The mastermind behind the first wave of surgical robots unveils the next generation

Frederic H. Moll trained to become a surgeon, but never completed his residency at Virgina Mason Hospital in Seattle. Nonetheless, the doctor-by-training and humble “gadget guy,” has changed the face of medicine for good.

Moll, who is known as the “Bill Gates of robotics,” ushered in the first wave of surgical robotics in 1995 with his company Intuitive Surgical and its Da Vinci systems. That business is now publicly traded with a market value around $51 billion.

But Moll has started a new venture, his fourth, called Auris Health in Redwood City, California. There, he is creating a “second generation of robotic capability” for doctors, he says.

For the unfamiliar, Moll and his team built the Da Vinci surgical systems in the early 90s to help surgeons do their work in a minimally invasive way. These large robots translate the movements of a surgeon’s hands into smaller, more precise motions.

“That was complicated when we did it,” Moll says. “And the challenge was two-fold. We were pushing the capability of robotics as they existed at that time. And we were really fighting from a conceptual standpoint to convince people it was a reasonable idea to use robots in surgery.”

For all the tech advances he’s personally brought to medicine, Moll still doesn’t call himself an engineer.

“I never had formal training. I grew up when we were in the space race and trying to go to the moon. The types of things that got me excited about tech were simple ways to automate tasks that could otherwise take people forever to do. When I got back thinking about tech as early as I can, things like Homer Price [a character in a kid’s book] and his automated doughnut machine inspired me.”

Today, robots are commonly accepted in surgery thanks to Moll. And the innovator has turned his attention to endoscopy, a procedure which lets doctors diagnose or deliver treatment to a patient’s organs through their natural bodily openings, no incision required, not even a pin-sized puncture.

At Auris Health, Moll and his team have put a high-tech spin on the endoscope with a robot they call the Monarch Platform.

The Monarch includes a robotic endoscope which is operated with something that looks like an X-box game controller. Instead of one long hose-like instrument, the Monarch endoscope can be extended like a telescope. It can maneuver through a patient’s airways, into the far and narrow reaches of their lungs, giving doctors a direct view of what’s inside.

The system provides computer-assisted visualization to doctors, too. Monarch software guides doctors to a particular part of the lung that they need to evaluate.

The company aims to help doctors diagnose lung cancer earlier than current technologies and methods, including traditional endoscopes, and needle biopsies. Auris’ chief strategy officer, Josh DeFonzo, says that long-term the team also wants to expand beyond diagnostics.

He explained:

“There are so many therapies being developed today outside of Auris to treat lung cancer, like external radiation therapy, chemotherapeutic agents and devices that aim energy or ablation to adjust a pathology. Or, if you have advanced lung cancer, you may need a pneumectomy, a lobectomy or another surgical procedure. We’d hope to deliver unique therapies endoscopically, so you can diagnose and treat patients in a single procedure.”

Roughly 19 percent of people who are diagnosed with lung cancer will only survive 5 years, but if you catch it early that number jumps to 56 percent, according to research from the American Lung Association.

DeFonzo said at the Auris office in Redwood City, Calif. anyone can try their hand on the Monarch. Most employees have “taken a spin.” One dexterity test asks Monarch users to place a biopsy needle smack in the middle of the eye of the eagle featured on a U.S. dollar bill.

Many laypersons can master this task, DeFonzo said. But Auris isn’t out to replace doctors or other clinicians with robots. No matter how good robotics and AI become, Moll said he doesn’t think that will ever happen.

The CEO said:

“I’m a big believer that electromechanical control of medical intervention is the path of the future. But I don’t mean surgery is going to be fully autonomous and we’d replace surgeons. We’re not. Because the most important aspect of surgical technique is judgment, you will always need surgeons. But robotic controls will be able to do more and more.”

Because Moll believes that “tech and technique” are the only things that limit patient outcomes, he’s willing to build doctors a robot army, if necessary, so that they can treat patients at the best possible levels, consistently.

He also believes tech from robotics to virtual reality, will make health care less expensive, especially for routine procedures.

Auris has been in “stealth” for nearly a decade. But in March, it attained FDA approval for its Monarch Platform to be used for “bronchoscopic procedures,” such as diagnosing lung cancer. So its machines may soon become a common sight at hospitals across the U.S.


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