Surgery Robotics, VR

By pjain      Published Jan. 22, 2021, 9:42 p.m. in blog Health   

Robotics in Surgery Keys and Trends

What is it

Robotic-assisted surgery is a type of minimally invasive surgery that uses technology to give surgeons greater control, access and accuracy during the surgical procedure while benefitting patients by minimizing trauma and scarring, enabling accelerated post-surgical healing.

Robot-assisted surgery generally involves a human surgeon controlling instruments via a computer or a remote manipulator. It allows for more finite control and precision than is normally possible with a human operating with their kludgy meat hands, no matter their skill or dexterous ability. The result can be far less invasive procedures, meaning faster recovery time.

  1. SMALLER, BETTER SURGICAL FINGERS. Tiny humanoid robots with arms with REMOTE Surgical control - "Two robotic arms that have the same degrees of freedom and proportions of a human arms and a camera that is placed above the shoulders of the robot… it’s a few inches across.” Using the motorized robot a surgeon can remotely control the robot’s movements to operate on a patient. “They can be in another room or they can be hundreds of miles away (with an excellent internet connection,” says Sachs.
  2. Improving by miniaturize robotics and put all of the motion of surgery into the abdominal cavity

  3. BETTER EYES. Pushing VR virtual reality headsets like the Oculus Rift -

  4. REAL TIME FEEDBACK TO SURGEON. The primary feedback is virtual, Sachs says. They look through the “eyes” of the robot and can look down and see the robot’s arms. “We track the surgeon’s arm motion and mimics their arms and hands. The primary feedback is to create the impression of presence of the surgeon as if they’d been shrunk down.”

Autonomous Surgery - The Frontier

Autonomous STAR beats both Humans and Robot-Assisted Surgeon tools

A robotic surgical system outperformed humans and robot-assisted human operators in a soft-tissue procedure, bringing us that much closer to automated medical care. The Smart Tissue Autonomous Robot (STAR) was designed at the Children's National Medical Center as an attempt to bring automation to soft-tissue surgery, a field where the versatility and spatial skills of human surgeons have long made them essential. STAR uses advanced computer vision tech that uses fluorescent markers and 3D cameras to get a detailed view of the surgical site. It then chooses from a variety of surgical techniques programmed into its database, and carries out the action with, naturally, machine-like precision, speed and efficiency. "As surgeons, we usually do three things," said lead researcher Peter Kim, of the Sheikh Zayed Institute in a press call, "we use our vision and we use our hands for dexterity and then we use our mind as cognition to make judgment and then carry it out. We improved on all these things." STAR won on a number of metrics. "Despite dynamic scene changes and tissue movement during surgery, we demonstrate that the outcome of supervised autonomous procedures is superior to surgery performed by expert surgeons and RAS technique." - Techcrunch.com

STAR uses a motorized robotic suturing tool that automatically positions and rotates the needle through, in this demonstration, a pig’s intestine.

Rewards of using medical robots

USP1 Drive down both the cost of higher impact surgeries

USP2 Better access to the best surgeons through remote technologies.

Risks of using medical robots

Industry Money Seducing Surgeons into Controversy, Biasing with Grants for Studies

While some innovations and technology have improved medical care and how it is practised, others have been proven ineffective or even harmful. It seems obvious that a new surgical device considered an “innovation” requires thorough evaluation through studies of the highest quality.

The use of robotic surgery is controversial. Many surgeons who advocate for the robot have strong feelings based on their anecdotal experience and perceived relative advantages, while others may have been influenced by industry marketing. Critics, on the other side, argue that users overstate the advantages of this technology and are unwilling to accept the limitations. Much of the published research supporting the use of the robot is derived from observational studies performed by authors receiving funding from the robotic industry.

Financial relationships between industry and authors are associated with an enormously increased likelihood of publishing reports favorable to industry. When evaluating the true benefit of any new technology on patient outcomes, such bias must be considered

In addition to our recent study, most randomized trials have demonstrated that current robotic platforms provide no measurable benefit in clinical or patient centered outcomes, but do increase cost and operative duration.

