Surgical robotics promises to democratize high-quality care by providing better data to medical professionals. Activ Surgical Inc. today announced that it has raised $45 million in Series B funding with the participation of seven new investors. The Boston-based company said it plans to use the financing to support further development and commercialization of its ActivInsights software in the U.S. and Europe.
“2021 continues to be a critical year for Activ Surgical, as we are laser-focused on democratizing surgical care at the global level,” stated Todd Usen, CEO of Activ Surgical. “We received FDA clearance for our ActivSight enhanced visualization module that will power the ActivInsights software suite. [We] were issued our first U.S. patent for ActivSight, as well as completed our first in-human clinical trials and have grown our team by 35%.”
“We went from concept to design, submittal to the FDA, and approval in April, all within two years,” said Dr. Peter Kim, founder and chief science and medical officer (CSMO) of Activ Surgical. “Kudos to our leadership and team. We've had human trials in Texas with almost 70 patients and all the necessary COVID-19 precautions.”
Activ Surgical said it completed the world's first autonomous robotic surgery of soft tissue in 2018. The privately held company's patented ActivEdge software is designed to use computer vision, robots, and artificial intelligence to aggregate surgical data from around the world. The goal is to enhance interoperative decision making and reduce preventable errors.
Activ Surgical moves to commercialization
“The funding is helping Activ Surgical transition from an R&D to a commercial organization, with a product launch in the first quarter of next year,” Kim told Robotics 24/7. “We're helping to connect the way surgeons visualize the world with how they operate.”
“It's like autonomous cars and advanced driver-assist systems [ADAS],” he explained. “Not only are we providing perception to cars or robots, but these systems are also helping people drive more safely with features such as lanekeeping. That's where we're focused.”
Activ Surgical's hardware-agnostic ActivInsights software is intended to combine augmented reality (AR), machine learning, and robotics for autonomous and collaborative surgery.
“We're working with a number of robotics vendors to make their systems better,” said Kim. “With a realtime flow of information and optical signatures, the surgeon can identify different types of tissue.”
“ActiveSight is a simple module between any camera and endoscope system, allowing it to become multispectral,” he explained. “A surgeon can see perfusions without dye. It's as simple as pushing buttons on demand and has minimal workflow interruption. We're really transitioning the way surgeons look at the world from anatomic to physiological.”
How does ActivInsights' AR capability help surgeons?
“The easiest way to look at AR, going back to the car analogy, is when you back up, the box on the screen shows things so you don't have to turn around,” said Kim. “The AR shows critical structures at critical stages of surgery.”
“Even three years ago, surgeons said, 'Show me the proof,' but we found a significant shift during human trials and presenting to SAGES [Society of American Gastrointestinal and Endoscopic Surgeons] board meetings,” he said. “Now, even older surgeons don't mind, and everyone is getting more comfortable with decision support.”
Reducing errors with data
“Medical errors occur in 250,000 to 400,000 cases per year ... that's the third biggest killer after cancer and heart disease,” observed Kim. “We want to make surgery more precise, accurate, and objective.”
“If ADAS can decrease the mortality rate by 30% by providing additional information on anastomotic perfusions or leaks caused by pilot error, we could have a huge impact,” he added. “Because we've gone digital, we can use the metadata set to make humans better at what we do.”
“There are two levels of data. No. 1 is visualization, which we make more relevant and useful through software upgrades to hardware,” Kim said. “No. 2 is using actual patient data in how surgeons make decisions. Activ is going the last mile, bridging eyes and mind.”
What about privacy regulations, such as the Health Insurance Portability and Accountability Act (HIPAA)?
“We have ways to anonymize data to be HIPAA-compliant,” replied Kim. “At the same time, we can imagine the amount of data that could be collected. We have thought leaders in the clinical space as part of our scientific advisory board.”
With more available data, not only could best practices be shared, but AI could also increasingly help surgeons, he said.
“When you get such a large data set, I'm hoping machines can get the topography—build a map—and come up with solutions that we didn't think about,” Kim said. “It's seeing differently but acting intelligently.”
Activ Surgical finds place in growing market
The global surgical robotics market will experience a compound annual growth rate (CAGR) of 18.5% between 2021 and 2026, predicts Research and Markets. Grand View Research expects a 21.6% CAGR between 2021 and 2028, and Emerging Market Research also forecasts 21% CAGR between 2021 and 2026. How does Activ Surgical see its technology in the growing surgical robotics market?
The ActivSight visualization module. Source: Activ Surgical
“It's not just laparoscopic companies; we're also working with surgical robot companies,” said Kim. “We have a clear, differentiating value proposition.”
“For perfusion, our technology displays actual blood flow rather than as liquid in a volume,” he added. “It's more accurate and can be easily incopororated into any system. A lot of robotics players find it incredibly attractive.”
“By adding positional information, the machine knows where it is—this is the paradigm for collaborative robotic surgery,” Kim said. “Within the infrared spectrum, visualization could add to depth and tissue characterization. We could look at tissue signatures for tumor margins, ultimately guiding dexterity and decision making. About 60% to 80% of errors are from how surgeons see the operative field.”
Cota Capital leads round, joins board
Cota Capital led Activ Surgical's Series B round. The company said it has raised a total of $77 million to date. Existing investors DNS Capital, Tao Capital Partners, LRVHealth, Rising Tide VC, GreatPoint Ventures (GPV), and ARTIS Ventures also participated.
In addition, seven new investors, including Cota, BAM Funds, Magnetar Capital, Mint Ventures, Castor Ventures, Dream One Vision, and NVIDIA, joined the round.
“It's not just medical device investors who are enthusiastic; tech investors are also interested now that there's clear evidence that we can add value in patient care,” said Kim. “This allows to really scale up. This funding clearly puts us in in a first-mover advantage, not just in laparoscopic surgery.”
Activ Surgical is a resident member of MassRobotics, a collective dedicated to nurturing the Massachusetts robotics community. The company is looking to expand globally, starting with Europe.
“We have filed the paperwork for CE Mark and expect approval by the end of this year or early next,” Kim noted.
Bobby Yazdani, founder of Cota Capital, will join Activ Surgical's board of directors. He has more than three decades of entrepreneurial experience, including more than 20 years of investing in technology companies.
“The addition of seven new investors spanning the medical and technology industries is a wonderful testament to our team’s vision and work to date,” said Usen. “We are thrilled to be supported by this diverse group of investors, and we welcome Bobby to our board as we look to make our ActivInsights software suite commercially available in 2022.”
About the Author
Eugene Demaitre is editorial director of Robotics 24/7. Prior to joining Peerless Media, he was a senior editor at Robotics Business Review and The Robot Report. Demaitre has also worked for BNA (now part of Bloomberg), Computerworld, and TechTarget. He has participated in numerous robotics-related webinars, podcasts, and events worldwide.
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