Medsider: Learn from Medtech and Healthtech Founders and CEOs - Designing for Access, Not Just Affordability: Interview with SS Innovations Founder Dr. Sudhir Srivastava

Episode Date: July 6, 2026

In this episode of Medsider Radio, we sat down with Dr. Sudhir Srivastava, founder, chairman, and CEO of SS Innovations (Nasdaq: SSII). The company’s SSi Mantra surgical robotic system supports a variety of surgical robotic procedures, including cardiac surgery. Sudhir brings more than three decades of experience in minimally invasive and robotic cardiac interventions, having served as Director of Robotic Cardiac Surgery at the University of Chicago and founder of the International College of Robotic Surgery. A pioneer in the field, Sudhir has performed more than 1,400 robotic procedures, including over 750 beating-heart totally endoscopic coronary artery bypass (TECAB) surgeries.In this interview, Sudhir discusses what it takes to democratize robotic surgery beyond affordability, how SS Innovations built teleproctoring, telesurgery, and the supporting infrastructure for its robotic platform, and his milestone-based approach to financing a capital-intensive medtech company. Before we dive into the discussion, I wanted to mention a few things:First, if you’re into learning from medical device founders and CEOs and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.And if you’re ready to level up your medtech game, you should check out Medsider Courses — 8-week masterclasses covering topics like fundraising, M&A and exit planning, design and development, clinical and regulatory strategy, and commercialization.These courses, featuring hard-earned lessons from elite medtech CEOs, can be purchased individually or come free with our All-Access Pass.If you'd rather read than listen, here's a link to the full interview with Sudhir Srivastava, which includes a link to ScottBot — an AI version of host Scott Nelson trained on every Medsider interview and playbook. Feel free to ask ScottBot any questions you'd like!KEY MOMENTS FROM THE INTERVIEW(03:01) - Sudhir's journey from performing the world's first beating-heart robotic bypass to founding SS Innovations (07:14) - The 22-year-old patient who became the catalyst for Sudhir’s affordable robotic surgery platform (08:59) - Building Mantra 3 from the ground up in just five months (12:14) - Inside the engineering process that eliminated months of costly iteration (16:20) - The question that shaped SS Innovations: "How do you democratize access?" (27:10) - From one office to performing 24 telesurgeries in 12 hours across India (29:29) - How a mobile training bus became part of Sudhir's answer to make robotic surgery accessible (33:49) - Lessons from commercializing a surgical robotics platform across developing markets (39:43) - Starting with just $5 million: Sudhir's milestone-based approach to fundraising

With the whole idea of our teleproptering and telepresents, not only be able to guide, but then this way avoid patients traveling, having to go to larger centers or metropolitan cities. I think that was one of the things, you know, the question of how do you democratize? And that's the only way because otherwise only large centers we have, but not only we created an affordable system, back now in tier two and tier three cities, But through, tell you so is a leaf. Welcome to MedSider, where you can learn from the brightest founders and CEOs in medical devices and health technology.

Join tens of thousands of ambitious doers as we unpack the insights, tactics, and secrets behind the most successful life science startups in the world. Now, here's your host, Scott Nelson. Hey, everyone, in this episode of MedSider, we sat down with Dr. Sudir-S-Strava, founder, chairman, and CEO of SSI. innovations. The company's SSI Mantra Robotic System supports a variety of robotic procedures, including cardiac surgery. Sudhir brings more than three decades of experience in minimally invasive and robotic cardiac interventions. He is also the founder of the International College of Robotic A pioneer in the field, Sudhir has performed more than 1,400 robotic procedures, including over 750 beating heart, totally endoscopic coronary artery bypasses or teacabs. Here are a few topics we

explored in this conversation. First, beyond affordability, what does it take to democratize health care? Second, how can early stage companies reduce costly iteration cycles? Third, what it really takes to build the right infrastructure for advanced medical technology to scale. And last, how do you build a capital-intensive med-tech company without raising hundreds of millions of dollars? Before we dive into the full episode, if you're a med tech founder or CEO preparing to raise capital, you should check out the med-sider fundraising cohort. This four-week live workshop combines small group sessions with real-time feedback to help you sharpen your investor story, build a targeted investor pipeline, and run a focused fundraising sprint instead of a never-ending slog. Over the month,

you'll walk away with an investor-ready narrative in deck, outreach scripts that actually get responses, a refreshed LinkedIn profile, a simple content plan that keeps you on investors' radar, and a repeatable system for running your raise. You can join the waitlist at medsider.com forward slash fundraising cohort. Again, that's medsider.com forward slash fundraising cohort. right, let's get to the interview. All right, Dr. Sudhir Shavastava, thanks for joining the MedSat Radio program. Appreciate you coming on.

