This article originally appeared in the May/June 2025 issue of Startups Magazine. Click here to subscribe

Laparoscopic procedures are minimally invasive surgeries (MIS), meaning that surgeons make smaller incisions and patient recovery time is faster compared to major surgery. To perform these procedures requires highly trained surgical teams that need to be able to work together as a cognitive whole. Since its inception, MIS has become the standard for many soft tissue procedures, and while the benefits to the patients are clear – the reality for the surgical team is much more complex. With strained staffing, complex workflows, and a growing reliance on interim support, many surgical teams are feeling  the increased strain, both physically and mentally, as they work hard to orchestrate consistent outcomes in such demanding environments.

Moon Surgical, led by Founder and CEO, Anne Osdoit, has set out to redress this challenge with the Maestro System – a completely new robotic platform designed to assist and augment existing surgical workflow and reduce the physical and cognitive burden on surgical teams.

Conceptualisation

From a young age, Osdoit wanted to be a doctor or involved in the medical field in some way, though practical barriers led her instead towards engineering.

“I always wanted to work with clinicians. I had a passion, fascination, whatever you want to call it,” she said. “I decided to go into engineering and then specialise in biomedical engineering, with the goal of doing that … I've been basically a medtech entrepreneur for the last 22 years or so.”

The reason for Osdoit’s foray into laparoscopic surgery is because when procedures shifted from open surgery, the surgeon didn’t need as much assistance. But as this process evolved to MIS, additional roles and responsibilities were introduced – camera control, tissue exposure, and instrument handling – and surgeons using assistants became the standard. And it remained this way for quite some time.

“This has been the same for the last 30-40, years. But, in the postCOVID world, it has become increasingly difficult.”

Moon Surgical’s Maestro System is designed to give surgeons more control while relieving the strain on assistants. “We are at a stage where technology is able to learn how to best assist a particular surgeon for a particular procedure … we can really make the life of the surgeon easier by providing the best assistance at any given time.”

The Maestro System

Other surgical robots require the surgeon to operate from a remote console, “they’re not at the patients bedside anymore. They’re in control of the instruments, but in a way that completely changes the surgical technique.”

The Maestro System enables to surgeon to remain at the patient’s bedside and use the tools, instruments, and techniques that are familiar to them.

It works by using high-resolution force sensors what are embedded into the robotic arms that respond in real-time to the surgeons touch. When force is applied to the instrument, the arm unlocks and moves freely. When released, it holds the instrument steady: “There’s no foot pedal, there’s no button, there’s no clutch,” said Osdoit. “It’s all very fluid.”

The system has been designed to enable a seamless workflow. It integrates into current operating room practices which reduces the need for extensive retraining or disruption. “We designed a platform that … integrates into the surgeon’s practice so that it can be used for all the low acuity procedures, without changing everything they’ve been trained for, without changing their instrumentation, without changing the workflow.”

Fast training, immediate results

A key selling point for the Maestro System is its accessibility – training can be completed in a matter of hours. Talking about a recent demonstration, Osdoit said: “We had a surgeon in for a demo this morning … and he’s like ‘So, I can use it now?’ That’s all there is to it.” T his comes back to the benefit of the design. Because surgeons can carry on using the tools and techniques they are used to, the learning curve is minimal. 

This provides the surgeon and surgical teams greater comfort, less fatigue, and more consistent procedures. “It’s about the cognitive load of not having to manage all these transitions with other people … and the other thing is the physical aspect, the surgeons are more comfortable because they don’t have to share their workspace.”

Building confidence with clinical success

Bringing a new system into the operating room is not without its institutional hurdles, not least the cost. Yet, since its launch, the Maestro System has been implemented in 12 hospitals and has assisted in over 1,300 procedures. That’s because another key selling point for the Maestro System is its return on investment.

“Hospitals do need to get a feel for the fact that your programme can be cost neutral,” said Osdoit, and it can achieve this in three areas: “Reduced duration of the procedures, and the reduced variability – the staffing component, and shifting simpler cases from more expensive robotic platforms to ours.”

T he ability to improve scheduling predictability and make better use of staff is particularly valuable in today’s pressured healthcare environment. It also supports a gradual, but evolving, change in mindset about what robotic assistance can be.

The future of the operating room

Reflecting on what the future of the operating room looks like, Osdoit believes it can be found in measurement and feedback.

“The operating room is one of those few places where it’s still almost entirely analogue. There’s no sensing, there’s nothing really meant to measure ... You can’t really optimise what you don’t measure.”

However, the goal isn’t to turn surgery into a fully digital process, but rather to create a feedback loop that will enable continuous improvement – something that is lacking in most surgical environments. “I think that’s the future of the OR; it’s benefitting from digital progress and using technology to enable that.”

Moving forward

The current fundraising environment has been challenging, but Osdoit remains pragmatic. “You have to be resilient ... plan for the worst, and then execute.”

However, with the reliability and adaptability of the Maestro System proven, Moon Surgical can now focus on expanding commercially. “We’ve learned what we wanted to learn in the last nine to 12 months. So [we are] going broader commercially, which means scaling all the functions of the company.”

For Osdoit, the journey, though not without its challenges, has been deeply rewarding on many levels. “For me, it’s about treating patients. When you think that we’ve treated hundreds of patients ... you're like, 'Okay, it's worth it'.”

And the proudest moment? “It’s the people behind it. When we started developing this, it was just like a thought. So I’m incredibly proud of that.”