Surgical Innovation from Vision to Reality with Amy Lorincz, CEO & Co-Founder @ Vopemed

Nectar: Amy great to have you on. Really excited. I know we met at that dinner a little while ago, and they've been meaning to poke you and learn, like I said before, recording selfishly talk about what you're building at Vmed. And I find just the health tech space in general to be fascinating, right?

Where it's it's, there's so many interesting things. Maybe for for the honest, maybe if you can explain a little bit about Volpe and what you guys do. 

Amy: Sure it sounds great and really happy to be on the podcast today. So at Vmed we're developing a software that improves visualization in minimally invasive surgery.

And for those that may not know a lot about minimally invasive surgery, it's a type of surgery where actually about 70% of all surgeries are performed in this fashion. The surgeons use a camera that is inserted into a tiny incision that allows the surgeon to see a full picture of internal organs.

But during this time, the camera often gets dirty with internal fluids. Fog condensation. And what surgeons have to do is remove this camera to clean it. It's stressful. It's inefficient. So what we have proposed is a software that enhances the image feed that the surgeon sees in real time so they can continue on with the maneuver that they're performing.

nectar: Oh, that's fascinating. I know, I'm thinking about like my, something happened with my dad where it was like a little while ago. He, he's since passed, but he had a, this tube shoved up his nose and it was like, and you could see all the mucus gathering. Yeah. Is your solution applied to any type?

Does it have to be surgery or does it have to like, 'cause there's not just surgeries that it's used for. Is it really specifically you're going after the surgery market? 

Amy: Yeah, so surgery is our lapole. Laparoscopic surgery specifically is our first market, but like you mentioned, the endo nasal procedures that are endoscopic for diagnostics, that is also a market for us as well in the future.

And actually in that pre that's specific procedure that you mentioned it's such a problem in those procedures that. The surgeon or clinician is actually removing the camera every 1.2 minutes because of that fluid that builds up on the camera. As you can imagine, if you're trying to get a look at the interior cavity of a patient, that's can be quite stressful.

nectar: Oh, interesting. Yeah, I can imagine. Made me make a clunky analogy smartphones do this right out of the box. So how does your solution then work with these, I wanna say existing systems, right? I imagine these cameras like of these camera systems that are made by big OEM manufacturers.

They've been around for a while, right? So is it, is it easy to simply plug into their software stack? Like how does that work? 

Amy: Yeah, so we have designed our product so that it's compatible with all of this existing infrastructure because in the medical and surgical workflow, when you introduce new technology, and if it.

If it results in the surgical team changing their workflow, there can be quite a big barrier to adoption. So we've designed this product it's a computer vision AI model that runs on A GPU and this GPU is deployed in the operating room and it. Plugs between the endoscopic processor, which is the camera system you mentioned, developed by the OEMs and between the display.

So it constantly is providing that enhanced image feed and is compatible with all the endoscopic systems on the market. Yeah. 

nectar: So who do you have to sell to? Do you have to sell to the OEM or to the hospital? 

Amy: . We're actually evaluating both of those go to market strategies.

So if we're selling to the OEM, that would be companies like Olympus, Stryker. Medtronic intuitive and we've already started having conversations with them, which is really exciting. So that would be through a licensing agreement. And really with AI and surgery is in line with what the products that they're currently deploying, so that's.

That's one option that we're looking at. And the second option is to sell directly to hospitals through a distributor. And how we would do that is by partnering with a large hospital system likely in the US as a first market, and then getting our product into a hospital system that maybe has 600 to 900 operating rooms so that we can take advantage of that that large number of operating rooms.

nectar: Yeah, interesting. But you still have to connect to the end OEM at any point where you mentioned all those huge, massive companies, right? So do they have to be in the loop at some point? Or does the distri, is the distributor able to work directly and in implement your solution? 

Amy: I.

For laparoscopy towers, we would be able to work directly with the distributor since the cameras are designed to plug into different types of monitors or softwares. But for a company like Intuitive or the robotic companies, that's when we would need to have more formal conversations in an integration plan.