Very, certainly. And thanks for giving the opportunity to talk. Thanks. Well, I'm looking forward to the discussion and learning a lot more about SS innovations. I think a lot of our listeners are probably at least, at the very least, loosely familiar with the company, but maybe less so your background.

So let's start there. I recorded a very abbreviated bio at the outset of this episode. But give us like a one to two minute overview of your background before starting the company. Sure. So I am from India originally. After graduation from medical college moved to United States, I started out in St. Louis, then moved on to Vancouver, British Columbia, and did my private plastic and general surgery in the city. After that, moved back into Texas and back in the early I guess 90s, was hard to see and are there different areas of building art

and because we were all trained doing the screening of the sternum, who stopped the heart and do whatever we get to do. I think if we're in the mid-90s, become very interested in less than ways the approaches to art surgery and started out with bypassed and then later on the overlap and upwards I called the product that by by-by, I'm just through small incidents between the lips on the left side, you were doing all bypasses and even the valve strategy, started to go through small incision.

And the whole idea was to reduce the patient morbidity, complications, and the recovery times. And then in 2000, the Vinci system got approved by FDA. And then I was building a hospital in West Texas, a small town, Odessa, Texas, population of 100,000, surrounded by a bunch of giants that have been there for 50 plus years. And everybody thought,

were crazy. Will it really work or succeed? And you're pretty confident in what we were doing. And so we give the hospital. And with that, we purchased the dementia system because I wanted to really take it to the next level where we can actually do our surgery through tiny, you know, small fingertips size decisions. And I was part of the clinical trial also for Da Vinci that time. The leading heart pickup came along later. But the initial trial was arrested heart and which was subsequently approved and also an electric population.

And then I think I just kept pushing the envelope and did all kinds of early pioneering work that nobody in the world had done. In fact, I was the person to do beating hearts totally an underscore practice surgery under FTA permission. I think I'll tell you this

a little story. I think people might be very interested. So the patient came was a perfect candidate for what we were going to do. And I did tell him, I was, you were going to be the first one. So he said, Doc, I'm going to be a guinea pig. I say, yes. And so let me think about it.

And then two days later he called, he was ready to go. And he did his operation first time in actually the United States. Took me five hours. We got a lot of figuring out to do. But that patient went home in 23 hours after surgery homes. And then a week later, he drove from West Texas to Phoenix, Arizona, 800, months away. And that was very, very inspiring. And then I just kept going, actually, and what we saw, I did almost like 1,400 per psorbic cardiac cases, 830, and hospitality, and these numbers

were the largest in the world at the time when I was in the United States. And almost 20% patient went home next day after heart surgery, 50% in two days or less. And I think this was almost like its final frontier for our surgery and we were really proud and happy. I just kept going. Then got invited to EMJ Chicago. I was on the faculty and director of robotic credit surgery launch their program. And then Atlanta went to St. Joe's Hospital, which is part of Embry now. 2011 decided to go back to India to launch robotic programs to bring wonderful

technique and technology. It's very quickly found out. It was very expensive. And maybe I should fogs here. And it kind of gave you a background until I got to India. And that makes up as to what made you get away from heart surgery and get into technology development. And maybe I'll let you ask again a different question first. That's a great background.

And I think for those that have loosely heard of you, right, they may not be so familiar with like how prolific of a surgeon you are and were kind of leading up to starting the But we're recording this in kind of, let's call it, mid-20206. But the company, you kind of started, I mean, it looks like you started it back in 2014. So we're over over a decade now into SS Innovations. So give us a sense. Like what caused you to say, I mean, it sounds like cost was a big driver, but was there anything else? What caused you kind of say, look, like there needs to be an alternative here other than intuitive? Wonderful question and a wonderful story to tell.

I had a 22-year-old female patient that had an age of septal defect, which is a continental defect, and mostly it closes, you know, at births or shown after. But in some patients, it remains open. And a perfect candidate for robotic surgery, and this is now back in India around 2012. And a brother brought saying that if she has this card in front of its test, based on culture and local reasons, she may not be able to get married, except they didn't have money. where the hospital wants to charge $400,000 rupees. I offered you to do it free. Rather, I tried to raise money. A month later, he called me.

He was too struggling and I never heard from then. That was the time that it was like a wake-up movement. They must do something. And that's when I started. Huge things. Anyway, so actually made a commitment. We must do something because there was monopoly by the entry research and they were doing great for developed economies.

and great for the shareholders, but almost 7 billion people at the time didn't have easy actually. So I used up almost for an $1 million of my saving is an art surgeon from U.S. tried whatever I could, went to Germany first, didn't work out, and they put a team together of 10 engineers,

worked out of home, then after that money, I wasn't practicing anymore, and borrowed money, sold my car, sold my furniture, kept looking for funding, And finally, actually in 2017, we thought funding, small $5 million to get started. And we just kept going. And I think the best part was being in India, the low cost of trussar across the board. And the team that was so enthusiastic, we would work very fast.

