Robotic surgery should solve the entire clinical problem, not become another expensive tool in the operating room.
In this episode, Tomas Baltrunas, Chief Medical Officer and Founder of Sentante, discusses the development of an intuitive robotic platform designed for endovascular procedures. He explains that successful medical robotics must support the entire procedure while allowing physicians to work with familiar instruments and established techniques. Tomas also shares Sentante's progress, including European approval for peripheral procedures and FDA Breakthrough Device designation for remote stroke treatment. He believes remote robotic care has the potential to expand access to specialized treatment and reduce healthcare disparities regardless of a patient's location.
Tune in to learn how remote robotic procedures could make advanced vascular and stroke care more accessible!
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[00:00:03] Hello everyone, welcome back to the Outcomes Rocket. Excited to be here at the Society of Robotic Surgery in Hollywood, Florida. I'm here with Dr. Thomas Baltrunas. He is the Chief Medical Officer and Founder of Sentante. Thomas, thanks for being with us today. Hello, it's a pleasure that you're having me. So it's a huge and nice opportunity.
[00:00:27] Yeah, it's our opportunity. And so to kick things off, tell us a little bit more about you, your background and Sentante. Yeah, so I am vascular surgeon and by education and I am practicing vascular surgeon. I am doing both open and vascular interventions. And many years ago, I had an idea. Well, it's so awful that we are just standing next to the patient and x-raying ourselves.
[00:00:53] And actually, this could be done remotely. And many years ago, I have seen and tested Corindus, Magellan in those days. And well, Magellan was a better robot, but Corindus was just a toy, I would say.
[00:01:08] And yeah, from there, there was an idea. And eight years ago, yeah, I have started developing this. So I met perfect engineers, perfect team. And eight years ago, we established a company. And from there, yeah, we progressed. And eight years later, we have a robot, which is just freshly seen, Mark.
[00:01:32] Congratulations. Thanks. So first clinical installations are upcoming in several months from now. And yeah, it took a long time, actually, eight years, but the robot is not a trivial thing, I would say. It's not. And you know, meant device takes a while to from idea to prototype to conception. And I would say eight years is really good, probably on pace, if not faster. Yeah, thanks. There's a lot of platforms on the floor today that have taken a lot longer than that.
[00:02:01] Exactly. I'm very happy with my team. So they are working as hell and we reached it, but eight years still, it's a part of our life. Yeah, that's for sure. So what's the key challenge in robotics within the vascular space right now? So maybe I will start a little bit from several years ago. So the thing is that in the operating room, me as physician and all other physicians, we do not need another toy.
[00:02:29] Anyway, we have more than enough various toys there. I mean, they are expensive, they take time and they add a marginal value, sometimes to the hospital, sometimes to the patient, sometimes to the operating team. But we don't need yet another one. If we invest as a hospital in a solution, so it means that it should work.
[00:02:52] So this was the initial background. So what robot do we need? We need a robot which is capable to do the whole procedure from the very beginning to the very end. Then it is a solution. Other than that, if it's only part of the procedure, it's an expensive toy. So this is how we started. And then it was another thing. So how to manipulate the robot.
[00:03:17] So you can take a joystick, you can take a gamepad, but conceptually with a joystick, it's just a control of the speed. So if you push joystick like this, it's a slow speed. If you push more, it's faster. But actually, it's not a control of the distance. If you want to control a distance, you have to train that physician. And those physicians are typically already starting their own cases at age like 35 or 40.
[00:03:47] For them just to be trained for another new technology, it seems nonsense. So that's why we came to a decision. Just take the same catheters and let the doctors do the same maneuvers as if they would be standing next to the patient. Okay. Okay. So it's super intuitive. And then the technology is super difficult and super sophisticated in between. But for the doctor, it's easy to use. Okay.
[00:04:15] This was the initial concept. And this is how the sentante was built. It was built around these ideas. Okay. I like that. And so ultimately, the physician doesn't have to do a lot of relearning. You learn to use it, but you incorporate your techniques and the way that you operate. It takes typically like five minutes. I think there is a very nice demonstration live in Congress where there was taken a doctor, never seen the robot, never touched it.
[00:04:43] He just stood up. And after the initial training of two minutes, he started doing a case live for the first time in his life with this robot. And he was successful. That's awesome. It was not definitely on patient. It was a... Cadaver. Yes, it was on a model. But still, I mean, it's the perception is super quick there. Totally. Yeah. And what brings you SRS?
[00:05:08] Yeah. So it's a nice Congress. It's the biggest robotic Congress in the world. So I think it's valuable to be there. A lot of important topics are discussed. A lot of similarities. Take it orthopedic robot. Take it laparoscopic robot. Take it endovascular robot. There are a lot of similarities.
[00:05:28] So it's like how the hospitals could acquire them, how they are installed, how the single-use kits are being used. There are a lot of things in exception of the technology. But also, this is also a common background, a common playground for every one of us to share their ideas.
[00:05:51] So how we could shape the future. There are companies who are bringing very nice teleconnection solutions. There are companies who are bringing some very sophisticated, let's say, haptic force solutions. But all in all, it could be aggregated into one super nice solution which could help the patient.
[00:06:14] That's fantastic. Everybody that is part of the ecosystem comes together from the builders to the parts people to the health systems wanting to acquire the products. So, all right. Talk to me about the nuances of each of those phases. You said end-to-end. What are those phases? You mean phases of the procedure for what the Sentante system can do?
[00:06:40] Yeah. So, endovascular is a huge area. So, endovascular, it's coronary interventions. Endovascular, it's peripheral interventions. If some artery is blocked in the leg and there is a gangrene. And it's 2 million of each procedures annually in the Western world. Endovascular is also electrophysiology, another 2 million procedures annually.
[00:07:03] Endovascular is also stroke treatment, another like 1,500 or so interventions in the Western world. So, there... And in addition to that, it's some embolization, cancer treatment and so on and so forth. So, it's a huge area. And actually, there is no single robot which is actually targeting avrears. So, Sentante was created as a platform. Interesting.
[00:07:30] And right now, it is C approved for peripheral indication in Europe. It is recognized by FDA with breakthrough device designation for remote stroke treatment. Oh, here in the US? Here in the US. It is still not approved for clinical usage. It has this designation, but it allows to have an approval in a quicker way. Sure, sure.
[00:07:53] But then it comes all other indications. But right now, just these two indications are targeted by Sentante. Okay. But you're building it as a platform to be able to do a lot more. Yeah. Really helpful to know. Well, Thomas, if you wanted to leave our listeners and viewers with any takeaways of what the future looks like in robotics, what should they be thinking about?
[00:08:17] Okay. So, I think robotics will bring some regional inequality down to unsignificant levels. Let's take if you are living in a huge city and you are hit by stroke. So, typically, it's very likely that you would be treated in a neuroendocrine center with a stroke thrombectomy.
[00:08:40] But if you are living in a nice coastline somewhere remote, so these chances are going close to zero. The robotics could actually equalize this. It could help everyone, it doesn't matter where you are living, actually get the same treatment. So, this, I believe, is the most important message as of 2026. There are a lot of coming in the future.
[00:09:06] I love that. Thomas, thank you so much. If people wanted to learn more about Sentante, what's the best way they can do that? So, probably it's www.sentante.com. It would be the first approach. And yeah. Yeah. That's great. There you have it, folks. Dr. Thomas Faltrinas, Chief Medical Officer of Sentante. Check out the show notes for all the ways to get in touch with him and the team on the future of robotic-assisted endovascular approaches. Thank you all for tuning in. And Thomas, thanks for being with us. Thank you.
[00:09:36] Thank you.