It is only through high-quality research that the value of new emerging technologies and treatment strategies can be rigorously assessed. Although most individuals in healthcare share the same belief, to our surprise, some do not.

Affordability Issue - Miniaturizing helps

There were 900,000 surgeries done using surgical robotics and tools out of a total of 313 million surgical procedures. It’s a low percentage and it’s very expensive to buy those… In general that’s not offered to the vast majority of patients.

  1. Smaller hospitals can’t afford these $2 million robots. Instead of room-size robots, by making the devices tiny and fitting the motion inside a patient we can expand access long-term and in smaller hospitals where a surgeon might be able to start a procedure.

  2. AUTOMATING Procedures one by one. As companies like Vicarious is able to build up taxonomies of different surgical practices and methods, the hospitals could begin to automate more aspects of the procedures to the point where many of these surgeries may just be handled by the robot.

  3. BETTER ACCESS. Companies like Vicarious are about democratizing that access… if it works it will open a huge market for people who can use much better procedures for much better surgeries.

  4. MODELING TO SPEED UP PROGRESS LONG BEFORE Actual SURGERIES. Vicarious is also modeling the human abdomen and conducting as many virtual tests as possible.

Market Size, Growth

Size robotic surgery $90b in Revenues

Estimates put the robotic surgery market at somewhere around $90 b

Timeline

  • 2019 Robots are proliferating in operating rooms around the country, with more than 6 million robotic-assisted surgeries taking place across multiple specialties. They’ve been scanning, excising and drilling into brains, hearts and bones for years, but it has only been in the past few years that robots have acquired the dexterity necessary to start rooting around in people’s mouths.

Frontiers of Advances

1. Human Control as of 2020 end

The trend is going from Human Control to Collaborative-Better Vision, to Autonomous Surgery Robotics

Surgeons use million-dollar robotic devices such as Intuitive Surgical Inc.’s da Vinci robot in operations that require more precision, range of motion and control than they might get by using their own hands. The robot assists them with suturing, dissecting and retracting tissue, but the surgeons are always in control. Clearly, each movement of the surgeon’s hands directs the robot’s arms, which hold the surgical instruments.

2. Better Vision and Fingers assist

3. Robots to replace Drudge Work

Scut work is usually done by Junior surgeons. Automating mundane and repetitive tasks, such as cutting open, suturing, could allow surgeons to focus on more critical and complex parts of operations and minimize the mental and physical fatigue associated with hours long procedures. The coronavirus pandemic also highlighted the need for robot help in operating rooms to minimize the risk of exposure to the virus for staff and patients.

4. Collaborative, surgeon Guided - for precision needed steps.

The U.S. has a worsening shortage of surgeons, with an expected shortfall of as many as 28,700 by 2033, up from a projected shortage of up to 5,600 this year, according to the Association of American Medical Colleges.

Automating the navigation would free up the surgeon to focus on deploying the occluder and optimizing the valve repair, much like a fighter pilot on a mission, Dr. Dupont says. The pilot “is doing all of the higher-level mission planning work,” he says. “The plane is in autopilot.” Dr. Dupont and his team are currently researching ways for robotic catheters to help with more complex valve repairs.

5. Autonomous Surgery

Researchers from Children’s National Hospital in Washington, D.C., and Johns Hopkins, including Dr. Krieger, are developing a robot capable of conducting a colon anastomosis on its own. An anastomosis refers to the closing up of a tubular structure, and is normally done by suturing, or stitching, the tissue back together. Reattaching a healthy colon requires about 15 to 20 stitches. If even one stitch is too loose, the patient risks an anastomosis leak, which can cause a deadly infection; consistent, high-quality sutures could reduce such complications.

This is for operations performed in Space eg Mars, in Antarctica or in rural areas without access to surgeons.

