Our Investment in Realtime Surgical Assistance – Activ Surgical™ Raises $45 Million in Series B Financing to Advance Autonomous and Collaborative Surgery

By Brent MacDonald – Principal @ Rising Tide VC

A surgeon’s decision-making abilities during a procedure are indubitably seconded by none. However, certain steps in any surgery–even in standard surgical procedures–require surgeons to make decisions based on not only what they can see, but what they cannot see as well. Regularly, surgeons are forced to make vital decisions during surgery based on intuition and prior experience. 

Activ Surgical (Activ), the company that completed the world's first autonomous robotic surgery of soft tissue[1], is building ActivEdge™, a hardware-agnostic surgical software platform that empowers minimally invasive surgical systems to autonomously collaborate with surgeons. The first product on the ActivEdge™ platform is ActivSight™, an intelligent light system that augments surgical vision in real-time, providing surgeons with information not currently available today. The initial target market is the 12.4 million most common laparoscopic procedures, where perfusion and critical structure identification are crucial to optimal outcomes. Anastomotic leaks account for a 13-30% hospital readmission rate in Activ Surgical’ s focus markets.[2]

The Company is backed by over 100 years of med-tech experience in its senior leadership team and was spun out of research conducted by its founder—Dr. Peter Kim. Activ’s CEO is Todd User a seasoned leader with more than 25 years of medical device and healthcare experience. Activ recently announced the completion of its first-in-human surgery clinical trial utilizing the Company’s technology-as-a-service bundle—the ActivInsights™ augment reality (AR)-based software suite and the ActivSight™ imaging module. Procedures for the study at The University of Texas Health Science Center at Houston (UTHealth Houston) were led by Dr. Erik Wilson, professor in the Department of Surgery at McGovern Medical School at UTHealth and a leading bariatric, endoluminal, and robotic general surgeon; and Dr. Shinil Shah, associate professor at UTHealth Houston and a preeminent general surgeon with expertise in advanced gastrointestinal surgery. The safety and feasibility study was conducted across bariatric, colorectal, and gallbladder procedures—surgeries in which intraoperative assessment of perfusion and anatomic structures are critical to prevent costly and life-threatening complications.

On the regulatory front, the Company was issued its third patent from the United States Patent and Trademark Office (USPTO) for its ActivSight™ interoperable imaging module. Activ’s first U.S. patent for the ActivSight™ imaging module was issued in 2021, with a second patent granted later that year. This third patent – U.S. Patent No. 11,206,991 – was issued in December 2021 and protects the Company’s proprietary system and methods for processing laser speckle signals, which are currently delivered via the ActivSight™ module.

Activ Surgical will use the Series B financing to support the commercial availability of the ActivInsights™ software suite, including the first Insight—an AR-based overlay that displays tissue perfusion in real-time without the use of traditional dyes. The funds will also be directed to support US commercialization, enhancing the ActivInsights™ software platform, and developing its first ML-based insights. The Company has raised a total of $60 million to date.

Why We Are Excited?

Activ Surgical presents a compelling opportunity for investment as it is focused on propelling the surgical robotics standards while mitigating risk from a regulatory perspective. While achieving full autonomy will be challenging and likely a long road ahead across all surgical robotics, the Company’s strategy to implement autonomy in shorter portions of surgeries (like suturing) provides a stepwise change toward larger autonomy. The Company’s software and sensing platform work dynamically with the installed base of surgical visualization and robotics systems to provide real-time intraoperative visual data and images not currently available to surgeons through existing technologies. Its ActivEdge Platform will likely allow other traditional robotics companies to enter the surgical space and create an accelerated push where both robots and surgeons have collaborative decision-making capabilities.

Read the full Series B press release here.

Activ Surgical Vision - Founder and CSMO, Peter Kim MD Ph.D. Link here.

Rising Tide Fund Managers, LLC and its affiliates (“Rising Tide” or “We”) is a United States venture capital firm investing primarily in the information technology and healthcare/life sciences markets. Over the last 35 years, we have partnered with family funds, high-impact investors, and strategic partners to help launch and expand startups in a variety of industries across three continents. We are dedicated to cooperating with our entrepreneurs at all stages: from financing to leveraging our international networks to facilitating exits by design. For more information, visit www.rtf.vc.

The portfolio companies described herein do not represent all the portfolio companies purchased, sold or recommended for portfolios advised by Rising Tide. The reader should not assume that an investment in the portfolio companies identified were or will be profitable. Past performance is not indicative of future results. Investors should be aware that a loss of investment is possible.

[1] Journal of the Society of Laparoscopic & Robotic Surgeons. JSLS. 2019 Oct-Dec; 18(4): e2014.00154.

[1] In 2016, inspired by a vision to democratize surgery, Activ Surgical performed the first fully autonomous suturing of soft tissue, outperforming open, laparoscopic, and robot-assisted techniques (STAR). This breakthrough achievement demonstrates a new realm of possibility for medical technology.

[2] Journal of the Society of Laparoscopic & Robotic Surgeons. JSLS. 2019 Oct-Dec; 18(4): e2014.00154.