15 minutes with the top man of Titan Medical Inc


How’s this for a fantastic start to the new year? We got the opportunity to snag an interview with the CEO of Titan Medical Inc. Even though time was limited, we managed to get into our short interview all of the pertinent info needed to give us great insight into the company as well as the security behind having a skilled leader at the helm.- We were not disappointed.

David McNally is the President and Chief Executive Officer of the Company and joined Titan after serving as the founder, President, CEO and Chairman of the Board of Domain Surgical Inc. and Co-founder of ZEVEX International Inc., both of which are within medical instruments sector, which was acquired by Moog Inc. David earned an MBA from the University of Utah, and holds a BSc degree in Mechanical Engineering from Lafayette College, Easton, PA. He is also co-inventor of 40 patented systems.

Can you give us a brief overview and history of Titan Medical?

Titan Medical was founded by a cardiovascular surgeon in 2008 and initially sought to develop a multi-port robotic surgical system to compete with Intuitive Surgical’ s multi-port da Vinci platform, which requires multiple incisions in the body. Based on early research efforts and additional surgeon input, the company pivoted to single incision surgery in 2012. Following five years of research and early development on single-port robotic  technology and approximately 100 million U.S. dollars in invested capital, a new management team was brought in in 2017 to drive the company through the regulatory process and into commercialization.

So in terms of Titan medical, it originally started as a platform to complement the da Vinci system is that correct?

That is correct, based on the inspiration of a cardiovascular surgeon who used the multi-port da Vinci platform.

What are the unique properties for your next generation products. And in a snapshot. Can you give us the lowdown of one port concept?

Our single-port system delivers the cameras, light sources and two multi-articulating arms into the body through a single 25 milimetre diameter incision. The surgeon is seated comfortably at an ergonomically optimised workstation with a 3D HD flat panel monitor, and controls the system with two custom hand controllers and a set of foot pedals.

Via the patient cart, the multi articulating arms deliver instruments for tissue manipulation with not only precision and dexterity, but also the forces necessary for essential surgical tasks such as tissue grasping, blunt and sharp dissection, coagulation, and suturing.

The system is capable of suturing?

Yes. The hand controllers at the surgeon workstation and the 9 millimetre instruments that are delivered via the patient cart operate with such great dexterity that the surgeon can actually suture and tie knots with our system.

What is the margin of error, in terms of accuracy and vibration management?

With respect to the delivery of energy to the tissue, the margins of tissue damage are similar to the margins produced by manual laparoscopic tools. Also, we have virtually  eliminated hand tremor using robotic technology that might otherwise be associated with manual laparoscopic surgery. Typically, the margins of damage to the tissue are dictated by the form of energy, whether it be monopolar energy for coagulation or bipolar graspers for vessel ligation. And that is typically a function of the energy source and the end effectors that deliver the energy to the tissue.

The da Vinci system has been around for a few years. How does the Titan Medical system compare to the da Vinci?

We aim to deliver a simpler yet versatile cost-effective design, unlike other robotic surgical systems. Our patient cart has no external moving parts, which virtually eliminates interference with the bedside assistant. We have also integrated training simulation software into the workstation in order to hasten surgeon training, improve patient outcomes and speed adoption. Overall, from a cost perspective we plan to price our capital equipment at substantially lower pricing than existing multi-port robotic systems, and we expect to also deliver our technology at a lower cost on a per procedure basis. Further, we expect the service costs associated with our robotic surgical system to be lower than those associated with other robotic systems.

When designing your systems, it is with ease of use in mind for surgeons as well as patient outcomes. How successful have you been with the early adopters of this technology?

Experienced robotic surgeons from Europe, the U.S. and South America have given us high marks for ergonomics, and through 45 successful pre-clinical procedures, they have validated the utility of our system, even for very complex surgical procedures.

What has the reaction been from current surgeons and is there a difference of opinion between traditionalist surgeons and those who are new to surgery?

Our initial adopters are likely to be experienced robotic surgeons seeking to reduce trauma to the body by minimizing the number of surgical incisions, as well as surgeons who have been on the frontier of manual single incision laparoscopic surgery.

Following early adoption, we foresee the next wave of adoption to be more widespread, after demonstrating the safety, effectiveness and versatility of our system.

What is the uptake likely to be in different parts of the world for this technology?

We believe that the drive for improved patient outcomes and the cost effectiveness of care are universal global initiatives. With this in mind, we expect that our offering will have global appeal. Based on the portability of our system, we think that Europe will be a strong market for us, particularly in smaller hospitals that desire to adopt robotics but have budget, physical space and scheduling constraints that may limit the adoption of larger, less portable, and more expensive systems.

How are you planning to develop your product lines with respect to hardware, software?

Our research and development is managed by our Senior Vice President of R&D, Perry Genova, PhD. He directs our outsourcing strategy with global experts in their core areas of expertise including optics, electromechanical systems, software and firmware. This allows us to remain nimble and achieve best-in-class performance with key components of the system. In this manner, we can ramp up technical initiatives in key areas and then ramp them down when we have completed specific development projects.

What about intellectual property?

We have expert in-house counsel. Our Director of Strategic Development and IP, Jasminder Brar, has been prolific in developing and executing our global intellectual property strategy.  

As of today. We have secured twenty nine U.S. and international patent issuances, and 70 more applications are pending.

What about enforcement of your intellectual property. How are you going to protect those that seek to see for example reverse engineer?

Having the benefit of in-house counsel also allows us to constantly be canvassing the globe for any potentially infringing technology. To date, we have not identified any technology that appears to overlap ours, but we are vigilant and constantly watching

What excites you most about Titan medical?

I continue to be inspired by our team of executives and employees and the expert surgeons who advise us. This, combined with our unique single incision offering and position within the multi-billion dollar global robotics market opportunity sets the stage for a very exciting future. Further, we are publicly traded on the Toronto Stock Exchange under the symbol TMD and on Nasdaq under the symbol TMDI, so there is potential for us to generate substantial returns for our shareholders.