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Start-Up Previews (01/08)

Executive Summary

A preview of the emerging health care companies profiled in the current issue of Start-Up. This month's profile groups are "NOTES Companies Sing an Upbeat Tune," and "Solid Support for Flu Vaccine Development." Plus these Start-Ups Across Health Care: Carigent Therapeutics, Cizzle Biotechnology, Genesis Medical Interventional, and ValveXchange.

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NOTES Companies Sing an Upbeat Tune

There was an almost dot-com-like euphoria about NOTES at 2007's annual meetings of endoscopists and surgeons. NOTES (natural orifice translumenal endoscopic surgery) is being described as a revolution in minimally invasive surgery, incisionless surgery, or at the very least, a major advance over laparoscopy. It represents a billion-dollar category not yet dominated by the companies that gained preeminence in the $4 billion worldwide laparoscopy market. But most companies in the area agree that the NOTES revolution isn't going to happen overnight. The challenge for today is to create products and technologies for procedures that can happen in high volume in the near term, while waiting for more advanced NOTES procedures to come about.

Minos Medical Inc.

In the emerging field of natural orifice surgery, Minos Medical is taking a blended-risk approach by initially going after high-volume procedures that aren't complicated, and which are done laparoscopically today. The company's strategy is to develop the tools and gain experience in near-term markets that would position it for more advanced NOTES applications in the future. Minos has already launched its first product, called MegaChannel, a platform for delivering tools in and out of the bowel, the stomach, or the upper GI tract. According to the company, MegaChannel is the NOTES equivalent of cardiology's guiding catheter.

Cardiorobotics Inc.

Cardiorobotics has developed a highly articulated robotic catheter with 32 degrees of freedom and multiple internal lumens through which off-the-shelf surgical tools and catheters can be delivered. The company's founders believe that the Cardiorobotics platform is very suitable for NOTES procedures, but in the short term, while the NOTES market develops, Cardiorobotics is initially focused on a single-port approach. It diverges from its peers in the NOTES and single-port spaces, many of which are focusing on minimally invasive gallbladder removal and other gastroenterology procedures, by addressing minimally invasive cardiac surgery, specifically, applications in electrophysiology, where there is plenty of business to feed a small company.

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