used to robots with navigation. So it's like driving with your windshield covered, and you look at the GPS system; you don't see what's inside, but with our system, as you fit inside the gantry, you can actually clear the windshield, and you see the navigation, but you also see where you are. We also have proven stark radiation on procedure time and radiation. And of course, owning the budget, the cost of our system is in the low hundreds of thousands. We have flexible pay-per-use models and pay-per-month models. If you don't need the IR, you will be already saving money. Actually, the Advent Health Celebration group has done a health economic study and has communicated to us that they expect to save close to $5,000 per case if they use our technology. This can grow up to $10,000 if you count drugs and hospitality. And of course, if you look at the growth of the savings as the cases pass by, you can pay for the system within one year. So it's not only about having a nice technology that helps you, but it also helps your hospital to give access and to save money while you do so. Interventional Systems is a 14-year-old company. We've been bootstrapped for a long time based on the partnerships and the relationships we're having. We are CE Mark and FDA cleared technology. We own our own manufacturing supply chain. We have freedom to operate through 15 patent families and have never had an attack to date. So why are we here? Right? We believe that this is a commercial opportunity, and we are an innovative R&D company, so we are looking, and LSI is essentially the kickstart of our fundraise process. We are looking for a strategic or financial investor that wants to partner with us on the commercialization. As an investor, if you look at this technology, all of the risks are out. Technology is clear. It is validated over 5,000 cases. We have done deals with publicly traded companies; the IP is safe. We only want cash for commercialization. Interventional Systems is committed to making sure that we are going to release the product next year. And we need the money for the US commercialization. So every dollar, every euro that an investor will put will go to commercialization. We want to set up five to ten reference sites in the US, mostly in stone centers. We want to avoid the big hospital environment. We want to prove that physician-owned facilities can make money with this technology, and we are aiming at a revenue growth that will enable us a short term, up to 36-month exit to a strategic. Essentially, this market hasn't been disrupted for 10 years. All of the strategics have access kits, guide wires, endoscopes, lasers. So you know, a laser is a laser is a laser. Everybody does the same procedure. Everybody is fighting for fractions of the market share, but we do believe that robotics can do here what it has done in the spine market, which is to really give the leadership to a partner. Thank you. Applause.