But that's. Farther down the line. And so we're focused on the laparoscopy towers as a first step. 

nectar: Yeah. And what is laparoscopy? Sorry. 

Amy: So laparoscopy is a subset of endoscopy, which is a minimally invasive procedure, whether it's diagnostic or therapeutic. Laparoscopy scopes are rigid and about 10 millimeters in diameter.

And those procedures are specifically for general surgery urology surgery procedures and gynecologic. So it's a type of scope that is used for those procedures. 

nectar: Oh interesting. Yeah. I guess I I'll come back to the arms for a second, but maybe to talk about a little bit about how your solution is built.

So it's a pure software solution. Like how, maybe just a little bit of under the hood of how you built it with, maybe without sharing too much of the secret sauce. 

Amy: Yeah. So we see ourselves as purely a software based company. And we've trained our models using computer vision algorithms.

To recognize where there is an obstruction present, whether that's fluid or fog or smoke. Essentially all of the challenges in minimally invasive procedure. And then based on that, we're able to provide the restoration of the specific area that is obstructed with that type of contamination. 

nectar: Oh, interesting.

Yeah. Are you not worried, I know it's again a very rookie question, but you're not worried if someone being able to replicate the software solution, particularly the OEMs and I know maybe some of the legacy ones you mentioned that are from the eighties, maybe less, but intuitive seems maybe a competitor in one sense.

How do you think about that? Or are you very confident that. Your training data, the way you've built a solution, is gonna be faster for the museums to just partner with you rather than try and build it themselves? 

Amy: From what we've seen in the market specif specifically for medical devices, I.

They often don't intuitive is a separate case, but most of the other OEMs don't have a huge r and d practice within. And we feel that the patents that we have filed with our technology, I. Protects us that from that space. And it allows us as a startup to be more innovative and then attractive to OEMs like Stryker or Olympus to purchase this product, to add really an enhancement to their product offering.

And what's really nice about this is that there are many different camera companies that can adopt our solution which we see as. Is really exciting and from what we've seen on the competition, we don't have any AI based direct competitors that are on the market right now. So we want, we are one of the first movers in this space.

But you also mentioned intuitive. They're really working on extracting a lot of data from the surgeries themselves and then of the surgical teams and then developing solutions based on that. Yeah. So we'll see what they come up with in the future. Yeah. 

nectar: For how did you train your model? Because imagine there's a part of it that you're using the generative aspect, right? So it's capturing images and then improving upon it. Did you have to use a training set? Did you have to like, scan thousands of hours of like surgeries or like how did you actually get to a point where you're confident that there's no hallucinations, that, the, and the resolution is high quality?

Amy: We have quite a large training set and our model is seen thousands of examples of what smoke looks like or any type of obstruction. And then the associated clear image. So that's how we're able to train our models. We have a proprietary data set, which also provides that strong IP asset for us as well.

And we're continuing to acquire more data in different types of procedures so that we can continue improving our model. 

nectar: Yeah, no, super interesting Amy. I guess like maybe talk about the ROI or the value, right? Like I imagine for the surgeon it's it must be almost like a magical thing, right?

Where it's like, now the, like you said, they don't change their workflow. They're able to see crisp, high high re resolution images and, always look at your website like the before and after comparison, which is yeah, well done. 

What's been the. Feedback so far, I guess you're almost, like you're still developing, you're at a pre, pre-seed stage, but have you been able to get it into the hands of actual users?

Amy: That's something that we're working on right now. We're always getting feedback from surgeons. So whenever I attend conferences, I usually have an iPad with me and demos and I get live feedback and we often get a lot of. Just wow feedback that we're able to accomplish this type of image augmentation.

But in terms of the ROI we see it from three stakeholder feedback or perspective one on the surgeon side. If they're allowed to just continue their maneuvers, it's a lot less stressful. It's less time spent in surgery where they're cleaning the camera lens. And so that leads to less time in the operating room where in the future it could be possible to add additional procedures.