Robotic Catheters

Robotic catheters would help

To minimize risks and recovery time for patients, cardiologists typically prefer to use a catheter—a thin, flexible tube that is inserted through an arm, groin, thigh or neck—to get access to the heart, rather than cutting open a person’s chest. But navigating with a catheter to the right part of the heart is tricky work. A team led by Pierre Dupont, chief of pediatric cardiac bioengineering at Boston Children’s Hospital and professor of surgery at Harvard Medical School, has developed a robotic catheter that would navigate on its own. In an experiment that concluded in 2019, the robotic catheter was able to help with leaks that sometimes happen after valve replacements. The catheter navigates using a haptic vision sensor, in which images from a tiny camera are combined with machine-learning algorithms that can tell whether the catheter tip is touching blood, tissue or valve. After the catheter arrives at the repair site, the surgeon takes over and patches up the leak with an occluder, which resembles a small metal plug. - SRC WSJ

Thread like Robots can navigate into Brain

They could make even the least invasive current brain surgery techniques even less so, and potentially make it easier and more accessible to treat brain blood vessel issues like blockages and lesions that can cause aneurysms and strokes.

The new development from MIT researchers combines robotics with current endovascular (i.e. within blood vessel) surgery techniques, reducing the risks associated with guiding incredibly thin wires through complicated brain blood vessel pathways. Today, this type of procedure, which is much less invasive than past methods of brain surgery, nonetheless requires an incredibly skilled surgeon to guide the wire manually. It's a very difficult surgery for surgeons, and it also means that they're exposed to radiation from the X-rays required to provide a view of the path they're weaving through the patient's brain.

Telesurgery Problems

Adequate bandwidth

Dealing with Remote Lag Time and delays in video feedback - 300ms+ likely

Latency is a particularly important measure for telesurgery because it determines how safely a surgeon can operate with delayed video and control signals.

Some of the best uses are for between countries eg from advanced surgeons to developing countries, or 24/7 surgery from other countries to beat time zones.

Since within the USA latency is generally maxed at 150ms, telesurgery is possible and generally safe for large areas within the United States. Limitations are no longer due to lag time but rather factors associated with reliability, social acceptance, insurance and legal liability.

Impact on Surgeons to compensate for Lag time

Surgeons could feel a lag in their movements at 300 milliseconds and higher. In the 300-500 milliseconds range, surgeons compensated for the lag by slowing their movements and becoming more conscious about each step. After some practice, the surgeons’ movements at this level were no longer one fluid stroke, but a sequence of individual steps connected together. But at 600 milliseconds, most surgeons could no longer handle the latencies and performed the tasks unsafely. Using this information, we labeled 0-200 milliseconds as a safe range, 300-500 as a potentially usable range, and 600 milliseconds and higher as an unsafe range. There are plans to test longer distances in the future, but we remain confident that the networks that exist between hospitals today are more than sufficient to support telesurgery. -- Surgeons at Florida University

Latency Varies a LOT

  1. 5 ms Enterprise Networks. Using the IT infrastructure between multiple hospital campuses in a large Florida university, we measured an actual latency on large packet delivery of only 5 milliseconds within metropolitan Orlando.

  2. 10-150ms. Regional City-to-City. Latency between Orlando and Tampa, a distance of 65 miles, ranged between 10 and 150 milliseconds.

  3. 30-150ms. Interstate latency from Orlando to Fort Worth, Texas, a distance of 1,200 miles, was 30 to 150 milliseconds.

  4. 135 theoretical but 300-600ms Intercontinental. The light propagation speed is 186,282 miles per second (299,792 kilometers per second), and in theory nothing can travel faster than light. In miles per hour, light speed is, well, a lot: about 670,616,629 mph. In one second, light can travel around the Earth 7.5x times. Or roughly to cross across would take 133 ms lag time. But real networks can be VERY LAGGY, as it has to go through switches and routers - so can be upto 300 ms across continents.

  5. Research In Lag Time Set To Determine The Future Of Telesurgery | TechCrunch

Ethics and robocalypse

Brain Computer interface Control

  • Ways for a person to control a robot arm with their minds — with no surgery or invasive procedures required to make it possible.

