[00:00:00] Speaker A: My team here in Silicon Valley, one of the most advanced and innovative robotics programs in the world, and we are focused on surgical robotics. I often see posts from clinicians and their teams on LinkedIn proudly holding up signs saying things like 400 Monarch Procedures. That really brings joy and motivation to keep innovating for these clinical teams and patients.
You.
[00:00:29] Speaker B: Hello, everyone, and welcome to the Robot Industry podcast. My guest today is Martin Bueller from Johnson Johnson. Hey, Martin, welcome to the podcast. We're glad you're here.
[00:00:38] Speaker A: Hi, Jim, and thank you for having me on your Robot Industry podcast. I'm super excited and honored to be here with you.
[00:00:45] Speaker B: Martin, thanks for joining us. Could you just give a little introduction about yourself for the audience?
[00:00:51] Speaker A: Well, looking back, I feel like I had an incredible journey in robotics over a span of 30 years. I actually started out in academia at McGill University. There I was doing research on manipulation and legged robots. I led an active research group. I had tenure in the end, and I taught and mentored many students. And I had an absolute blast working with a lot of smart young people, groundbreaking research problems. And then I sort of got the twelve year itch. I really wanted to work on more practical problems that would have a more immediate impact to humankind. So in 2003, I moved to industry. I was extremely fortunate to work at some world class companies like Boston Dynamics, irobot and Walt Disney Imagineering, and also a number of very innovative high tech startups in robotics. My ongoing quest for maximizing impact then led me to join Johnson Johnson Medtech early last year. Johnson Johnson is the largest and most diversified healthcare products know. Most folks used to know J J as the baby products company. But today we are Medtech and a pharmaceutical company and a top rated employer for high tech talent. My team here in Silicon Valley, one of the most advanced and innovative robotics programs in the world, and we are focused on surgical robotics. The company was actually created around surgical products over 130 years ago. So helping this iconic and historic brand to create the next generation of surgery, I find that super inspiring.
[00:02:32] Speaker B: Thanks, Martin. Thanks for that. And you're happy, of course, to be back into the healthcare industry with robotics. And why is that and why do you find it?
[00:02:42] Speaker A: All right. Thank you, Jim. You know, for me, that goes to the heart of my purpose. What do I do and why? For me, it's all about working with teams to bring robotics and healthcare together to do the most important and most impactful work I can imagine, to improve and save people's lives. And we do that by making surgery smarter, less invasive, and also more personalized.
I'm very passionate about being part of a mission driven company that is fueled by our bold ambition to really change the future of health for humanity and to achieve that, we have what we call our credo. It is a one pager written by Robert Wood Johnson 80 years ago. We all live it every day, and it articulates our purpose in a really beautiful and timeless fashion. It's our commitment to our patients, to our employees, our communities, and deliver a fair return for our shareholders.
[00:03:42] Speaker B: It's great to talk about mission and purpose on this podcast. It's so exciting. And you've called this sector a rich landscape. And can you talk to our audience a little bit about what you mean by that?
[00:03:53] Speaker A: Yeah, absolutely. So, in short, I think health care, and I feel strongly about it, is very rich, both in need and it's also rich in solutions.
If you think about it, health health is always the most important thing. And we have so many opportunities and urgent unmet clinical needs to dramatically improve health care on all levels. We need to catch diseases much earlier and best really even to prevent them altogether. We need surgeries to be much less invasive. We need to be them more personalized and more effective. And then after surgeries, we want patients to be able to return to their lives much quicker. Why not within the same day? And finally, we talk about variability of outcomes. We need to reduce the variability of outcomes. Too many surgeries still have post surgical complications because of that variability. And at the same time, we also need to make healthcare much more affordable and accessible globally. The second part of the rich landscape is the incredible core technologies we have available today and in the future to dramatically improve health. And this is what really gets me excited and out of bed every morning and out to work with my teams to build the solutions to address the needs steady advances in robotics, instruments, sensing, actuation computing, and visualization. And then we combine that with advances in digital, in all forms of artificial intelligence, from machine learning to traditional AI to generated AI. So I believe that surgical robotics has already started to accomplish to address some of these critical needs, and yet we still have a long way to go.
[00:05:35] Speaker B: Thank you for that. Martin, how important is leadership to your role in developing these complex systems?
