We know that you are fed up with the description of every startup as the Waze of canned vegetables and the Mobileye(NYSE: MBLY) of cello-tape. In the case of Body Vision Medical, however, a startup founded by CEO Dorian Averbuch, the comparison with Mobileye is a valid one.
Body Vision is active in intra-body imaging using computer vision and augmented reality. The principle guiding the existing players in this field is reminiscent of Waze's mechanism. The vehicle can be located on a stationary map by calculating the distance between a cellular device and two satellites. Body Vision is more like Mobileye - it photographs the picture (the road) and the medical device, and calculates where they are with respect to each other in real time, rather than on the basis of previous knowledge about the "road."
Averbuch is well-known in the intra-body navigation segment. He was a partner in the founding of MediGuide, which started as a project in Elbit Systems Ltd. (Nasdaq: ESLT; TASE: ESLT). He was later an executive in superDimension, another company in the same niche. These two companies both achieved successful exits of $300 million each, with MediGuide being sold to St. Jude Medical and superDimension being acquired by Covidien (now Medtronic). The knowledge that Averbuch acquired in these two companies was useful to him when he founded Body Vision in 2014.
"I thought I was in the Garden of Eden"
Averbuch encountered the medical devices industry almost by accident. "I immigrated to Israel when I was 20 with $100, which was all I was allowed to take out of Russia in the 1990s," Averbuch told "Globes" in an interview. "When I arrived in Israel, I thought I was in the Garden of Eden - it was February, and I saw a palm tree."
"Globes": Did you want to go back when August came around?
Averbuch: "I never, ever, even thought about going back."
During his university studies, Averbuch worked in the developing computer vision industry in diamond polishing. He joined a startup in the field, but left when the startup failed to raise money. "I left after the first 'no.' I wanted to work in a large enterprise in order to learn," he remembers.
He came to Elbit Systems in the late 1990s with practical knowledge in computer vision. When they suggested that he join a new Elbit medical project, he agreed. "It reminded me a lot of my childhood, when I was hospitalized for four months, and dreamed of being a surgeon in order to find a way to make operations less painful," he says. The project later officially became a separate company - MediGuide - but Averbuch and other partners in its founding were not transferred to it. Frustrated, Averbuch decided to leave the company, and left the medical devices sector for a while.
Then, however, he received a tempting offer. "superDimension was initially founded in order to develop navigation technology for games - something like Wii, but years before Wii. When the investors saw the technology, however, they suggested converting it for the developing area of intra-body navigation, in which both MediGuide and Biosense, sold at the time (1997) to Johnson & Johnson for $427 million, operated.
"The company was initially based on cooperation with Boston Scientific. Boston Scientific was to have prepared the device, while we prepared the software, but the agreement was canceled. Since then, I have learned not to trust these agreements. When the agreement was canceled, we went back to the same point and started over with several technological improvements that I had worked on before."
Did superDimension compete with MediGuide?
"No, because MediGuide was dealing with intravenous ultrasound at the time, and later on cardiologic navigation, for example guiding catheterization devices and pacemaker components. At MediGuide, we first developed the technology, and then looked for where it was needed," Averbuch explains. "At superDimension, on the other hand, we came with more experience and a desire to develop a product that would conquer the market. I developed things there that they didn't ask for, and didn't think of doing at the company. People sometimes told me, 'That's impossible' when I was already seeing it happen." superDimension decided to focus on pulmonary navigation, which was regarded as a less competitive market.
In retrospect, Averbuch admits that superDimension's first product reached the market before it was ready. "In 2006, a change took place in superDimension's management. OrbiMed Advisors LLC entered the picture and brought in a US CEO (Dan Sullivan). He first of all fired all the senior managers in Israel, and then brought in advisors from overseas - 40 advisors. When I walked in the corridor, I saw advisors instead of employees. Fortunately, both the CEO and the advisors agreed with me that the product wasn't ready. They recalled the existing product - a measure I though was a little extreme and political - but mainly, we started improving the product."
Averbuch was appointed manager of one component of the product - the catheter - even though he preferred managing the imaging software. "I told myself that if this was what the company needed now, it was all right. Because I didn't like doing it, however, I finished it in three weeks. We worked using innovative methods. One of our ideas was to put all the paperwork in the corridors in order to force everyone to work together. Eventually, I was appointed manager of the entire project."
In 2008, removing development of the project from Israel was proposed. "The company already had 140 employees here. We Israelis fought to leave at least the software and hardware set-up in Israel. This activity is still here. I recognized several managers from the team in the US. We succeeded in forging a real partnership with them, and the combined team simply thrived. We managed to raise money and increase salaries, while showing the Americans that the Israeli team was as good as they were. When the connection between Israel and the US works, it's great, because it's possible to utilize all 24 hours in a day. What is prepared here is ready for them when they wake up, and vice versa." The improved product was successful, eventually leading to the superDimension exit.
To forego an important component
Following the exit, Averbuch worked as a consultant, until one day he thought about founding a new company. "At superDimension, the electromagnetic system constantly limited us. I asked myself why we needed it." Averbuch's idea was to eliminate one of the most important components in the existing products in the field.
Averbuch explains that superDimension's system is guided by a magnetic field generator under a mattress, while the ends of the medical devices inserted into the body are guided by a sensor capable of receiving the location of magnetic field. Once the distance between the end of the device and the bottom of the mattress is known, the location can be "projected" on an image of the patients photographed in advance.
There are problems with this approach. One is that doctors do not like bringing a magnetic field into the operating room, because it disrupts the activity of some of the other devices. They have to turn the field off when they reach the tumor itself and want to remove it or take a sample from it, and that means that they are "blind" - they have no image.
There is also a difference between the image photographed in advance, even on the preceding day, and the patient's real body on the operating table, which constantly moves, breathes, and changes.
"For these reasons, superDimension's product did not really become the standard in pinpointing and removing small lung tumors, as had been planned," Averbuch says. The product is still suitable for relatively large tumors, but Averbuch says that a breakthrough in the field will come when it is also possible to sample and remove relatively small tumors, instead of taking the risk of allowing them to grow, because when the current technologies are used, removing them is liable to be more dangerous than leaving them in. Body Vision wants to change the balance of risk by making a "friendly" product that will make it worthwhile to remove small tumors, thereby avoiding the development of lung cancer in certain cases.
Body Vision's solution is based on a CT image taken in advance, "but when the medical device is inserted into the lung, an ordinary two-dimensional X-ray machine is turned on. We create synergy between the real-time two-dimensional X-ray image and the three-dimensional CT image that also contains the location of the tumor we want to reach and the planning of the route by the doctor in advance in order to project the small changes that take place in the body in real time, as captured by the X-ray, on the CT image.
"We have no sensor at all on our catheter, but we see it in the X-ray image. No electromagnetic field is needed; there isn't even any need to move the patient to another bed. This is augmented reality - as if I were looking outside from the window in real time (the X-ray image) and seeing marks that my spectacles project on the road (the location of the tumor on the CT image)."
The company raised $6 million last October and has raised $10 million to date from leading investors, including angel investor Zohar Gilon, a director in the company, Ari Steimatzky, and Israel Tauber, who sold medical devices marketing company Medtechnica Ltd. (TASE: MEDI).
Body Vision has four employees, who previously worked at superDimension, and has already carried out 120 imaging procedures in the US in the framework of a clinical trial. "We're a year or two away from sales, and we're already starting to establish a sales set-up in the US," Averbuch declares.
Published by Globes [online], Israel Business News - www.globes-online.com - on May 7, 2017
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