Limitation on Interface only by Implants

In the past successful, highly precise demonstrations and executions of BCI tech in people has depended on systems that incorporate brain implants, which pick up the signals from inside the user. Implanting these devices is not only dangerous, but also expensive and not necessarily fully understood in terms of their long-term impact. This has led to them not being very widely used, which means only a few people have been able to benefit from their impact.

Prosthetic Help in Future

In everyday life, it could provide people with paralysis or other kinds of disorders that affect movement an alternative way to operate computerized devices.

CMU Brain Computer interface

The mind-controlled robot in this experiment also showed a high degree of motor control, as it’s able to track a computer cursor as it moves across a screen.

The CMU breakthrough is to develop a system that can deal with the lower signal quality that comes from using sensors that are used outside of the body, applied to the skin instead. They were able to employ a combination of new sensing and machine learning technologies to grab signals from the user that are from deep within the brain, but without the kind of “noise” that typically comes with noninvasive techniques.

  • https://engineering.cmu.edu/news-events/news/2019/06/20-he-sci-robotics.html

Neuralink Surgical Robot

  1. Elon Musk's human brain computer inference company

  2. A surgical robot the company debuted made a splash of its own - actually the creation including look and user experience by San Francisco-based industrial design firm Woke Studio.

Fetch-and-Carry Robots for Health Care

Twenty-eight percent of a nurse’s time is wasted on low-skilled tasks like fetching medical tools.

Companies like $10m funded, Diligent Robotics wants to give them a helper droid that can run errands for them around the hospital. The startup’s bot Moxi is equipped with a flexible arm, gripper hand and full mobility so it can hunt down lightweight medical resources, navigate a clinic’s hallways and drop them off for the nurse.

Artificial Skin with Real Feel

Prof Benjamin Tee, assistant professor of materials science and engineering at the National University of Singapore. are developing devices that can perform surgical tasks with minimal human oversight.

The device has about 100 sensors per square centimeter, with data running through a single wire connected to a neuromorphic chip, a type of computer chip that allows AI models to be trained using a fraction of the data of traditional computer chips. In early tests this year, the finger was able to tell which of two similarly shaped objects was softer, about 10 times faster than the blink of an eye.

  • “artificial skin” that would give robots a sense of touch, allowing them to do things like differentiate between healthy tissue and tumors and make surgical incisions. -Robots that stitch up incisions and navigate to repair organs.

Companies in Surgery Robotics and VR

ISRG

Intuitive Surgical, whose da Vinci robot has been performing surgery since it received FDA clearance in 2019 and changed surgical practices in operating rooms across the US. The da Vinci ushered in the first age of robotic-assisted surgical procedures with a promise of greater accuracy and quicker recovery times for patients undergoing certain laparoscopic surgeries.

With an IPO in 2000, and starting with funding of $46m, these days, the SRI spinoff is currently valued at more than $60 billion.

JNJ Auris Health $3.3b cash acq

Auris is a maker of robotic diagnostics and surgical tools to treat early-stage cancer using more precise endoscopic robotic assisted tools.

Its endoscopic robotic manipulators for surgical procedures that is less invasive and more accurate to test for — and treat — cancer. While a CT scan shows a precise location of mass or a lesion .. BUT it doesn’t tell you what it is. Then you have to get a piece of lung in a biopsy, and if it’s a small lesion. It isn’t that easy — it can be quite a traumatic procedure rooting around trying to find it. So you’d like to do it in a very systematic and minimally invasive fashion. Currently it’s difficult with manual techniques and 40 percent of the time, there is no diagnosis. Often the lesion is missed. This is has been a problem for many years and [inhibits] the ability of a clinician to diagnose and treat early-stage cancer.