[00:05:41] Speaker A: Wow, leadership. Yeah, it's critical, absolutely critical. We are developing very complex interdependent systems. And so to do this, I lead large cross functional teams of mechanical and electrical engineers, software developers, PhDs in robotics and controls, and really many other disciplines as well. To me, an important part of leadership is to make sure what I call the three big rocks are in place. First and foremost, it's the people. It's always people. I make sure we invest our best efforts and attract and retain the best and brightest people. And the second big rock is to create the structure for success, direction, alignment, and commitment. We need very clear direction that is having compelling goals. And our goals typically address the most urgent unmet clinical needs. We need effective alignment and that's around how we will achieve those objectives, what is the right organizational setup and governance. We need to ensure that everyone is fully, everybody's all in to achieve the goals and also committed to the path to get to those goals. And finally, the third big rock of leadership for me is being the cheerleader to empower, to inspire and elevate my leaders and teams, to remove friction and obstacles and then really step back and let our brilliant minds do what they do best and always generously celebrate their successes.
[00:07:08] Speaker B: Martin, you said part of your job is leading your teams and your suppliers and commercial groups at J J Physicians and Planning for those patient outcomes. How do you balance all of these often competing priorities?
[00:07:22] Speaker A: Well, yeah, great question. It's important to emphasize that we're not just building prototypes, we are creating robotic solutions that can be delivered to millions of patients globally. That requires that we look really end to end, from research and development to manufacturing, clinical testing, regulatory submissions and commercialization efforts. And that requires what I call the daily dance. That's to adjust resources in close collaboration with my peers across the entire organization.
I like to say you plan the work and then you work the plan. So the process is more like a continuously tuned and finely coordinated machine versus just a competition of priorities.
[00:08:12] Speaker B: You specified in a recent like you and I follow each other on LinkedIn and you specified in a recent LinkedIn post that Monarch is a urology platform. Can it be used for other areas of the body? And maybe you have to explain what Monarch is.
[00:08:26] Speaker A: Yeah, absolutely.
Maybe I first talk a little bit about Monarch for urology. It's a great question. So let me talk about urology. And for us, that means kidney stone treatment. So Monarch is what we call a flexible robotic solution.
That means it has a flexible endaluminal scope or an endoscope that enters the body via natural orifices. So then we use robotic arms to control these flexible endoscopes to improve their reach, their stability and control for the entire induluminal procedure.
So the surgeon then commands the untiring steady and precise robot arms to hold and drive these endoscopes with a video gamelike controller. This greatly improves the Ergonomics for the physician and the ease of use compared to manually operated endoscopes.
So, Bacteriology, I'm very excited by the future potential of Monarch for kidney stone treatment. And by the way, so are the physicians and patients.
Our system for kidney stone treatment was approved by the FDA last year and is currently in clinical trials.
So there's really a great need about one in eleven people in the US will get kidney stones. And the unmet clinical need here is that the traditional treatment approaches for kidney stones often require repeated treatments and it's up to 50 50%.
And that is because little pieces of kidney stones are inadvertently left behind, they grow into the next kidney stones, and that makes for a very painful and a difficult patient pathway. For example, I heard of a patient who has been living with kidney stone disease for 16 years and had no fewer than nine repeat removal procedures. The potential impact to become completely stone free after these procedures with our robotic assisted procedure is really huge.
[00:10:26] Speaker B: Martin, what about diseases like lung cancer? Can you talk about how you're realizing the future of medicine by being able to inject reactive agents or oncolic virus into the tumor?
[00:10:39] Speaker A: Yeah, that's another great question. So let me talk about lung cancer. So, in fact, Monarch is a platform for innovation, and it's the first and only multispecialty flexible robotic solution that can be used for both bronchoscopy and urology. And its first use is actually for bronchoscopy for early diagnosis of lung cancer. Lung cancer is the leading cause of cancer deaths globally, with about 150,000 annual deaths in the US. Earlier diagnosis can improve survival times significantly.
But earlier diagnosis often means that physicians have to reach smaller and smaller suspicious nodules, and these are often located at the hard to reach outer periphery of the lung. This is where our robotic assisted bronchoscopy system really helps. So Monarch for bronchoscopy is approved and is making an impact today in more than 25,000 procedures so far. I often see posts from clinicians and their teams on LinkedIn proudly holding up signs saying things like 400 Monarch procedures.
That really brings joy and motivation to me and to keep innovating for these clinical teams and our patients in general, I believe that endaluminal robotics will play a major role in the future of care, particularly cancer care.
[00:12:05] Speaker B: It's funny how LinkedIn has progressed, isn't it?
Since the robot is a diagnostic tool paired with a treatment platform, it reduces the number of times that a patient has to have a procedure or surgery. And that's correct, right?