And again, when you don't have money, you have to do the job faster. Otherwise, you shut down. And so we kept going and develop this mantra system. And then the mantra two, we did the trials and then mantra three. And mantra three, believe it or not, we developed this entire new generation from ground up in five months. Wow, that's impressive. I want to go back in time and learn a little bit more about kind of those early days. But let's talk about Monja 3.

So what's the short pitch on why a hospital should consider, you know, Monja 3 versus, you know, versus another robotic system that they may be considering? Manthra three is very different than what was existing at the time. And mostly the Da Vinci was monopolizing everything. So my support was really one is not to copy, like many other companies now we know have done. And to make it different, more advanced, more technology, more user-friendly features, and all specialties including cardiac, because that, the winchi had to stop supporting at that point in time.

And also, beyond all this thing, most important, without compromising the quality, make it cost effective. So we literally created a system that is almost close to one-third the cost of the top model of the competing technology. And also with more features, more abilities, use of up to five-arms for in future we are developing certain newer technology. and also the focus on teaching and training. So along the way, we develop teleprocoring as well as tele surgery. So we really just foolish ourselves across the spectrum. Very good. I'm looking at the website right now.

I'm sure most of you that are listening to this interview have probably heard of SS Innovations, but we'll link to the website and the full write-up on MedSider, but it's SSinnovations.com. If you don't get there, it's ssinnovations.com. That is the website. You can learn a little bit more about Mantra as well as the the company and in Sudhir's background as well. So let's kind of rewind the clock here and go back in time. Let's stay on this topic of early stage development, right? Because it sounds like driving down costs,

you know, coming up with a system that works as well as, you know, the Da Vinci, but at a significantly reduced cost was one of the primary requirements. And so were there a couple of key things that were, you know, really important to kind of getting to that point early on in development where you could, you could actually have a workable system at a drastically reduced cost point. Yeah, sure. So I think, you know, I must say that I'm very grateful to Da Vinci and particularly to Dr. Fred Wall, who was the founder and, of course, she is now part of us as the vice chairman. So I think they did a great job in creating something that literally changed how we do surgery.

Let us do a very different pathway. And except that, I think there were many opportunities that things would have been. differently, but sometimes monopoly does not allow you and nobody else is there to compete, so people just keep going out they started out. So I think the one is that I want to express

my gratitude, I think, to early people who were involved, actually. But then I saw many opportunities that these things could be different and better. And also with my clinical experience as a robotic pharyosurgeon, having done all the number of cases, I knew

exactly what is needed by the end user. And I must say that helped a lot. And, you know, I will just sit down. The thing was that we didn't have a bureaucracy. You know, we and my small team. So we'll sit down around the table in a conference room. We just discuss the ideas, you know, draw on a blackboard, then have some digital drawings starting to evolve. And so every time, you know, virtually day and night with our engineering team, they were very bright. They had no idea about how the the surgical robotics are a little about, you know,

even the robotic experience was not there in India. But then I think they worked really hard, very creative. And the best part was that we will not waste time. You know, if they'll do something, I will know immediately that it's going to work or not work. So we're not waiting like for six months to call some surgeons, you know, test it and then start the cycle all over. And that's why if you look at some of the new,

the bigger companies that took this. 10, 12 years. And also I think so that was, I think, tremendously rectifying. And also, I think the team was very proud that we are trying to do something that nobody else could do, you know, because that monopoly lasted for a very long time. And as you are aware now, only recently in the last few years, other companies are coming up. So I think the brilliance of the team, their commitment, worked through holiday, didn't matter.

and to be able to do things very, very fast. And also they felt very proud because the surgical robot is a very complex technology. You've got all these components of the hardware, electronics, and various firmware and then integration the software. And it must work very precisely. And most importantly, it must be absolutely very, very safe.

And one of my messages always to the team was, let's create something. thing that you or your family, you'll be willing to have them go through tragedy with our system. So that attitude of perfection. I think, you know, so all played out, I think very, very well. You know, so today we have a team of almost 500 some people. Average age is 26, 27. And today, they know more than the IRT professors. They're all homegrown. And the best part was my core team. They stayed with me right from the inception. And so, It's been a wonderful experience.

We grew together literally as a family. And most importantly, you know, apart from the safety, the performance part of it, it was that not become stagnant. Let's keep thinking how else we can do it better. And that was always a motive actually for us that, you know, just don't get contented. And I use this kind of statement that best is enemy or better.