Its Monarch system uses an endoscopy procedure to insert a flexible robot into hard to reach places inside the human body. Doctors trained on the system use video game-style controllers to navigate inside, with help from 3D models. J&J says that the Monarch robotics platform will play an important role within the Lung Cancer Initiative within the company, and, more broadly, will be used to support the company’s approach to open, laparoscopic, robotic, and endoluminal surgeries. - Monarch is a new platform from surgical robot pioneer Frederic Moll | TechCrunch

  • Founded by serial entrepreneur Dr Fred Moll after his ISRG now valued at $61b, and then Hansen Medical, a company that developed tools to manipulate catheters.
  • 2018 Launched its Monarch platform endoscopic robotic manipulators for surgical procedures that is less invasive and more accurate to test for — and treat — cancer.
  • Funded total of 500m+ - Auris closed on a ton of money | TechCrunch
  • 2019 Auris recently received approval from the Food and Drug Administration for its novel, robotic approach to surgery.
  • 2019 On top of the $3.3b in cash on day one, an additional $2.35 billion in payouts may be possible if Auris hits certain milestones. This is a windfall for investors, including Lux Capital and Coatue Management, which both invested as part of a whopping $280 million round the company closed in 2018.

  • https://techcrunch.com/2018/03/24/monarch-is-a-new-platform-from-surgical-robot-pioneer-frederic-moll/

Ethicon - J&J

Ethicon, a medical device company in the Johnson & Johnson family, entering into a partnership with the Life Sciences team at Google to develop surgical robotics. But what is the real future of medical robots?

  • http://www.wired.com/2015/03/google-robot-surgery/

Medacta.com MEDGF MOVE $350m

A company specialized in the design and production of innovative orthopaedic products and the development of accompanying surgical VR and tools.

In the weeks leading to the procedures, surgeons would take computer tomography knee scans of the patients and loaded them into Medacta’s NextAR cloud-based platform, which created 3-D models of the knees. The 3-D models are used for preoperative planning, such as deciding how much damaged bone and cartilage to remove and determining the optimal placement for an implant based on each patient’s particular anatomy.

Two quarter-size sensors attached by clamps—one above the knee joint and the other below it—were used to transmit a signal to the AR glasses with a precise measurement of their spatial position in 3-D. A key to any successful knee replacement is ensuring the ligaments that hold the knee in place retain their preoperative balance, or stability. The data was used to help calculate the balance of the ligaments as the surgeon put the patients’ legs through a range of motion during surgery.

So, during the procedure using AR glasses manufactured by Vuzix, including a digital display that let him view the patient’s knee and the surgical planning parameters that helped him accurately position the implants. The display screen inside the glasses can show a 3-D model of the leg with a diagram of planned cuts. The display is interactive. If a surgeon makes cuts exactly as planned, a green line appears as instruments are moving. If cuts are off, the line turns red.

  • CEO Francesco Siccardi
  • Emp 1101, Revenue $376m
  • Gewerbestrasse 3, Frauenfeld, Thurgau, 8500, Switzerland. Phone:+41 91 696 60 60
  • US HQ 6640 Carothers Parkway Suite 420 Franklin, TN 37067

  • Nov 2018. personalized medicine co acquisition of Balgrist Computer Assisted Research and Development (CARD). Balgrist CARD’s MyOsteotomy, a proprietary solution for planning and executing complex osteotomy with a patient-specific approach. MyOsteotomy combines 3D preoperative planning and custom-made drilling, cutting and reduction guides to produce an “exact preoperative assessment and a highly accurate and controlled surgical procedure,” according to Balgrist CARD. The MyOsteotomy system is available for extra- and intra-articular corrective osteotomies of upper (finger, carpal bones, radius, ulna, humerus, and clavicle) and lower (pelvis, femur, tibia, fibula and tarsal bones) extremities. Medacta believes that the software is an answer for all corrective osteotomies, including periacetabular and high tibial osteotomies.

  • 9/2019 Used in Australia

  • July 2020 Its NextAR received Food and Drug Administration approval for total knee replacements .

Metric Medical Devices, $5m

Funding $1.5m, 10 emp Headquarters is in Helotes, Texas, and was founded in 2009. Metric Medical Devices, Inc. also competes in the Health Care Equipment field. Metric Medical Devices is part of Medacta?. generates 1.44% of Medacta's revenue.

