Activ Surgical, a Boston-based digital surgery company, announced a $45 million Series B round on Thursday. The round comes during a critical year for Activ Surgical. It’s in the process of developing new tools that give surgeons the ability to see otherwise invisible structures, and has plans to roll out those tools in the coming months. 

The first of those tools is the company’s hardware component, called ActivSight, which allows surgeons to see things that would otherwise be invisible, like blood flow through microscopic vessels inside tissue. The hardware, which received FDA 510(k) clearance in April of 2021, fits between any type of endoscope and a white light camera system. 

With the push of a button, ActivSight already allows features like blood flow (usually invisible, unless injectable dyes are used) to light up like a Christmas tree. But unlike injectable dye methods, ActivSight can visualize blood flow in real time (i.e. the images of tissue change color if blood flow slows or stops). 

“It’s the only system in the world that intraoperatively can visualize things like blood flow without the injection of any dyes,” says CEO Todd Usen. 

This most recent round will be used to support the commercialization of ActivSight, which is expected to go live in hospital systems in seven states in Q4 2021 or into next year. It will also be used to help glean a CE certification — a marketing clearance that allows medical devices to be marketed in Europe — which will allow ActivSight to roll out in seven European countries in 2022. Finally, the round will support the buildout of Activ’s more ambitious AI-based projects, which will allow the ActivSight devices to identify even more key structures for surgeons who use it. 

The round of funding was led by Cota Capital. Including Cota Capital, the round will bring seven new investors to Activ Surgical: BAM Funds, Magnetar Capital, Mint Ventures, Castor Ventures, Dream One Vision and Nvidia. The company has raised $77 million in funding so far. 

Activ Surgical first made headlines in 2016 for creating a robot that performed the first totally autonomous suturing of soft tissue. The company’s founder, Peter Kim, holds a patent for a type of robot assisted surgery. But despite this, the company isn’t focused on building robots. 

“While robots are great, they’re only used in about 10% of minimally invasive surgeries. A robot can reach things that a human can’t but, until this point, a robot cannot see anything that a human can’t,” Usen says. 

Instead, the company is investing in tools that make surgeons themselves more savvy. Usen likens ActivSight’s current approach to installing a rear view camera on a car. 

“Your rearview camera on your car can see things that you can’t down below, then it will start beeping. When a robot can start identifying things a human can’t, that’s when robotics will really take off. That’s what Activ is doing, and that’s what our our robotic partner surgeons are excited about.” 

ActivSight has already shown that it can be used in the operating room. It’s been tested in a clinical trial on 70 patients at the University of Texas Health Science Center and the University of Buffalo. The results of those trials have not yet been released, but the company expects to publish data from that trial in October, a company PR confirmed to TechCrunch. 

However, the ActivSight system has already gleaned FDA 510(k) clearance, which means it will be rolling out in several hospital systems this year. Those include seven systems in New York, Buffalo, Texas, Ohio and Florida. 

The commercial deployment of ActivSight is just the first step for Activ Surgical. The goal is to ultimately collect a unique intraoperative data set based on surgeries completed with ActivSight. Then, a software suite called ActivInsight would analyze the data collected, and apply machine learning algorithms to help identify even more features that would otherwise be invisible to surgeons. 

“We have the most unique data set anywhere in the world,” says Usen. 

“From that we’re able to do autonomous annotation and label key structures. It’s collecting nerve identification, veins versus arteries, key critical structures — that information will be annotated and labeled using machine learning, and then fed back to anyone using the ActivInsight module on their scope.”

This machine learning application won’t be rolled out right away. Usen expects ActivInsight prototypes to be used in patients for the first time in 2022. 

With this round of funding, those first steps will be set in motion. 

​Emma Betuel@emmakbetuel / 10:37 PM GMT+9•September 30, 2021

Activ Surgical raises $45 million Series B round to give surgeons eagle eyes | TechCrunch