Vicarious Surgical : Investor Presentation - April 2026
RBOT
Published on 04/20/2026 at 01:20 pm EDT
A New Surgical Architecture for the Abdomen:
Open-like Access, Minimally Invasive
Built to solve the limitations of current robotic systems
Designed to solve the limitations of current robotic systems
The Majority of Abdominal Surgery Remains Open
Open surgery persists despite higher trauma, longer recovery, and increased cost
Robotics transformed pelvic surgery
Adoption drops sharply in abdominal surgery
High-volume abdominal procedures still performed open
Driven by system limitations
Robotics fails to address the majority of abdominal surgery.
New systems increase competition, not capability, as they share the same underlying architecture
Current Robotic Systems Were Not Designed for the Abdomen
Core architectural limitations restrict access and scalability
Designed for confined anatomy, not the full abdomen
External arms create collisions and procedural complexity
Limited reach across multi-quadrant surgery
Iteration improved performance, not architecture
New entrants replicate the same architecture
Current Multi-Port System
This is not a market limitation,
it is a structural design constraint inherent to current robotic systems.
External arms create collisions and limit access
A New Architecture Designed for Full Abdominal Access
Enables procedures current systems cannot reach
Internalized single-port eliminates collisions
→ Enables true abdominal access
Human-like articulation enables full dexterity
→ Enables complex procedures minimally invasively
Purpose-built for the full abdomen
A fundamentally different architecture
→ Not an incremental improvement.
We extend robotics beyond the limits of current systems.
Internalized architecture enables full abdominal access without external constraints
A New Category in Robotic Surgery
Not an incremental improvement, a structurally different platform
Different architecture
Different market
Different economics
A new architecture unlocks a new market.
Clear Path to Near-Term Value Inflection
Design freeze = the moment risk collapses → development risk behind us
Parallel Execution Strategy: Australia FIH and U.S. IDE conducted in parallel
~6 months from FIH submission to initial clinical data
Mid-2026
1H-2027
Mid-2027
YE-2027
Porcine lab to validate core IDE elements
Regulatory V&V
YE-2026
Primary value inflection point
Design freeze, clinical-ready system
Submit in Australia
Submit IDE (U.S.)
Initiate FIH trial in Australia (N=6)
IDE cleared
FIH trial complete
Pivotal clinical trial (U.S./Australia)
35 to 40 patients
Open-label
30-day primary endpoint
FDA-aligned design
A fully integrated, de-risked system marks the primary value inflection point.
Starting with Ventral Hernia Repair
A high-volume procedure where access limitations drive open surgery
Initial adoption is driven by open conversion, not displacement of existing robotic systems
Reach where others cannot
Full abdominal wall access → enables minimally invasive treatment of cases that are currently performed open.
Large, Constrained Market
>60% of ventral hernia repairs remain open, driven by access limitations.1
High-Impact First Indication
High-volume procedure → strong utilization and repeatable, high-margin consumable revenue.
A direct application of our architecture in a high-value indication2
"We begin by converting the >60% of ventral hernia cases that remain open."
FRY BT, HOWARD RA, THUMMA JR, NORTON EC, DIMICK JB, SHEETZ KH. SURGICAL APPROACH AND LONG-TERM RECURRENCE AFTER VENTRAL HERNIA REPAIR. JAMA SURG. 2024;159(9):1019-1028. DOI:10.1001/JAMASURG.2024.1696
CADAVERIC IPOM+ PROCEDURE, DR. IGOR BELYANSKY 8
Why Vicarious Enables Conversion of Open Procedures
Designed for full abdominal access and visualization
Limited Access (Laparoscopy)
This is what enables conversion of open procedures to minimally invasive robotic surgery.
Constrained Access (Multi-port Robotics)
Full Access (Vicarious Surgical)
✔ Miniaturized shoulders, elbows and wrists, as if a full arm was operating inside the abdomen
✔ Fully articulating robotic camera enables full abdominal visualization
Simplified Workflow Drives Utilization and Recurring Revenue.
Higher throughput → more procedures per system → increased recurring revenue per installed system
Current Multi-Port Systems
Multi-Port Systems Limit Throughput:
Vicarious Single-Port System
Single-Port System Enables Efficient Turnover:
Faster setup and turnover drive higher system utilization.
Integrated Architecture Lowers Cost and Expands Adoption
Patient Cart
compact footprint, easy integration
Surgeon Console
with integrated display, no vision cart required
Replicating the access of open surgery through a minimally invasive approach
This is what enables conversion of procedures that remain open today.
