11 kilometers from Barcelona, in The Prat of Llobregaton a three-hectare plot of land – which was an experimental farm of the Institute of Agri-Food Research and Technology (IRTA) of the Generalitat of Catalunya– the finalization launch of the Bitrack, which will be the eighth European surgical robot. develops it Rob Surgicala Catalan company that was born in 2012 as a ‘spin off’ of the Polytechnic University of Catalonia (UPC) and the Institute of Bioengineering of Catalonia (IBEC) and that in April already performed its first operations on patients from the Hospital Clinic of Barcelona.
The first three surgeries with the new Bitrack robot there have been three radical nephrectomiesoperations that consist of the removal of the kidney due to malfunction or previous illness. The promoters estimate that by the middle of next year they will have all the certifications approved to begin marketing and install the first 10 units in different hospitals in Europe before the end of 2024.
The surgical robots last generation allow for more precise and less invasive interventions. The best known to date, the Da Vinci, was born within Silicon Valleybased on military patents, and was developed by the Californian company Intuitive Surgical. It was launched on the market in 1999. There are 17 Da Vinci in Spanish hospitals, but it is not the only robot. The Barcelonan Puigvert Foundationfor example, also operates with Hugo, from Medtronic.
In fact, the germ of the Bitrack It arose from wanting to improve the deficiencies of the Da Vinci. “Professors specialized in robotics Josep Amat and Alicia Casals They met at a conference with surgeons who were beginning to work with the Da Vinci and who saw some possible improvements. From the two perspectives, that of the surgeons and that of the engineers, a research group in surgical robotics was born in 2008 that generated the first patents,” recalls Jaume Amat, Telecommunications technical engineer, son of Josep Amat and CEO of Rob Surgical.
Start with 180,000 euros
They started with a simple prototype that they financed “with the little money which was achieved in a first round of family and friends and some grant, 180,000 euros in total.” “As more elaborate prototypes were devised,” says Amat, “more financing could be raised. And in 2016 we carried out a investment round which allowed us to take an important leap in research with almost two million euros“. Three years later the first important partner joined, Scranton Enterprisesshareholder of emblematic Catalan companies such as Juvé & Camps, Aigües de Vilajuïga and the Club Joventut Badalonaand got new financing from five million. To date they have been raised in bull 21 million.
Jaume Amat argues that one of the main contributions of the new robot is power universalize and democratize surgery precision, in addition to incorporating improvements at the time of operation. And, according to the CEO of Rob Surgical, “after more than 20 years of implementation of the Da Vinci in the market, It is only used for 3% of all surgeries that could be done with a robot“. “With current systems,” he continues, “when a hospital plans a surgery with a robot, it does everything with it, both the parts where it makes sense and those where it does not provide differential value. This makes Robotics are slow, expensive and inflexible. Furthermore, it has caused these types of operations to remain trapped at the top of the pyramid: in reference hospitals and surgeons and in highly complex operations.”
Rob Surgical’s proposal focuses on soft tissue interventions in the abdominal areawhich in practice translates into treatments of urology, gynecology and gastrointestinal, and proposes to put a precision tool for hybrid use on the market. “Surgeons can start with their conventional hand tools and pick up the Bitrack when millimeter precision is required.” In this way, “the range of centers that can afford to have access to roboticsas well as the number of surgeries that can be performed with it,” he emphasizes.
New goal
The CEO of Rob Surgical assures that there is “very little left to achieve a new important milestone”: “We have already closed the first study with people and we are waiting for authorization for the second, which should allow us to complete the clinical evaluation that authorizes the certification of the robot.” If the deadlines are met, mid-2024 They will have the robot certified and will deliver all the design characteristics to the European Union so that it can give them the seal to start manufacturing. The objective is have 50 Bitrack robots installed in different hospitals in Europe by 2025 and achieve the first 500 operations.
To get it They are setting up the first “mini production plant”who must register in the Spanish Medicines Agency to begin the assembly and accessories process. Last July they sent the application and expect to receive the permit “shortly.” “We have assumed the manufacturing risk so we can begin marketing” once certification is obtained, he says.
Right now, “each robot is almost a work of art, very unique, with exaggerated costs per piece and per unit.” “We are reviewing the scalability of the system to facilitate the process,” he highlights. To exemplify this, Jaume Amat explains: “Each piece of the first instrument we made of the robot It cost us 6,000 euros to produce it, a cost that clearly cannot even be considered. After a first review, the production cost is around 200 euros per piece and we will still do some more reviews.”
Rob Surgical, with a staff of 35 people, has sufficient capital to advance the final design and certification. “But we are ambitious and it is evident that we will seek to incorporate new partners, not only from the point of view of financing, but also as partners that help us in the marketing part with a global perspective,” highlights the CEO.
They have conversations with him Clínic and with the Vall d’Hebron, “as front-line public hospitals”, but they also aspire to demonstrate that a hospital “in the Vic health consortium, for example, can afford to have this type of surgery.” Marketing of the first 10 units They want to do it with a mix of hospitals that represent all types of public centers, large, medium and small throughout Spain, also some private clinic and some European center that gives them “international visibility” advances.
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The marketing model has yet to be defined. Amat points out that in the case of the Da Vinci, three lines of income are generated: 30% of the turnover comes from the sale of the robot; 60%, of surgical instruments necessary, and the remaining 10%, of the maintenance services. “If we can sell the robot, fantastic, and we will invoice from the first moment. But more and more hospitals are not willing to make this investment and that is why we are preparing for a second scenario that represents an additional challenge of mobilizing funds and where income will be generated basically by the use of the robot and the sale of material,” he says.
In Europe they have been approved to date seven robots for these types of surgery. “We will be the eighth,” concludes Jaume Amat.