You know, this is how is it better? So I think from that view point, our team has been very dynamic and is really grateful to them. It's very gratifying that what we could achieve. And the best part that we created this system that is now reaching people that could never afford robotic system actually in tier tier two or three cities, almost 70% over today in small systems, particularly in India, are in smaller cities. would never think about getting a system. So now the way I was looking at, you know, how do we decentralized and democratize access? Because if technology is expensive, it is not going to

reach masses. I mean, that's what we have seen with the world. You know, very small penetration between United States, Europe and Japan mainly. And many of the developed economies also, and particularly Europe, they just could not get the system because it is expensive. The running cost is expensive, the maintenance agreements are expensive. So my goal was to really reduce the cost without compromising, performance should be same or

better, which I think we have really created this system today. It is better with not only our technology features, but our abilities, our tele capabilities that they don't even have. And so I think all that is how that is how. We have

done more than 175 30 surgeries and they have only anyone that they've done already tele surgery. And that means we are able to bring our expertise wherever required. So the patient don't have to travel. And I think you may have seen recently I did the longest distance case from Guyana into India 20,000 kilometers away. With the whole idea of our teleproptering and telepresents were not only to be able to guide,

but then this way avoid patients traveling, having to go to larger centers or metropolitan cities. I think that was one of the thing, you know, the question of how do you democratize? And that's the only way because otherwise only large centers we have. But not only we created an affordable system that now in tier two and tier three cities, but through telestrosily and we'll talk maybe a little bit more on this subject, you know, where we are going with it. Yeah, I want to touch on that for a second. But before we get there, I want to circle back around to your comment earlier about building in India, right?

Because I think, and I'm sure you probably heard this early on, most people said, well, Sudhir, if you're going to really get serious about this robotics company, you got a, you got to set up shop in the United States. You got to set up shop in Silicon Valley or maybe Germany, as you mentioned earlier. It sounds like you went to Germany, maybe out of the gate. But you decided to stay in India, build there. And it sounds like that ended up becoming an advantage because of the excitement of the team, right? This idea that, like, we're doing something completely different that no one has done.

It sounds like you were able to use that, obviously, to your advantage, right? But was that, how difficult was that, you know, to overcome some of the engineering gaps maybe early on? It was challenging, you know, some parents, you know, I'll say, you know, come on, guys, you know, what the hell are you doing? You know, let's think through, you know, spend time, you know, discussing things. You know, let's think loud because, you know, we don't have money to go through generation one, two, three, four. You know, let's really discuss whatever we need to do. of time so that we can bring it as close to a usable system as possible. And I think that really helped because, you know, again, being in India turned out a blessing.

Mostly, I was very frustrated. My God, you know, why did I leave U.S. and, you know, it's everything. Everybody wants to go to U.S. and hear, you know, people used to question my sanity. And I said, but that turned out a really blessing because we could actually hire people at much lower cost. These guys are brilliant. They did not have an opportunity to showcase what they could actually do. So basically, you know, we created a platform for them to really apply their knowledge and creativity. And I think that really was very helpful.

And same thing, manufacturing in India, because of all of these same reasons, is much cheaper. I mean, if I was in US, I can tell you, because even until now, we are all self-funded by the way. you know, we have not raised money from public. And even though we are a public company at this point, but so far we have not raised money from public. It's been always family, friends, colleagues, and who trusted me. So so far, this is how we function. Literally with the shoestring budget compared to some of the giants that have spent

hundreds and hundreds of millions or some more than a billion dollars, you know, and then not even have a product. So I think, you know, being in India, I turned out a blessing. Also, the bureaucracy, although we are not saying that the biggest process of regulation, I should not be there. We followed every principle to make sure that, you know,

it is the safest system that one can actually apply on patients. Again, coming from my heart surgery background and having a spirit of perfection, and they'll trust that people place in you. The same trust should be carried as we are creating a technology that will be touching the payment. So I think, you know, a lot of these factors actually help being in India. And then, of course, the hospitals that are willing to try,

done clinical trials at much lower cost. You know, if I was to run clinical trials in the United States, it is very, very expensive. And this is why if you look at some of these other companies, can you talk to them? Oh, you must raise at least $200, 300 billion. dollars and here I start out with five million and then in incrementally we you raise money as we needed and it really turned out that you know with small money we will get to the next stage show that

yes we are doing on the right track here things there's more money and I think so the investor had the confidence one I think whatever credentials I carry give my personal experience and the prediction but also we were constantly demonstrating that we are going to actually have a product and it's not just playing around here. So I think being in India turned out a blessing across the board and also the need is there in the country. And you look at India as a population of 1.4 plus billion people, 70,000 hospitals. And by that time, then we got into it, only around 250 total robotic systems in India. Nothing else. When you look at it and large centers only. So I think one is that there was a huge need and people were really hungry for it.