VC Funded Companies

ISRG is being challenged, backed by hundreds of millions in venture capital dollars, new businesses are coming to refashion operating rooms again — this time using new visualization and display technologies like virtual and augmented reality, and a new class of operating robots. Their vision is to drive down the cost and improve the quality of surgical procedures through automation and robotic equipment.

Very Large TAM

“There were 900,000 surgeries done using surgical robotics out of a total of 313 million surgical procedures,” - VC Dror Berman, a managing director of Innovation Endeavors.

VCs love Disruptive Power.

“We like to invest in things that if they work they truly change the industry. Minimally invasive surgeries and surgical robotics is definitely the future and it’s just getting started,” says Dror Berman, a managing director with Innovation Endeavors.

    1. Medical device and robotics startups raised roughly 600-700 in VC rounds with most deals occurring at the early stage (over 25% of rounds occurred at the seed stage).

Neocis -- Dental Surgery Robots

Funding 120 m, Founded 2009, Market entry 2019

Since the robotic dental surgery assistant Yomi first came on the market in 2019, more than 2,700 patients have stared up at its plastic sheathed metal arms. Now the company behind it, Neocis, has raised $72 million to bring it into more dentists’ offices. .. Yomi is the only robot that’s been cleared by the U.S. Food and Drug Administration for dental implant surgery. It’s currently being used by two dental schools — Boston University’s and the school at West Virginia University — to train a cohort of willing dental students. The Neocis robot is a navigational tool used in planning and completing dental implant surgery. Traditional techniques to dental implantation cuts away a flap of tissue to expose the jaw bone. Using the Yomi robot, doctors don’t need to be quite so invasive with their surgery and can implant teeth more quickly and with less risk of complications from extensive surgeries, the company said. - techcrunch.com

Activ Surgical, Boston for better VISION safer Surgery in semi-autonomous robotic surgery

  • 2020 raises $15m led by LRVHealth, DNS Capital, GreatPoint Ventures, Tao Capital Partners and Rising Tide VC.
  • Total funding so far $32m
  • Focus advance autonomous and collaborative robotic surgery

Main niche is bringing technological innovation to the sphere of surgical vision, which still relies primarily on methods like using fluorescent dyes that date back more than 70 years. Now its ActivSight technology can make it better than surgeon's own eyes and is a small, connected imaging coddle that can be attached to existing laparoscopic and arthroscopic surgical instruments. The company is currently tracking toward getting their hardware cleared by the FDA for use by Q4 this year, and are working with eight hospital partners for pilot projects in the U.S.

Its platforms uses data collected from surgical implements outfitted with sensors created by the company to collect real-time data during the actual surgical process. That data is then used to inform the development of machine learning and AI-based visualizations that can provide guidance to surgeons and surgical systems to help them reduce the occurrence of potential errors, and ultimately improve outcomes for patients.

Vicarious Surgical, Mass - tiny humanoid robots, VR

There were 900,000 surgeries done using surgical robotics and tools out of a total of 313 million surgical procedures. It’s a low percentage and it’s very expensive to buy those… In general that’s not offered to the vast majority of patients. "Companies like Vicarious are about democratizing that access… if it works it will open a huge market for people who can use much better procedures for much better surgeries,” VC Berman said.

  1. BETTER SURGICAL FINGERS. Tiny humanoid robots with arms with REMOTE Surgical control - "Two robotic arms that have the same degrees of freedom and proportions of a human arms and a camera that is placed above the shoulders of the robot… it’s a few inches across.” Using the motorized robot a surgeon can remotely control the robot’s movements to operate on a patient. “They can be in another room or they can be hundreds of miles away (with an excellent internet connection,” says Sachs.
  2. Improving by miniaturize robotics and put all of the motion of surgery into the abdominal cavity

  3. BETTER EYES. Pushing VR virtual reality headsets like the Oculus Rift -

  4. REAL TIME FEEDBACK TO SURGEON. The primary feedback is virtual, Sachs says. They look through the “eyes” of the robot and can look down and see the robot’s arms. “We track the surgeon’s arm motion and mimics their arms and hands. The primary feedback is to create the impression of presence of the surgeon as if they’d been shrunk down.”

