Verb Surgical and ‘Surgery 4.0’

One of the great promises of machine learning is its capacity for quick iteration—find out […]

One of the great promises of machine learning is its capacity for quick iteration—find out what works, and what works better, and then do it and do it again. Searching for patterns and methods that improve results bit by bit has been the story of human technological advancement writ large, but distilling those concepts and focusing them on a single task aims to unlock a new revolution.

That digitization and automation of progress aims not only to show us ways forward but also to make it easier to bring those “Eureka!” moments to more people, through the democratization and distribution of newfound skills. This applies not only to research and discovery but also to interventions.

Verb Surgical, founded by Johnson & Johnson’s Ethicon division and Google’s life science-focused sibling Verily, refers to these objectives as “Surgery 4.0”: a step past the robotics tech that has already helped bring a new generation of steady and precise hands to the operating room. So-called digital surgery combines robotic instrumentation with computer-aided visualization and decisionmaking, supplementing them with a continuum of outcome data tracking patients before, during and after the procedure. The planned result: a machine learning platform that rapidly refines and relays best practices. This could provide any of Verb’s connected devices with the knowledge and experience of the world’s best surgeons.

In terms of procedures, Verb has been developing a general surgery robot capable of open and laparoscopic operations for everything from the pelvis up to the neck, though details have been scarce. The company unveiled its first prototype to its industry partners and benefactors in early 2017, but little has been made known about its details.

This past July, the 2016 Fierce 15 company tapped a new president and CEO: Kurt Azarbarzin, who previously founded the laparoscopic startup SurgiQuest, now a part of ConMed. Azarbarzin brings commercial experience as Verb moves closer to its previously announced goal of a 2020 launch.

“The company has an incredible vision for the future of surgery,” Azarbarzin said at the time. “I’ve spent time with the technology and believe it has the potential to transform surgery on a global scale.”

He takes over from Scott Huennekens, who departed Verb at the top of the year after leading it from its founding in 2015. Prior to that, Huennekens headed up a series of catheter-based treatment and imaging companies, and he currently serves as executive chairman of arrhythmia-focused Acutus Medical, a fellow 2016 Fierce 15 company, as well as on the board of spine surgery company NuVasive.

Despite its overtures to revolutionizing the field of surgical interventions through AI and data analytics, Verb has some strong competition ahead.

Medtronic recently unveiled its soft-tissue surgery robot, the Hugo, to investors in an event last month. It includes up to four individual, cart-mounted surgical arms and 3D visualization, with the goal of getting per-procedure costs down to levels on par with manual laparoscopy.

The medtech giant is aiming for a 510(k) clearance within two years, alongside plans to bring robotics to “virtually every area” in which the company has a procedural presence over the next decade, according to CEO Omar Ishrak.

The Hugo is similar in design to U.K.-based CMR Surgical’s modular system, the Versius. That system secured a CE mark in March and is currently under FDA review. In September, the company raised a mammoth £195 million ($240 million U.S.) to fund its worldwide commercialization and potentially double the company’s headcount.

Meanwhile, Verb’s progenitor, Johnson & Johnson, is moving forward with its own robotic surgery plans through its $3.4 billion acquisition of yet another 2016 Fierce 15 company, Auris Health, and its lung-snaking endoscopic Monarch system. That all-cash deal also saw Auris’ founder and CEO—robotic surgery demiurge Frederic Moll, M.D., who formerly helped establish Intuitive Surgical and its mainstay da Vinci system—join J&J as chief development officer for its medical device companies.

Whether Verb’s layer of data analytics will be enough to differentiate it and make an outsized impact on patient outcomes will be important to watch since it’s not a stretch to expect its competitors to incorporate those tactics in the coming years as well.

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