Patients want robotic surgery, except the doctors could not have accident because hospital won't buy it. And I think so all this really opened in a short time. Now we have installed 210 systems. And we began every record of everybody so far in terms of our clinical valuation, clinical results, the number of systems, and all these advances that we have achieved. And being in India made it very easy because of the relationship with people to be able to do trials. And so all that became much easier. Again, you don't have all the lawyers that you have in your legislature. So this is another thing that kind of gives you a break.

The most important thing was that it must work and must keep that in mind that outcomes are absolutely perfect. Yeah, yeah. And most people, and this is a fair argument, would say, I could see the advantages of building a company to India for the cost, right? But with something so sophisticated, right, a platform like yours that's highly, highly sophisticated, they would have said, you know, you can't do it, right? But you've turned that, you've flipped that upside down and said, no, no, we can, right? And you've obviously built out a group of engineers that have proven themselves very capable and use that to your advantage. So I just think it's a really cool story. And one, it's a good example to point to when, you know, when other CEOs or other founders are building companies and hearing knows all the time, right, when they have a conviction around, you know, a certain direction for their companies. So I think it's a great story. But I want to touch on the telesurgery aspect, too, because I think when most people think of a low-cost robotic system, they think it offers less features, maybe, or is less capable,

right, than others. But there again, you've proven probably people wrong and said, no, actually, it's full of features as an example. you perform this very long-distance telesurgery case. So how have you gone about kind of overcoming that perception and really proving others wrong that you've got a full-featured platform here? Hey, everyone, let's take a quick break to catch you up on MedSider courses. These eight-week courses are designed to help you learn winning formulas

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Okay, let's get back to the conversation. And I must say, you should not come out as being arrogant, but I can tell you today as a robotic surgeon, but not as a founder of the CEO of SSI, that our system has the best features, the most features that many of these companies don't even have. And all their technology capabilities, all the specialty capabilities, instrumentation that we are developing constantly to make surgeons life easy. Because all these things ultimately will translate into plaster procedures and better outcomes. Because if surgeons find difficulty, then, you know, challenges are there and outcome may not be grave. So from that viewpoint, I think we feel that we really have achieved, you know, and I don't want to say superiority,

but results speak for themselves. We currently have zero mortality, device-related, zero complication, zero injury. Nobody actually can demonstrate that. And then with the capabilities of teleprocting, see, because one of the biggest challenges is to be able to launch new programs. And so I started out with teleprocting, I think, almost three years ago, whereby literally we developed these VR classes. And it's like the old Tom Cruise's Minority Report movie.

You have all these multiple screens right in front of you. And you can tell you straight, you can guide surgeons. You know, I've guided people sitting in my office, having lunch, so I don't have to travel. And so the next thing for me was to be able to really implement tele-tragedy. So if you look back at the history of robotics, back in the 80s when research was funded by NASA and DARFA through Stanford Research, the idea was to do telechrist in space and in battlefield.

But that time, technology didn't exist and bandwidth just was not there. So once she saw that now high-speed connectivity is there. And our team figured out how to do. And we went through a very systemic, actually, development process whereby within our office, we will test it from one room to the other corner room. And then we did annual trial. Then we did human trials. So we went through very responsibly in terms of the whole development of telestroy,

make sure that the delay is acceptable, make sure that there is a team at the other end in case something needs to be done. So we took all of these sectors into consideration. And actually, we were the first one globally that in November of, I'm not successful in 2014. We got that approval for tele-surgery from the Indian regulatory body after we presented all the data. And since then, we have been performing, and the best part, what we found with tele-surgery, that various doctors, specialists, they're helping each other. So if general surgery hospital has got a complex urology case, but they will talk to each other.

And long distance, you know, the urology is helping general surgeon and vice versa. And I'll tell you, an example back in November, December of 23rd, we did 24 telepshire hours from our office. Nine surgeons operated, the locations scattered all over the country. You just imagine there's 24 patients in one day. about the benefit of experts that otherwise they have to go somewhere else and it's not easy and it's very inconvenient for the patient's family and pack up and go through larger cities and expense and emotional distress and etc and then of course we developed this chair

redefined working from home so in November of last year I actually operated sitting in my living room and the patient was 300 kilometers away so I think the whole like idea was that one that we must use the telestresory, not as a hype or marketing tool or anything, but to really help and what I say, the decentralized excellence, that means we can bring it the surgery to their roadstarts, you know, wherever they may be. So they don't have to travel. And also to be able to teach and train. So, you know, you can have the surgeon at the other end. They are watching what we are doing. Let them do the next phase. Proctor then and necessary take over and finish the job.

Then did that idea, we created this bus also. We are calling it Mantra M. And we have our system there. And this bus is toured easily over the last year, literally all over the country. So with the two ideas, things one to train people. We don't have to bring them to our headquarter. Secondly, create awareness in the general public that there are these options available. because many of the smaller communities or rural area don't keep it having an idea that such thing exists actually.