Decoupled actuators enable additional intra-abdominal joints with true intra-abdominal dexterity and reach.
360° camera articulation with 120° field of view provides full operative field visualization & self cleaning.
Instrument arms generate
high forces needed across soft-tissue indications.
VS Camera: 120° FOV
Integrated Visualization Enables True Abdominal Access
Unprecedented Range of Motion
9.7 mm
Best in Class Visual Performance
Immersive, natural depth perception
Wider field of view compared to competitors
Extended Interaxial Lens Distance
Self Cleaning
Physician can see the entire abdomen with immersive clarity all from a single access point.
Improves efficiency of surgical workflow
Designed for Real Surgical Workflows That Drive Adoption
Miniaturization
Faster workflow, reduced complexity
Full abdominal access
Enables minimally invasive treatment of open procedures
Stable visualization
Improves precision and consistency
Surgeon Validation
"Often with existing technologies, you fix the trajectory of your arms and your instruments and you're stuck there. If you have to move too far out of that region, the arms start banging into each other; your mobility gets limited. The ability to have a grouped camera and two arms that can move around anywhere in the belly through one incision, one fulcrum, is exciting."
Richard Hoehn, MD | Surgical Oncologist | University Hospitals (Cleveland, OH)
Faster setup, more consistent workflows, and reduced surgeon fatigue
Full-Stack IP Protection Across Core System Architecture
IP spans the full system, not isolated components
Initial Target Procedures: >1M Open Surgeries Annually in the U.S.
Across global markets, the opportunity expands significantly
Initial Target Procedures (~2M annually)1:
Ventral hernia: ~350-500K (60-70% open)
Inguinal hernia: ~700-800K+ (60-80% open)
Recurring, procedure-driven revenue model
Growth driven by conversion of open surgeries
Targets procedures robotics has not penetrated
Expands access, not just competition
Hysterectomy: ~500-600K (25-30% open)
Colorectal: ~300K+ (30-40% open)
Conversion Opportunity
~45-55% still open
~0.9M - 1.2M procedures annually
Near-Term U.S. Procedure TAM2
$2B - $4B recurring revenue
Based on $2K - $3.5K per procedure
A large, underpenetrated U.S. opportunity.
1US ONLY - PROCEDURE VOLUMES AND OPEN RATES DERIVED FROM AHRQ HCUP, CDC NCHS, ACS NSQIP, AND PEER-REVIEWED LITERATURE; REVENUE ASSUMPTIONS BASED ON INTUITIVE SURGICAL PUBLIC DISCLOSURES.
Same-Architecture Competition Compresses Price, Not Market Expansion
New entrants compete for the same procedures, not expand the market
Competing for the same procedures using similar architectures
New entrants are reinforcing this dynamic, not expanding the market
Pricing pressure already visible in competitive regions (e.g., China)
Likely to emerge in the U.S. as new systems enter
Incremental innovation drives competition, not market expansion
We expand the market, not compete for share.
Competing systems fight for share; Vicarious expands the market and creates new procedure volume
Technical Risk Reduced; Value Now Driven by Execution
Leadership now operating with a focused, capital-efficient model
~$300M invested in platform development
Core architecture complete
Major technical risks addressed
What remains is execution, not invention
Architecture is defined, system is integrated
Focus on reliability, validation, and regulatory execution
Capital-efficient model
Burn reduced from ~s50M to ~s19M
Lean, execution-focused team
Execution-focused leadership
Shift from development to clinical execution
Defined scope aligned to first-in-human pathway
Non-core development outsourced to accelerate timeline
Majority of development risk removed.
Focus now on execution, validation, and clinical readiness.
Prioritization of design freeze over feature expansion to accelerate clinical timeline
Vicarious Surgical
With a differentiated architecture, clear clinical application, and strong economic profile, the focus shifts to execution and clinical validation.
Vicarious Surgical
Eleven Years to a Defined, Integrated System Architecture
Core architecture defined and integrated
2014
The beginning
2018
Beta builds
2022
Engineering builds
2025
Controlled builds
Miniaturization Breakthrough: Foundation for fully internalized robotic system
Platform Architecture Defined:
Complete system concept validated
Integrated System Development:
Robotics, controls, and vision unified
Controlled Builds and Refinement: Production-intent systems and reliability focus
Eleven years and ~s300M invested to build a fully integrated, clinical-ready system.
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Disclaimer
Vicarious Surgical Inc. published this content on April 20, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on April 20, 2026 at 17:20 UTC.