[00:12:19] Speaker A: Yeah, absolutely. So let's talk about treatment.
Diagnosing and completely treating or even curing lung cancer in one procedure is still quite a bit of an aspirational future scenario. But already the patient journey can be much improved. So, first, early diagnosis speeds up the journey and can dramatically improve survival rate. As I've shared, there is less that scary, let's wait and see approach and monitoring then, if a suspicious lesion grows further. And second, with a diagnosis platform like Monarch in the future, we can do a variety of things. Once we have successfully reached an audio and obtained that positive cancer diagnosis, for example, we can mark the site with biochemical agents or physical markers to facilitate subsequent treatment or surgical lung resections. In addition, in the future, we could start injecting drugs to improve the success rate of subsequent treatment or to start treatment in a shorter time frame. Such local therapeutic solutions in conjunctions with Monarch are actively being studied and in general, exploring the question of diagnosis and treatment in a more targeted way and with a shorter time frame presents an opportunity to really transform cancer intervention. So this is the part where science and technology come together to make medical intervention smarter, less invasive, and more personalized.
[00:13:51] Speaker B: Digital is a big part of your life, especially in medicine, and it's hard to have robots without digital. So how is digital changing? The absolutely.
[00:14:00] Speaker A: Thanks, Jim. You know, every surgical robot is already, in some sense, enabled by digital, by all the algorithms built into the system that dictate its behaviors and functions. And going forward, just about every device will become a digital citizen. In the operating room ecosystem. For example, every piece of capital, every device or surgical instrument will have sensors to improve its performance, measure its usage, and track its location. All of these robots and devices are also connected and generating massive amounts of really valuable data, adding to the data that hospitals already generate. So we have to think about not just the one medical device or the one robot, but the way that we aggregate all that information and how we do that in a secure environment. Software can use all this data to provide information and insights back to the surgeons, to the clinical teams, the patients, and the hospital systems.
[00:14:56] Speaker B: So my next thought is about connectivity. And we have lots of challenges when it comes to connectivity, especially to the cloud or big ecosystem connectivity, robots to instruments, robots to robot. How is this changing?
[00:15:09] Speaker A: Yeah, so, Jim, the short answer is nobody has really figured it out yet. Everyone agrees that connectivity is a bedrock of progress and everybody's working to make it happen. In order to get the big outcomes from digital connected ecosystems, we have to bring the whole industry along. So the goal here is that not just all the devices from one company need to connect, but rather all the devices from all the companies need to integrate cleanly, both with each other and then with the cloud. And to get to that desired connectivity end state, we need all the right parties working together from security, hospital chief information officers, regulatory agencies all the way to the standards bodies and the government and of course all the device and equipment manufacturers like us.
[00:15:58] Speaker B: Johnson and Johnson CEO has said that there'll be more changes in the next ten years that have taken place in the last hundred years in medicines. And how will robotics play a role in this?
[00:16:09] Speaker A: Wow. Yeah, just stop for a second and think about that. Wow.
So this progress will happen across the whole range of medicine, and it will be powered by investment in innovation.
Talking about innovation, J and J is an innovation based company, and with $14.6 billion investment in R and D last year, is one of the largest, if not the largest, investor in R and D. And the life sciences and robotics will play a central role in pharma. Robotics will accelerate automated AIdriven, drug discovery, and in medtech, advanced robotics will enable the future of surgeries and deliver significantly improved outcomes. You know, a large portion of medicine will always require physical intervention like surgeries or biopsies. So that's where robotics is critical to the future of medtech. And I believe breakthroughs will come by a confluence of three factors. First, all the pieces of robotics technologies will continue to get better with improved sensors, actuation endoscopes imaging, and advanced visualization. Second, everything as we talked, will be connected always in a tight digital ecosystem. And third, that connectivity will allow the full power of AI and machine learning to act on these vast amounts of data to provide insights pre intra and post operatively to further boost the power of robotics. So, having worked in robotics for so long, I find this really exciting. Robots will have an impact for millions of patients around the world.
[00:17:49] Speaker B: Martin, you're a big fan of startups in the field and I'm not surprised by that at all. What are your thoughts about robotics and competition in this?
[00:17:57] Speaker A: Absolutely. You know, we say and we live it. Great ideas can come from anywhere, and that is true in healthcare as well. We believe in the innovation happening within J J within our own four walls. And at the same time, we are very active to invest in and collaborate with startups and anyone with new ideas for patient impact. And when it comes to competition, my what I call abundance mentality applies here too. With so many unmet patient needs and so much to do, the more competition, the better. It drives innovation, progress, affordability, global access, it drives everything.