So that's extra revenue on the hospital side. And then finally on the patient side there's still early research being done on this. But if you can't see what you're doing, there is a possibility that there's a risk of injuries for patients and with an increased injury for patients that leads to potential complications in their daily life, or also increased readmission rates for hospitals.

nectar: Yeah, no, I imagine like the, in the end, like you said, the actual, the real ROI is actually not on the surgeon. It's like the patient that gets 'em. X percent better, better surgery and less complications. 'cause you could actually see, the surgeon could see better. It's wild wildly simple idea, but so powerful.

Do you have to go through the whole RMA roll of FDA approval or like in the same thing in Canada or do you, are you able to bypass that? 

Amy: We do go through that regulatory pathway in both the US and Canada. So in the US we are considered a class two medical device. So with that, we will need to provide data on safety and efficacy of the solution, and it would be the same procedure in Canada as well.

nectar: Okay. Okay. So yeah, it's but once you get that, then hopefully you'll be able to grow like a, I've seen some startups, being able to like, hit their head against the wall sometimes. Like both what you're doing though, it seems so simple in one sense, where, like you said, where the workflow for, for the surgeon, for the patient doesn't change that much, so hopefully. Hopefully, fingers crossed that it goes through quickly. 

Amy: Yeah, definitely. 

nectar: Maybe just talk about, a little bit about the inception of the company, right? As you're relatively new, even though it's like you a few years in, right? Like it's, like the, what's the expression, a 10 year overnight success.

How'd you come up with the idea, you and your co-founder? Walk us through a little bit of the genesis. 

Amy: Yeah, definitely. So the company started during my master's program. I did a master's of experimental surgery. And within that, a surgical innovation concentration.

And within that course we followed the Stanford Biodesign framework, which is really all about finding a need in medicine and surgery before developing a product. So I had the opportunity to interview about 20 minimally invasive surgeons mostly from the general surgery practice or gynecologic surgery practice, and found that.

All of them had an issue with unclear vision. And in the literature it's even up to 37% of the total time. And a surgical procedure vision is obstructed somehow. And myself and teammates wondered, why is this still a problem? And when we looked at the competitive landscape, there were no AI based solutions to solve this problem.

So there are mechanical cleaning devices or chemical ones, but none of them. Really solve the problem of cleaning all types of obstructions. That's really how the idea came about in for the company. And then from there my, my co-founder Tim joined me after that and his background and regulatory and ai.

And patenting were all a very great component or a balance to my skillset. And so we've been full-time, both of us for about the past two years and that's how we came together to. To start boat me. 

nectar: Yeah. Interesting. How was it taking that leap of okay, like I'm finishing a master and okay, I'm gonna start a company, right?

That's my first gig. What was the thought process? Was it, was there any not want, what should, how should I say it? Prescribe that, the fact that you had butterflies in your stomach, or some qualms, but maybe just Yeah, maybe a little bit. The mindset building something I want I say straight out of your master's.

Amy: Yeah. So I actually ended up working full-time for two years out of my master's while I was finishing writing my thesis. And then VO was still, being pursued on the side of this work and I was able to enter a lot of pitch competitions in Montreal and raise some non-dilutive funding.

But I guess the forcing factor to go full-time on the company after my work experience working on surgical robotics and also managing clinical validations for another startup was I was part of a round of layoffs at one of my jobs. And at the time I was. Also looking into management consulting as well.

But. I also knew that there was this idea that had been validated. Surgeons were interested by it, so why not pursue it? And I'm really happy that I, I took the leap, it was definitely scary but quickly found the team right after that and then were able to secure peer prese funding. Yeah, I'm really happy that I did that.

nectar: Yeah. Very cool. Very cool. Where does the name come from? I get the med part, but what is VO exactly? 

