In September 2023, Moon Surgical, a robotics startup based in Paris and San Francisco, assisted in its first clinical procedure in the U.S. Dr. Steven Hodgett, Dr. Craig Morgenthal, and Dr. Alexander Rose used the technology to successfully perform sleeve gastrectomies at Baptist Health in Jacksonville, Florida.
Moon Surgical’s product, the Maestro system, is a two-arm robotic assistant that augments surgeon’s capabilities in the operating room by providing increased mobility and precision during minimally invasive laparoscopic procedures. The robot serves as an extra pair of hands by holding and manipulating surgical instruments and cameras, allowing surgeons to maintain focus on the patient. Compared to other surgical robots, the Maestro system is smaller and can flexibly adapt to a surgeon’s grip without being overly rigid. The robot is also able to hold any traditional laparoscopic tool, making it accessible in many clinical settings. Dr. Hodgett, medical director at Baptist Center for Bariatric and Reflux Surgery, describes it best by explaining that “during procedures, the two co-manipulative arms provided me with stable vision and dependable organ retraction, allowing me to give more focus to my surgical case and perform at my best.” The company also touts efficiency benefits such as higher procedure throughput, reduced time under anesthesia, and fewer surgical staff. Maestro’s newest features include cloud connectivity, tailored surgeon configurations, and surgeon guided hands-free scope control.
Moon Surgical (formerly known as MastOR) was founded in 2019 by Professor Brice Gayet and entrepreneur Pierre Campredon through joint research with the ISIR robotics lab at France’s Sorbonne University. Gayet is a renowned leader in laparoscopic surgery and a Head of the Medical and Surgical Department of Digestive Pathology at Institut Mutualiste Montsouris in Paris. Campredon is an entrepreneur with experience founding multiple startup companies in the medtech space. During its early days in July 2020, Moon Surgical received its first round of funding by Sofinnova Partners, a life sciences venture capital firm based in Paris. The round raised $3.4MM as part of the firm’s MD Start III fund, led by Anne Osdoit who eventually became the startup’s CEO.
Since its initial funding, Moon Surgical has successfully raised multiple rounds of financing. In June 2022, the company completed Series A fundraising of $31.3 MM led by GT Healthcare Capital & Partners, with participation from Johnson & Johnson. Most recently, in May 2023, the company raised $55.4MM and announced the appointment of Dr. Fred Moll as chair of the board. Moll previously founded robotics giant Intuitive Surgical and its notable technology, the da Vinci Surgical System. He now serves as J&J’s Chief Development Officer where he has been involved in multiple acquisitions. Regarding the latest funding achievements, Osdoit states, “this new financing is extremely exciting as it will enable us to focus on the upcoming commercial launch of our Maestro System. The support of Sofinnova Partners, NVIDIA, Fred Moll, Josh Makower, and our existing investor base is further validation of the mission of Moon Surgical and the achievements of our team.”
In terms of regulatory hurdles, Moon Surgical gained steam quickly by receiving FDA 501(k) clearance for its technology in December 2022 and the European CE mark in April 2023. The positive regulatory news came on the heels of the successful completion of a 30-patient trial using the Maestro robotic platform. Dr. Guy-Bernard Cadière performed the surgeries at CHU Saint-Pierre, a public university hospital in Belgium. A variety of clinical indications were included in the study, namely cholecystectomies, bariatric surgeries, hernia repairs, colorectal surgeries and antireflux surgeries. Dr. Cadière was able to complete all of them without surgical assistants. He emphasized the technology’s impressiveness by noting, “it gave me more control throughout the procedure, keeping me confident and less fatigued by the end. Maestro is a great benefit for any surgeon, giving them the freedom to conduct each surgery in the most efficient manner.”
The soft tissue surgical market is projected to grow at a CAGR of 29% and be worth $568bn by 2030. The space is currently dominated by the da Vinci system, the leader in minimally invasive surgery for over a decade. Moon Surgical aims to usurp this title by introducing an affordable option that costs a fraction of the price while seamlessly fitting into the OR workflow. According to Osdoit, the da Vinci robot is mainly used for complex surgeries and only 6% of soft tissue surgeries are robot-assisted. In contrast, Moon Surgical hopes that the Maestro system will be used for everyday, high volume general surgery cases such as bariatric procedures. The company hopes to achieve this by focusing on a roll-out to ambulatory care centers that have high volume soft tissue procedures. Chief Strategy Officer Jeff Alvarez says they hope to expand the robot’s indications to other specialties such as orthopedic surgery or neurosurgery in the future. For now, the Maestro will have a limited release launch in 2024 followed by a full commercial launch in 2025.