[00:18:39] Speaker B: In our initial conversations, you mentioned that you have a saying and the patients are waiting. What are your thoughts on that?
[00:18:47] Speaker A: Yeah, that's good. Actually, earlier last year, before I started, when I visited the J J facility in Santa Clara for the first time, I saw that prominent white, beautiful lettering on the wall of the 6th floor saying the patients are know it's really true. Think about any healthcare experience that you or a loved one has had. Even if we solve for one or two major things with technology, that's a huge win. Patients are waiting for those wins. So patients are waiting really resonated with my personal sense of urgency and literally saving lives. Every minute matters in the work we're doing that immediacy to have impact, that urgency to reduce suffering is exactly the reason why I left academia and joint industry 20 years ago. On the other hand, the technology we are developing is really complex. So we always have to balance our sense of urgency with our first and foremost commitment to safety, quality and regulatory compliance.
[00:19:47] Speaker B: Martin, are Cobots a good use for this platform for human to robot procedures?
[00:19:53] Speaker A: Yeah. Great question, Jim. For that, let's look first at the classical industrial. They're we all know those. They're large, they're fast, they're forceful, they're position control. Typically they're maximized for repeatability speed and precision. And they're not designed to interact with people for safety reasons. They are typically in cages or behind safe barriers. In contrast, Cobots are short for collaborative robots. They are designed to be more suitable for interaction with people. They tend to be smaller, slower, often are force controlled, are able to sense contact with people or the environment, and often have compliant control. So in healthcare, and in particular in the operating room, we are definitely using the Cobot type of robot arm. The care team around the patient in the or is often literally rubbing shoulders with a surgical robot arm. They manually move the arms for setup and repositioning. So I believe that we have maybe the most collaborative robot application there is.
But we have to keep in mind it's not just the robot itself that can ensure human safety. We have to design the entire end to end application and the whole workflow with safety first and foremost in our minds.
[00:21:15] Speaker B: When can AI and machine learning help?
[00:21:18] Speaker A: Yeah, that's a topic that is today on everybody's mind, and it really has the exciting potential to improve just about every aspect of our society, I believe. Even so, today AI is still in the early stages in healthcare. It will transform healthcare. In fact, it will be a key part of that great acceleration of achieving more progress in the next decade versus the past century. There are some interesting early use cases in simplifying time consuming tasks like reports and communications, and in doing so, freeing doctors and nurses to spend more time with patients. There's much more to come, but these tools are already in use in some areas, like screening chest x rays for suspicious nodules in the lung, or improving the detection of polyps and colonoscopies. On Monarch, we are also using already AI and ML algorithms to create accurate and segmented three dimensional models of the lung from two dimensional x rays taken preoperatively. Then these models and the AI tools help the physician to guide the flexible bronchoscope during lung biopsy procedures. And this allows them to locate and reach a potential tumor more predictably for more accurate diagnosis and treatment. I find it very exciting to be alive in a time like today where we get to shape these advances for the benefit of human health.
[00:22:49] Speaker B: Martin, thanks for coming onto this interview. It's been a great conversation. How can people find out more about Ethicon, Monarch and all the projects that are coming out of your work?
[00:22:58] Speaker A: Yeah, absolutely. Well, we talked about LinkedIn, so follow us on LinkedIn. Johnson and Johnson medtech on LinkedIn is a great place to hear about the latest innovation. You'll also see the kind of robotics roles we're recruiting for, and you can connect with other technologists who are passionate about our purpose.
[00:23:17] Speaker B: Our sponsor for this episode is Earhart Automation Systems earhart builds and commissions turnkey solutions for their worldwide clients. With over 80 years of precision manufacturing, they understand the complex world of robotics, automated manufacturing and project management, delivering world class custom automation on time and on budget. Contact one of their sales engineers to see what Airheart can build for you and you can reach them at
[email protected]. And earhart is spelled, ehrhardt? And I'd like to acknowledge a three. The association for Advancing Automation. They're the leading automation trade association for robotics, vision and imaging, motion control and motors, and the Industrial Artificial Intelligence technologies. Visit Automate.org to learn more. And if you'd like to get in touch with us at the Robot Industry podcast like Martin, you can find me, Jim Barretta, on LinkedIn. We'll see you next time. Thanks for listening and be safe out there. Today's podcast was produced by Customer Attraction Industrial Marketing. I'd like to recognize my team chris Gray for the music, jeffrey Bremner for audio production, my business partner and editor, Janet, and our sponsor, Earhart Automation Systems.