Amy: Yeah, so VO is a combination of vision and scope and so vom me demonstrates the surgical and medical aspect of that. 

nectar: Yeah. Interesting. I know you just mentioned funding, which I'll get to, but, and then, I think you mentioned in one of your, in, in your pitches, I've seen that.

Scale of the market, right? 70% of all surgeries are minimally invasive. How do you think about then going, which part to go out? Because it's it's a huge, obviously, it's a huge blue ocean. How do you figure out the next step of, is it by, am I going by country?

Am I going by use case? Just thinking about like, how, like thinking tactically breaking it down to start, getting revenue. 

Amy: Yeah. The way that we broke that down was first on the use case perspective. We built a framework on the number of procedures performed the amount of obstruction that specific procedures encounter data, except.

Accessibility was also a factor for us as well. It's quite difficult to get surgical video data sets to train models for commercial purposes. And then for the region aspect in the US. There are a lot of procedures being performed. And then as well that market is more likely to purchase cleaning devices versus the Canadian market.

So that's how we chose that. So within endoscopy as a whole, there are 225 million procedures annually. And so laparoscopy, which is the rigid scope that I mentioned we're focused on prostatectomy procedures. Hysterectomy procedures and cholecystectomy procedures for their presence of smoke contamination as a first step.

nectar: Yeah. Are there any equivalents in terms of like how you think of business model? Because it's like at the same time you said you're doing something so you that does it exist? Going back to like your original, okay. Shit, I gotta do this. It's, yeah. But then I imagine there must be equivalence of like how you sell it, how how you generate actual revenue.

Maybe may, curious to hear you a little bit on that. 

Amy: Yeah. In the surgical space, it's interesting because AI models are relatively new to this space. A SaaS model may not be really common, but actually intuitive. Has just started creating pricing models like this, which I think gives a lot of validation to us as a company to use a similar pricing structure.

Which is exciting because there are opportunities to bundle different, offerings within this. So right now we're focused on clarification, but there are also ways to improve on identification of structures and navigation, which is really where the market is headed. So having that type of bundled pricing structure while also incorporating a per use fee for the software are all models that we're looking at.

And it's nice to see intuitive leading that charge right now. 

nectar: Oh, interesting. Okay. Yeah, so yeah, with new technologies, you comes new ways of of, like selling and, generating generating revenue. So that's really interesting. You, so going back to pre-seed funding, I guess it just officially announced like, what are your goals with the funding, right?

So is it on the product side, sales side? Like how are you prioritizing your capital allocation? 

Amy: Yeah, I would say our main goal is to get the product into an in, in vivo setting. So whether that is in human or in animal, we really want to demonstrate the product in a live setting where the product Claris is running in real time and reducing visual obstructions.

So that's our main goal. And then within that it's really a big tech focus as we are. Really in the r and d stages where we're building a product that it hasn't been done before in the space. And so we're really creating literature on the topic, which is exciting and making these technological advancements so really de-risking our technology and bringing it into a live study.

nectar: Oh, interesting. Yeah. Very cool. So yeah best of luck. Yeah, I think, again, I saw your pitch at AA salon. You mentioned like you raising a seed next year if all goes well. So yeah. Best, best of luck with getting it into the real world. 

Amy: Thanks. 

nectar: What are you most excited about? As the next step?

I know like you said still early in the journey, but what are you what are you thinking about that gets you, kind, gets you going? 

Amy: It's every time I go to conferences showing I mentioned the iPad demos to surgeons and seeing how excited they are like that, that really energizes me in this development.

I even, I met a surgeon who immediately said, I want this product. In my operating room, when can I get it? And that, that's just, that feels really energizing and like a great piece of information to show that we need to keep building this. So yeah, just. Getting ready to complete that clinical validation.

We're now starting to evaluate the product on a retrospective data set. So that's on recorded videos to demonstrate the image quality improvements. We're starting to get surgeon feedback and then bringing our product into an animal study and seeing it working in real time. We'll be exciting and providing those updates to strategic companies as well.

nectar: Yeah. You're at the forefront of this whole I wanna say, health revolution, right? So I think everyone's talking about AI and healthcare. And you're going after one, one, one little piece of that, even though it's not a small piece. 

