III - From Prototype to Startup: The Bold Journey of AcuSurgical

The story of AcuSurgical continues. In a previous articles we talked about what led to the creation of AcuSurgical and the initial stages of the company. After exploring the birth of Luca®, a new turning point was inevitable: transforming an innovative concept into a structured company capable of securing funding and accelerating development to reach, as quickly as possible, the first human trials.

The objective was clear: to prove that robotics could revolutionize retinal surgery, convince investors, and build an organization ready to meet regulatory and clinical requirements. However, this ambition faced numerous challenges. In 2020, as the world was going through upheaval, a small team in France decided to take on this audacious challenge. Behind this ambition was one man: Christoph Spuhler. He knew the idea was promising, but turning a prototype into a viable company required much more than just technology.

"We had already been working on the project for two years at the incubator, but in 2020, we were preparing our first funding round and needed to officially establish the company." — Christoph Spuhler, Co-founder of AcuSurgical

The first major step was to build a solid team. AcuSurgical could not rely solely on a handful of talented engineers; it needed to integrate experts in regulation, clinical affairs, and industrial production.

"We have always taken the recruitment process very seriously. We only hire the people that are most suitable and see eye to eye with our vision." — Christoph Spuhler

Talent acquisition was rigorous, targeting professionals with prior experience in surgical robotics. The risk was significant: how do you convince these experts to join a startup still in its early stages? Yet, AcuSurgical’s vision and Luca®’s potential were compelling enough to attract top talent. Regulatory and Quality (RAQA) was one of the first priorities.

With a team in place, a major obstacle remained: funding. Investors were intrigued but cautious. AcuSurgical had to prove that its robot was not just a lab innovation but a true clinical revolution. To do so, the team employed a simple yet risky strategy: a real-world demonstration, with surgeons testing Luca® in simulation.

"We organized a very elaborate demonstration at the medical faculty in Montpellier. Surgeons were able to test the system and provide their feedback. This was a decisive argument in convincing investors." — Christoph Spuhler

The gamble paid off. In 2021, AcuSurgical secured its first funding round, followed in 2021 Series A. This investment accelerated development, expanded the team, and structured the company in preparation for clinical trials. But money alone was not enough—Luca® needed to be transformed into a product truly usable by surgeons.

"In 2020, we had a functional but still rough prototype. By 2023, we had something that genuinely looked like a product ready for operating room integration." — Christoph Spuhler

The improvements were significant: streamlining the design, eliminating unnecessary components, enhancing ergonomics, and strengthening safety mechanisms. Every detail was refined to make Luca® not only more effective but also more intuitive. 

The team had to conduct hundreds of tests on animal and ex-vivo models to anticipate every possible scenario.

"Every scenario was simulated and tested to ensure that no critical situation was left to chance." — Christoph Spuhler

As clinical trials approached, the intensity grew. Every detail had to be validated, and every test repeated multiple times to ensure absolute safety. Numerous backup mechanisms were added to ensure smooth operation and eliminate any single points of failure.

"Several surgeons told us they would install it immediately if they could, but we knew there were still a lot of hurdles to overcome." — Christoph Spuhler

After three years of relentless work, AcuSurgical was no longer just an innovative idea but a fully operational startup, ready to take the next decisive step. This remarkable transformation was not only about launching a groundbreaking device but also about the achievement of executing such an ambitious project with limited resources. In less than six years, and with a small team, the company managed to develop a cutting-edge surgical robot and reach a First-in-Human (FIH) trial—an extraordinary feat in the medical technology industry.

"The surprise in the industry was real—seeing a surgical robot emerge from such a small team, only ten people at the time, was astonishing. " — Pierre-Antoine Forest, founding team member

Yet, AcuSurgical proved that innovation is not solely about investment or team size but about the determination and ingenuity of those driving it forward. This journey, which once seemed almost unrealistic, was now a tangible reality.

In 2024, this vision took on a new dimension with the first clinical trial at Ghent University Hospital in Belgium, led by Dr. Fanny Nerinckx. Seven patients were successfully treated, marking a significant milestone for AcuSurgical and the future of robotic retinal surgery...