  5. USP1 Drive down both the cost of higher impact surgeries

  6. USP2 Better access to the best surgeons through remote technologies.

  7. 2015 MIT-based company’s co-founders, Adam Sachs and Sammy Khalifa, have been developing and refining the technology almost since they met as undergraduates, launching it in 2015. Joined by Vicarious Surgical chief medical officer Dr. Barry Greene

  8. Adam’s father, Ely Sachs, is a professor at MIT and one of the co-founders of the revolutionary 3D-printing company, Desktop Metal.
  9. Total funding of $32m from Bill Gates funded, , Khosla Ventures, Eric Schmidt’s Innovation Endeavors, AME Cloud Ventures (investment firm from Yahoo founder Jerry Yang), Singularity Holdings investor Neil Devani and Salesforce founder Marc Benioff.

Virtual Incision - two Pound Abdominal surgery robot

  • Its main product is MIRA (“miniaturized in vivo robotic assistant”), a two-pound robot designed for minimally invasive abdominal surgery. Among is biggest value propositions is the relative portability of the product, versus many existing surgery robots eg from ISRG, which are downright massive. “We designed the MIRA Surgical Robotic Platform with the fundamental understanding that minimally invasive procedures offer tremendous benefits to patients,” president and CEO John Murphy said in a release. “We believe our portable and affordable abdominal robot has the potential to bring these benefits to many more patients. The planned IDE clinical study of MIRA is the critical next step for the company.”

  • 2006 Founding

  • Jan'2020 for FDA journey, got additional funding of $20m - total $51m led by Bluestem Capital, with participation from PrairieGold Venture Partners and Genesis Innovation Group.

Verb - from J&J and Google Verily

Co-developing an advanced, robot-assisted surgery platform.

SMALLER COS

Infinite Wellness, $18m

  • Funding, 96 emp
  • CEO

OrthoSensor, $10m

  • Funding 151m, 96 emp
  • CEO Roland Diggelmann

Sonoma Orthopedic Products, $10m

  • Funding 61 m, 50 emp
  • CEO Rick Epstein

Spinal Elements

  • Spinal Elements (formerly known as Amendia) is a provider of medical devices used in spinal surgical procedures.
  • Founded 2008
  • Funding $4m,

SBi Small Bose Innovations, $7m

  • Funding 244m, 80 emp
  • CEO

Orteq $5m

  • Funding $?m, 25 emp
  • Private company that was founded in London, England in 2005.
  • Orteq works within the Health Care Equipment industry.

Uteshiya, $5.2m

  • Funding ?m, 36 emp
  • CEO Jignesh Uteshiya
  • Founded in 2013, and is headquartered in Ahmedabad, Gujarat and competes in the Health Care Equipment sector.

USGI Medical, $m

  • Funding 73m, 27 emp, Founded 2001
  • USGI Medical develops technologies to enable incisionless surgeries that treat diseases through the natural passageways of the body.
  • CEO

Sanovas, $m

  • Sanovas offers micro-invasive devices and drug delivery technologies for the treatment of lung and pulmonary diseases.
  • Funding 7m, 15 emp
  • CEO

Glaukos

  • Glaukos is a glaucoma treatment company developing micro-bypass therapies to moderate the intraocular pressures that help preserve vision.
  • Founded 1998, Funding 115m

Medical Devices Major, Diversified -- XFR --

Stryker, $14b

  • Funding m, 36,000 emp
  • CEO Kevin Lobo
  • Portage, MI

SmithNephew, $4.6b

  • Funding ?m, 17,500 emp
  • CEO

Biomet, $3.3 b

  • Funding m, 4204 emp
  • CEO Jeffrey Binder

BECTON DICKINSON

Franklin Lakes, NJ

MEDTRONIC

  • Minneapolis, MN

BAXALTA

  • Bannockburn, IL

BOSTON SCIENTIFIC

  • Marlborough, MA

BECKMAN COULTER

  • Brea, CA

COOK GROUP

  • Bloomington, IN

PERKINELMER

  • Waltham, MA

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