What else do you think is going on?

Like what el like in it could be in the surgery room or not, but curious to hear your thoughts. Someone that's in the trenches of what else is gonna change, if, 'cause then if you walk into a hospital setting today, it's oftentimes it's it's not that different from like 1970 sometimes, right?

Yeah. Do you think about this question at all? What's gonna change given this, these new technologies that we've developed? And then second of how, what is actually gonna change? I'm curious to hear you. 

Amy: Yeah, I think there's going to be a lot of change, especially with surgical robotics and there's a many more surgical robots coming out and with surgical robots.

That will allow or enable aspects like au autonomous suturing.

I think the whole surgical community as a whole is realizing that there's such a huge potential for AI-based technologies to assist in identification of structures, to prevent injuries. Training surgeons by guiding dissection planes or even being able to optimize the tool usage within the operating room.

So I see a lot of that in the industry and it's exciting to see where it's going. 

nectar: Yeah. Interesting. Yeah. Do you think the, surgeons particular as users will be early adopters or more laggards. Like in considering, sometimes I find this is maybe just a perception that, oh, it's hard to sell into hospitals, et cetera.

But sometimes you meet doctors that, like you said they're digitally native. They're not, they, especially the younger ones, right? Like the, they use this tech all the time. How do you think about that question? 

Amy: I think surgical society meetings are also bringing more attention to AI-based technologies.

And the fact that we're able to present our research at these clinical conferences is allowing surgeons to ask more questions and see the potential. I know there are some litigation concerns that surgeons might have with AI based technologies. Because all of this is so new, there's still some de-risking in that technology that has to be done.

And then as well on the pricing side some. Technologies may not be reimbursable, but add a huge additive value to the surgical space. So I think there will also be some changes in how products like these can be reimbursed in the system. 

nectar: Yeah. Great. Great. Maybe a final few questions around like you're building proudly building in Montreal, and I think we were talking about that, how you guys are new tenants in xxi in the space that was announced, the got the visit as well.

What are your thoughts? I'm curious more as a startup founder hey you're in this new space, brand new the value you're seeing, maybe areas of improvement, cur curious to poke your poke, pick your brain on it. 

Amy: Yeah. Oh, first on xe. It's such an incredible space where there are all the incubators, investors, different startup companies and really we've been there.

It's very new, just open, but the energy in the space is huge. And I had the opportunity to visit a similar space like this in France, and bringing all of the startup. Companies together for this synergy. And I am really happy that Montreal has a space like this to really foster innovation and drive that forward.

But Montreal, it specifically as a city, I feel is really entrepreneurial and I think there's such huge potential to bridge. The gap between AI and surgery here, because we have world-class surgeons at UDM and McGill who are all really interested in research and developing new solutions. And then we also have Mila for that AI powerhouse.

So it's we're really in a great space, I think for medical and AI technology. 

nectar: Yeah. Very cool. I think so too. Yeah, I've had a few health tech startups on, on the pod, luckily, and there's this cool little niche of health tech that's developing in the city and I find it goes a little bit under the radar.

I'm trying, try and play my part and bring it up. But yeah, some really cool companies and I don't know. I don't know why I don't have the exact reason what's in the water here of like smart people like you hey, we figure out this huge problem. So yeah, I wanna say kudos.

Amy: Thanks. 

nectar: Maybe I could probably poke you for a longer time. Be respectful. Maybe final question to wrap up. If people wanna learn more stay, keep updated on your journey, what's the best way, 

Amy: Following us on LinkedIn? Vote me. We're quite active on social media or if you visit our website.

www.vo.ai. We have a quarterly newsletter that we send out if you're interested in keeping up to date with our product progress. Feel free to subscribe there, 

nectar: Amy. Thank you so much. 

Amy: Thank 

you.