Paul: Today we are pleased to be sharing with you the first in a three-part series of interviews with Dr. Hannah Teichmann. Dr. Teichmann is the Vice President of Clinical Development at Medical Microinstruments, a Robotic Surgery Start-up company based in Italy’s famous Pisa region. Welcome to Robotic Surgery Today!
Dr. Hannah Teichmann, VP Clinical Development
Medical Microinstruments: Thank you Paul, for contacting us and inviting us to share our vision for robotic surgery, it’s an exciting time at MMI and for robotics in general.
How did Medical Microinstruments get started?
Paul: Firstly, let me congratulate you on the global visibility that you have been receiving! The Economist in its 16 November 2017 article “New surgical robots are about to enter the operating theatre”, featured Medical Microinstruments as a rising star in this field. During this interview I’d like to understand the journey of MMI and its Founders up to this time and hear about your future prospects.
Robotic surgery is a relatively new field, so I’m particularly interested in understanding how each founders became involved in the Robotic Surgery field. What were the key turning points or influences in your personal journeys that attracted each of you to this specialized field?
Medical Microinstruments: We each have an individual path that led us to embark on this journey together. Max loves both medicine and technology and the idea that science and technology could provide better healthcare always fascinated him. He came from a Ph.D. project that focused directly on robotic surgery and medical applications, so it was an obvious next step. I (Hannah) have a passion for data, and found myself being more attracted to reading clinical research papers during my Ph.D. So, I was keen to make the leap to a medical application rather than basic research. Giuseppe’s ten-year experience at Intuitive Surgical laid the basis for founding MMI. His first-hand involvement in the development of the most successful surgical robot to date gave him unique insight into the R&D process and the impact a device can have once it comes to market.
Paul: Could you tell me how you met and what brought you together?
Medical Microinstruments: Giuseppe and I met in California and are both partners in life and in business. Sharing the Stanford and Silicon Valley culture of start-ups and innovation, launching our own business was close to our hearts when we moved back to Europe. We had a number of ideas up our sleeve, including projects in digital health, but Giuseppe’s experience at Intuitive Surgical and fascination for miniaturization really drove the birth of MMI. Giuseppe met Max during a visit to the Biorobotics Institute while Giuseppe was scouting engineering talent to join the effort. Max was quickly convinced that this was the right path for him, rather than the academic track. It took a couple of years to have a preliminary prototype of the robotic microinstruments, Max was instrumental in developing this. On the basis of the prototype we were awarded a small grant under the Horizon2020 programme for a feasibility study. Clinical development and collaboration with surgeons followed from there.
Medical Microinstruments Unique Value Proposition
Paul: What is the big idea behind Medical Microinstruments? How did it emerge and what problem(s) are you seeking to solve?
Medical Microinstruments: The big idea is to open new surgical areas to the advantages of robotics by providing a miniaturized wristed robotic instrument small enough to be implemented in operations that require optical magnification. Due to the physical and mental challenges that microsurgery poses, there is a lack of microsurgeons and a problem of under-treatment. This leads to long wait times for post-oncological reconstructions or avoidable amputations in cases of trauma. Our vision is that by providing tremor elimination and motion scaling with a robotic microinstrument, we can open doors to the potential of robotics beyond laparoscopy and orthopedic surgery, which are the current main applications, and extend them to plastic reconstructive surgery, pediatric surgery and open surgery in general. The tools will hopefully allow more trained plastic and orthopedic surgeons to perform microsurgery. We expect that it will allow expert microsurgeons to innovate new procedures.
We think microsurgery is really the area that can reap the most advantage from robotics as physiological tremor represents a large portion of the targeted movement the surgeon needs to execute. Interestingly, a recent MenaFN report underlined this. It was fascinating to read this interpretation of surgical robotics in an independent analysis.
They stated that “the primary advantage of surgical robots is definitely the microsurgical application due to the apparent technological advantages surgical robots provide to the surgeons. However, a careful analysis of the trends of surgical robots reveals a very different picture. For instance, with the help of the Da Vinci system, a total of 563,000 procedures were performed in the U.S. in 2016, of which 44% were in gynecology, 33% were in general surgery, and 19% were in urology. Increasing precision is also claimed to be an advantage of surgical robots with the robotic arm programmed to filter out any tremors in the physician’s hands which increases the physician’s range of motion. Some experts have however charged this claim to be a sign of exaggeration. In our analysis we found this claim only to be partially true, which is applicable to microsurgeries only.”
Here is the whole article for those interested in a deeper analysis:
It has been satisfying to see our “big idea” of robotics for microsurgery being picked up by independent analyses like these and news outlets such as the Economist.
From Concept to Realization
Paul: How did you go about moving from idea to implementation? What were some of the main hurdles you faced and how did you overcome them?
Medical Microinstruments: We started from the greatest technological challenge of designing and manufacturing a miniaturized articulated instrument, which is really at the heart of our innovation. The idea was to make it smaller and smaller. After a couple of years of technical work, once the instrument performance and the manufacturing method were established, we started to explore surgical applications. We approached this with an open mind and identified microsurgery as a target application after researching various possibilities. The platform was designed upstream of the robotic microinstruments. The master instruments are based on the requirements of microsurgeons and the workflow in the OR. We have been collaborating closely with our clinical advisor Prof. Marco Innocenti and his team at the University of Florence. We are also listening to the microsurgery community at large via online surveys and in-person interviews.
Coming next week, part 2 of our 3-part interview series:
We will continue our discussion with Dr. Hannah Teichmann next week when we will look at MMI and the Robotic Surgery sector.
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