And moreover, we actually equip the bus that in sitting in the bus, we can do a trilogy and we did. And our next now is we are creating a mobile operating room actually. And it will be on a truck and we will park it and using high speed connectivity, we can operate from the river. And many of the things that we are developing, we are developing also a drone-based robots for the army, which can literally fly, you know, and get in the battlefield thereby a lot of people die because there's not enough time to, you know, bail out the emergency. And so we're looking at all of these things and not just army, but also many natural disasters that occur, whereby you don't have access to the efficiency or the road is blocked or whatever. maybe the reason. We're looking at a lot of these things in a very, very different way in terms of, you know, trying to see how we can help patients, you know, wherever they may be. Sort of redefining, you know, remote work, I guess, right? For surgeons?

Yes, that's right. Yeah. Most people thought there's no way a surgeon could ever work from home, right? And you're, you know what? I was going to do it from bedroom. I said that would be too much. Too much. Maybe wait for a couple years to do the first case from your bedroom. That's funny. The best part, but the best part also was that we don't tie up operating room to be able to do tele surgery. So now we have created this independent chair that, you know, a lot of surgeons, now I've asked, you know, can I put me in my office? So I don't have to even go to the hospital to do as long as I have a team there. It's really impressive. I mean, if you had to, if you had to look out five to 10 years from now, what percentage of global surgeries do you think are performed,

via telosurgery. Do you think this is a growing trend? I think absolutely. I think it will occur because if you look at a global level, you take Africa, you take Middle East, many other developing economies, even in developed economies for the United States, penetration is only 35% of robotics. And that means you have a large population, 60 plus percent that they still have to travel to the larger metropolitan hospitals. Just imagine if you have an affordable robot for, of call. And the only reason, even in the U.S., smaller community, are not able to buy, one is the

talent, and secondly, the cost. And so telecurs, really as a low-cost robots, it will really reach out even in developed economies that, you know, don't have to travel to, you know, Chicago or New York and, you know, all of these are the larger center. So I think it will help across the board globally. Yeah, it's really, really impressive. I want to circle back around to to Fred Moll's involvement in the company, as well as just, you know, you're kind of the way you've approached raising capital as well, because I think that's also unique. But before we get there, let's touch on commercialization. You said you mentioned over, you know, 200 systems have been installed to date.

When you think about commercializing in countries outside the U.S., whether it's India or whether it's, you know, another country, are there certain things that you've learned or may be surprising to U.S.-centric companies that have struggled, right, that have struggled bringing their technologies outside the U.S. Yeah, I think the most important thing, again, for, you know, years company particularly is a high price, that they have not been able to get to many, many countries. Absolutely.

And some countries never even had a single robot, and they won't even go there, you know, because they're not interested if we cannot sell a whole bunch of them and set up their, you know, servicing and all of those things. So currently, actually, we have approval in 15 other countries. 12 of them have our robotic systems. And these are all the countries that actually are, you know, what one would call, you know, developing economies, you know, and so on. And so I think having an affordable system system has to solve, having totally present capabilities actually to be able to launch programs to train them.

And I travel literally even through there all over the world, you know, operate with a surgeon there. So I think, you know, so we are addressing all of that thing. Again, as we are also going through virtually the restrictions or regulatory approvals in many countries, so there are almost 120 plus countries that do not require either USFDA or European approval. And of course, so we are pursuing all that thing, but also equally we are proceeding both the European and the USFD approval. And God willing, and if everything goes well, maybe later part of this year, we should have both of those approvals. And I must say people are actually looking for us to get these approval so that, you know, affordable system with all the capabilities that we have and the telecapability

is also becomes available in these two jurisdictions actually. It's not there even in the United tele surgery in U.S. doesn't exist at all. Wow. So you're a lot closer to possibly entering the U.S. market maybe than I even anticipated. So it'd be fun, certainly fun to watch your progress on that front. Let's chat about Fred Moles involvement in the company, because I think that was some recent news that you announced, and he's obviously synonymous with robotic surgery via intuitive surgical. So how did that come about? And what do you think he saw in SSI that led him to kind of say, I want to join. I believe in the mission. I want to join the team. Yeah. And I'm sure, as you know, that he was of course, the founder and, you know,

created this whole robotic surgical system. And then I think he left, I'm not mistaken, around 2004, he left in duty. And then he started some of these other robotic companies, actually. And the last thing was Orris Phael, which he sold to Amazon and Thompson. And so, of course, you know, Fred has known about me. And all these years, you know,

although when I was doing all these pioneering work, I'm sure he was aware of it, But we never actually met during early years. And it was not until 2022 that, you know, the dialogue started because I was really looking for money. You know, we have reached a state and now we need to scale up. Now what do I do? I tried in India. And so previously I was a circuit with Aura's surgical robotics whereby I lost a lot of money.

