Cambridge Medical Robotics (CMR), based in the UK, is working on revolutionizing the world of surgery by delivering what the firm believes is the next generation surgical robot. More versatile, affordable, and easier to use than other robots on the market, CMR’s Versius system is already generating significant interest. The company announced in September that it had closed the series-A funding round with $26 million of investment, following an initial round of more than $20 million at the end of last year.
The company’s mission is to make minimal access surgery available to all those who need it by breaking down the barriers that currently exist, including the size, cost, and complexity of current surgical robotic systems
Versius, CMR’s first robot, uses five self-contained robotic surgical arms that are part of a slim, modular system. Each arm contains all the intelligence and sensing capabilities needed to move itself in response to a surgeon’s commands and it also responds to the touch of the assisting surgical staff. The modular design allows for a surgeon to remove arms that are not needed for a procedure. To achieve the required level of precision, the arms self-monitor their position and the force they apply 5,000 times per second, which can be compared to a full-speed fighter jet measuring its location every 4 inches (10 cm).
We had the pleasure of speaking to CMR’s CEO Martin Frost about his vision behind the startup and the company’s growth plans in the coming years. Mr. Frost is an experienced commercial business leader, with over 20 years of experience in starting, growing, and leading technology and medical device companies.
Alice Ferng, Medgadget: Tell me about Cambridge Medical Robotics. Who’s the force behind your invention and what is your personal background?
Martin Frost, CEO of Cambridge Medical Robotics: Cambridge Medical Robotics is 150 people. We have accreted those people in three and a half years. The company was started in January 2014, and we anticipate being in a 15,000 sq ft building in North Cambridge within a year, which is a significant investment in doing manufacturing, integration, assembly in the Cambridge area.
I am 1 of 4 people who started the company. All of us have worked closely together in the Cambridge, UK area. We have worked a lot in medical devices, R&D, and consulting. My own background is that this is the sixth company that I have been involved in starting and building. I’ve been very fortunate that two of those companies have been listed on the London Stock Market. The reason we [Cambridge Medical Robotics] exist is that we all came together to solve a big problem: we believe that there are millions of people a year that don’t receive the right surgery, despite the fact that robots are not a new idea in the operating room.
If you look at the world today, there are 4,000 robots, doing 750,000 procedures, but the vast majority of these surgeries are in the area of urology. We believe that what the market needed was a far more adaptable robot that could be afforded at a better price.
Medgadget: What types of surgical applications are you targeting? How does your Versius robot differ from a system like the da Vinci from Intuitive Surgical that has been out in the field for a while?
Mr. Frost: The history of the da Vinci robot is that it was initially designed for mitral valve repair, but since then, the majority of the procedures it has been used for has been in the field of urology. We are a multispecialty robot working in all quadrants of the body, which more naturally lends itself to operations in general surgery, the lower and upper GI, colorectal, and hernia indications.
If you look at our technology and what we are providing – it’s a far more flexible, modular robotic platform where a piece of the robotic arms can be placed flexibly around the patient in the operating room. This makes it easier for the staff to work with and move around the robot and patient in the operating room as compared to other robots.
Medgadget: Can you give me an idea of the portability and sizing of your robot?
Mr. Frost: These robots are lightweight, and therefore also portable, and transportable. The existing robots are about 800kg [1,700 lbs] heavy. Our modular robotic arms – the first version of which will be on a cart – are less than 15kg [33 lbs] each.
We haven’t just designed these robotic arms to adapt to current systems, but instead have designed from the ground-up a new modular system that incorporates newer technologies and materials that did not exist 20 years ago. This has enabled us to build something that is significantly differentiated from what exists today.
Medgadget: You’ve mentioned the goal to reduce differences in cost to make your robot more affordable. What does this look like?
Mr. Frost: At present, the existing robots are sold as expensive capital, and the consumables can be around 2,000-3,000 British pounds [~$2667-$4000 USD] each for 10 uses. The whole lifetime cost for an existing robot can therefore be around 6 million pounds in the UK [$8 million USD], which is very expensive for hospitals that have very little money.
We intend to supply our system as a service, including the robot, all of instrumentation, and maintenance as part of a contract at a fixed annual cost. And we intend to reduce the whole lifetime cost for a hospital by as much as 30 to 40 percent.
Medgadget: What about your console and its user interface that make them more easily accessible compared to other robots?
Mr. Frost: The da Vinci System is similar to a periscope system, where the surgeon is hunched over the console. Frankly, there are a lot of surgeons who like that, and there are other surgeons who do not like that. But a majority of surgical staff do not like this. They prefer open communication with the surgeon during the course of the procedure. We have therefore designed our console to be open. The surgeon can either sit or stand up during the procedure. We have a more modern console interface that is almost like gaming, and have received positive feedback for this. It is also slimmer and more portable than the da Vinci console.
Medgadget: Do your controls include features such as haptic feedback?
Mr. Frost: While our controls can enable haptic feedback, it is likely that our first robots we will launch will not enable that feature. We do have it planned already though. We have done more than a dozen usability studies with a lot of feedback from surgeons. Some surgeons actually prefer the optical feedback that they get from the operating system.
One to two of our competitors already have systems with haptic feedback, and we are still working with surgeons to determine if they do or do not like this feature.
Medgadget: What are your growth plans for your company moving forward? Will you be building other robots and targeting other areas of medicine in the future?
Mr. Frost: We will launch our product initially in Europe, and we anticipate having a number of systems being used in the UK by the end of next year. We anticipate being in the United States in 2019. So the hope is to get from 20-30 systems to 100 or more over the course of three years. In the end, the market appetite for what we are doing for next generation robots is hundreds of systems per year. For example, Intuitive Surgical sells about 400 systems a year today. Most people see the existing market growing by at least five times over the course of the next 10 years, and we would agree with them.
We are a British company, not from the United States or California, and therefore this has both advantages and disadvantages. We are very familiar with the constraints hospitals have to operate in in Europe. This means that we spend a good deal of time figuring out how we best position ourselves for this market. Being small means that we do not already have an existing business. We can take a commercially flexible approach to this market.
We are very much looking forward into building a larger medical device company. We deliberately named our company “Cambridge Medical Robotics” because we plan to build other robots moving forward. However, our most important priority is to get good feedback from our first robot Versius, and then to go from there.