And we kind of got matched up by who server was working on the engineering side. But anyway, so in fact, that time I met Fred first time, back in, I think, 2014 timeframe in Germany. And that time we were looking for some robotic problems. And then, of course, you know, nothing worked out. So when we became aware that how far we had advanced, so through mutual context, he expressed interest to, you know, talk to me. So we be chatted actually, and then he came actually to India in 2000. see, 21, and he saw the setup. And I think that really got him excited that how far we had come very quietly. You know, we were like a submerge completely. And nobody else knew about us.

He were completely under the radar and just kept working. So I think he got very excited, and then he decided to invest certain funds with us. And then he kept investing also. And then somewhere along, you know, I asked him, I said, you know, please join him on with board and they very graciously agreed and then of course, you know, the president of the vice chairman. And so it's been, I must say, a tremendous relationship, not only as college, but as he's considered father of surgical romantics at least, you know, the cost of historical timeframes.

But he's a very thoughtful person and he's a great association actually with him because I am kind of a gogo guy and he has kind of. of really slowed out. You know, so it's a really wonderful balance, actually, with his experience and my enthusiasm and, you know, the speed that we want to really work. And this is one thing that he really liked because, you know, and then one of his thoughts always was that more patients should benefit. But unfortunately, because of the pricing that he has no more control since he had left

the organization. that was his restriction, that it created a system that would not help most people. And this is what I think he saw in us. Not only the technology actually worked, not only it has more advanced features, etc., but that it will reach many. And so I think it's been a wonderful, wonderful association with things. And certainly testament, right, to have, as you said, the godfather of robotic surgery invest personally, right?

And then feel strongly enough about where SSI is headed to join the board. So I think that's really cool. When you think about your experience is raising capital for SSI over the years, we could probably spend a whole hour talking about this. But are there a few things that come to mind that may be helpful for another physician that has an idea that wants to build a company? What would you advise them? What are some of the key learnings that you picked up on over the years?

I think, first together, as many angels as possible. Because initially, nobody wants to fund their idea. I know, unless you really have some. you know, sympathize or high level recognition. But I think, you know, we have an idea and wherever obviously do need to show some development and some future for what you're going to do because I mean most investors look for returns also. You know, there are some people who do it for impact. But most, again, and there is no criticism because I think money is needed and people who do invest more money, they hope that it will grow.

And so I think, you know, one is, you know, getting these angel investors. And then it starts all slow. And, you know, just don't raise large amounts of money because what are we going to do with it? Because when we are starting out, we still need to develop and show. And I think what at least the approach we took was, say, we graduated approach. So, you know, with certain money, I could have certain talent. There is more money after showing I could have higher level talent. And literally, this is how we've progressed.

because if you bring a whole team of people when you don't even have a product, what are they going to sell? You know, you may bring some high-flying people and pay them large amounts of money because of their, you know, historical credentials. But you need to have a product.

And I think so you did it in a very intelligent way, of course, because there was challenge also. So it's like you figure out what you have, how you're going to use best, and how do you take it to the next level? So now, you know, We'll literally at this point in time, almost $78 million we have reached self-funded. And again, trust of people, people like Fred on other friends who have, you know,

chibed initially. And now our goal is, of course, to get to the next level of commercializations, also getting to various global jurisdiction. We need to raise money. And, you know, whole marketing and sales in particularly in the United States will be, you know, and we will be doing directly. But this will need a lot more money. So we are at this point in time looking at all different options.

And that was one of my reasons, actually, to become part of the U.S. public markets. Because it gives, you know, people here in the U.S. particularly are known to invest into innovation and development. And, you know, look at the success of their intuitive news to be. And there they are today. So people aren't looking for other options at this point in time. So we are actually very aggressively pursuing this year because we are planning to scale up all our panic-sattering, more manpower, more countries. So we are looking to raise a fairly significant amount of money at this point in time.

And I think once we get past FTA, that may be very helpful because again, the U.S. side investor, you know, that's kind of a only way that you must have FTA or sure U.S. revenues. But I think the opportunities for us remain very, very good in U.S. because of all the business and the shots earlier. It's been impressive how far you've made it on, I would say, a relatively low amount of capital, right? I mean, I think you said roughly about $80 million to the company and you're this far long. I mean, these are not simple systems to build at all. And so huge kudos to tune in your team for not only moving fast, but also being very, very efficient with your capital. I know we don't have a lot of time left, but I want to, and I want to get to the rapid fire

portion of the interview. But again, for everyone listening, I'm sure you've already, you've heard of SSI a number of times, but again, sSinnovations.com is the website, SSinnovations.com. We'll link to it in the full write-up on MedSider, but highly encourage you to check out the company, which is, as you do you've pointed out, is publicly traded on NASDAQ right now. So be looking out for the opportunity, potentially, you know, buy a little bit, buy a little bit of SSI stock in the future here.

So let's get to the rapid fire portion of the interview here. Just three questions. feel free to expand if you want a little bit. But first one is when you think about the next 12 months, take us out to kind of mid-20207. What are you most excited about over the next year? I think we would have penetrated many more countries. We would have received both U.S. and European approvals.

We include market opportunities and meet the unmet need in both the jurisdictions. Keep adding new different types of surgical robots that we are working on right now. We have already opened up pedantic, actually, population. We have created a 5-millimeter instrument, so open a completely new arena. We are going to be a specialty-specific robots and instrumentation. Again, make life easy, and use up AI and machine learning, and initiate semi-automation and at some point automation. And then, of course, also the whole tele-sides whereby we have developed some single-on

application for diagnostics and therapeutics. Again, to be able to part these guys on small vans and take them to smaller community, whole camps and do the screening because, see, one of the biggest challenges is lay diagnosis, that poor outcomes. So all of that thing, and then mobile units that we can send when patients need surgery. All that was future. And secondly, also to initiate a step which we have done already in India, to introduce in the teaching programs, actually, in the post-graduate programs.

So instead of while you are already in practice trying to learn, right from the beginning, from the medical college, both here on, people are exposed to robotics because this will be the future. So yes, it will take time by the time they finish training, etc. But suddenly they will create a pool of surgeons, assisting teams, staff, all of that, actually. And I think the other thing that we are looking for the government and private partnership, because a lot of these things, because we cannot solve entire country's problem as a private

company. So the government must get involved. How do we bring the care in terms of the infrastructure side of thing, power, connectivity, and awareness? And so, and then covered it through as many insurance programs as possible so that it becomes completely affordable. So that is kind of the vision going into 27. There's certainly a lot of things to get excited about for sure. What's one lesson you think every MedTech entrepreneur should really understand if they're going have any semblance of success in their venture. Absolute commitment, first of all, that you really want to do it. Do all these studies ahead of time.

There is a need, and what we're going to do will actually, there will be a niche for you. So it's not just trying to actually mental. Secondly, you stay with it. Be patient. Always prepare that it's going to take more money and longer time than you think. And just be behind it totally. You know, it's like when I got into it, I dropped every single thing, and that was absolutely total focus.

So I think the focus is very, very important. And if you do have medical background, I can tell you it really is very helpful. Or if you don't have learned it. Because otherwise, you're always dependent on medical professionals. And that's translates into longer times. So I think if, you know, if you're going to be in that thing, learn the subject. matter. Don't try something that you have no idea at all. Because you'll fail almost always. So I think that's, and be persistent. Really good advice to leave a lot of entrepreneurs that are

listening to this with. All right, last question. If we had to add the opportunity to kind of go back in time, maybe take us to your early 30s as a kind of a stamp in time. Anything you tell, the younger version of yourself? Me, I was always, I guess, I just had a little stubborn personality. And as a hard surgeon, you become stubborn. Estabund means, you know, that don't give up. You know, it's just like when you're doing heart surgery, we have to do everything possible. We're dealing with sometimes patients that are almost dead.

But whatever we need to do, actually, don't give up, actually. And I think that is one thing I would say, if you have an idea, and this is how I guess I develop myself, you know, be as good as you can be, learn as much as you can. and be committed because you are in a very noble profession to do good to the patients. Never compromise that either because of your ego or you are in Harry. So I think that is what, and this is what I guess has translated into my journey with the robotics. Well, congrats on all your success, not only as a physician, but also building SSI.

It's really, really impressive. And I say that from, you know, from kind of entrepreneur to entrepreneur as well, right? I know what it takes to kind of get as far as you have. So huge, huge congrats. And thanks again for carving out some time to do this, especially considering you're at a conference right now and you're willing to do this interview. So I very much appreciate it.

Thank you very much, Scott. I really enjoy talking to you. Yeah, likewise. And for everyone listening, you made it this far. Again, check out the company, ssinnovations.com. We'll link to it in the full write-up, but s-sinnovations.com is the website. So thanks for your attention, as always,

until the next episode of MedSetter goes live. Everyone, take care. Hey, it's Scott again. One quick thing before you go. You see, I love bringing you insightful conversations with the best founders and CEOs of medical device and health technology startups. But here's the thing. I'd be super grateful if you could help me reach even more ambitious doers who share our passion. So if you found value in this podcast, if you found yourself nodding your head while listening, or if you simply enjoy what we're doing with Medsider, please take a moment to leave us a review. It's super easy. Just open your Apple podcast app or

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