Good morning. Thanks for joining us again at the 25th Annual Needham Healthcare Conference. I'm Mike Matson, and I lead the MedTech and Diagnostics Equity Research team at Needham & Company. I'm pleased to introduce Microbot as our next presenting company. We have Harel Gadot, CEO of Microbot. He's going to give a presentation, and then we should have some time for questions at the end. If you do have any questions that you would like to ask, you can submit them through the conference website electronically, or you can feel free to email them to me at mmatson@needhamco.com and I'll try to fit them in. With that, I'll turn it over to Harel, and I'll come back on to facilitate the Q&A.
Thank you, Mike, and thank you for inviting me and the company to present at the Needham Conference. Driving the Future of Intervention. We'll skip the safe harbor statement, and of course, I want to thank and welcome everybody on this call that joined to listen to the Microbot story. In order to understand how unique the opportunity we're looking at, we will start with the base, which is the simple three pillars. We understand the market, the barriers, and our solution, and what makes it not only so unique but also so attractive. To really understand what we're developing that can change the market is to understand the market itself. Everybody on this call, I assume, knows that the robotics market, the healthcare robotic or the surgical robotics, is probably one of the fastest and largest growing market in the U.S. and globally.
People will talk about different numbers, but it really doesn't matter. The numbers are there. It's growing fast. There's no wonder everybody wants to play with it, from big companies like Johnson & Johnson, Medtronic, and so on, to small companies, startups that are coming every day in the U.S. and other than the U.S. You can see how crowded the space is of surgical robotics. The question is, ''Is there a place where you don't have competitors, where the market is still attractive, that you can be unique and pave the way to build a whole new market?'' What is a blue ocean?
People ask me, "What do you mean by a blue ocean?" Well, it's a simple business terminology that's saying the red ocean is where you have either a monopoly or a lot of players, a lot of competition in a big market or a small market, versus a blue ocean, it's a big market, untapped, that you really don't have competitors either at all or very, very little competitors with very little differentiation. There is a blue ocean if you look very closely and if you look into the segments of surgical robotics, laparoscopy, for example, where Intuitive Surgical is playing. If you talk about orthopedics, where Medtronic, Johnson & Johnson, and Stryker are playing. If you look into those segments, you see that the segment of vascular intervention, you really don't have any competition. It's a completely blue ocean.
There is one company called Stereotaxis here in the U.S., but it's a very niche product, only for ablation in the heart, what we called EP. The question is, Why don't we see robotic playing a major role in that space? One of the question is, ''Is it a big market?' When you look closely into this market, the market has three segments. Neurovascular, for example, stroke management. Coronary, heart attack, for example. And peripheral. Peripheral, things like below-the-knee occlusion, BPH, for example, for prostate, large prostate. If you look at the entire market called endovascular, the market is about 5 million- 6 million procedures annually in the U.S. alone. This is probably the second-largest market for robotics in general after the soft tissue, the laparoscopy, where Intuitive is playing, which we're not in the same market, we're not competing with them.
If you break this market into three segments, you see that the neurovascular contributes about 200,000- 150,000 procedures a year. The coronary contributes about 3 million procedures a year, and the peripheral contributes anywhere between 2 million- 2.5 million procedures a year. The market is big. The question is again, '' Why don't we have robotics in there?'' Because maybe we don't have enough people doing these procedures. It's actually very interesting to look at it because across the three segments of endovascular space, you have 15,000 physicians which are split between the cardiologists, the radiologists, and the vascular surgeons working around 8,000 facilities. The spend annually on healthcare in endovascular is huge. At least $40 billion a year in the U.S. alone. Another very interesting thing about looking into this map is it is 15,000 physicians in the U.S.
That sounds like a lot, but it's not. It's a very concentrated target audience. If you look at the urologists in the U.S., just that group has about 40,000, 50,000. The nice thing about it is you capture an audience in a very big market that are doing a lot of procedures per individual. The market is need. Most of these procedures are life-saving, so when you talk to interventionalists and you ask them, "Do you see robotics as part of your future?" All of them saying, "Yes." This is a study we have done about three years ago, and you can see that 75% of the interventionalists we discussed with said yes, they expect the integration of robotics into their practice. And part of it's because of the life-saving feature. When you talk about hysterectomy, prostatectomy, hernia repair, there is no urgency. People can wait.
When you talk about stroke, when you talk about heart attack, when you talk about cancer, when you talk about GI bleeds, for example, time is life. You have to go and get the procedure done, and that's where the role of robotics can really help us as a healthcare system to get to that point. Again, the question is: Why aren't we seeing robotics in there? Another question we hear is maybe there's not unmet needs in the market. Well, if you look into even the American Medical Association at the end of last year when they came with their 2026 Public Health Initiative, they clearly called one of the four pillars that they're going to focus on about radiation safety protection and ergonomics in the workplace design. And when we look into the unmet needs into the endovascular space, it is very clear.
It's starting from radiation and ergonomic risk for the user. If you look closely, physicians, techs, nurses are six times higher risk of cataracts, higher risks for cancer. A lot of physicians suffering from herniated disc from wearing a lead vest the entire day. If you ask yourself, if you had to go through a surgery tomorrow, will you try to take the 7:00 A.M. or the 4:00 P.M.? We all know the answer, the 7:00 A.M., because we want our physician to be as fresh as possible. Add to this radiation exposure, add to this 30, 40, 50-pound lead vest, and now you see the effect it has on the daily practice of our caregivers that we're relying on them. On top of that, there's an unmet need for access to quality care across not just emerging markets, even here in the U.S.
I live in Boston. Those of you who live in New York or Chicago, you're in a great place. What if you're not? What if tomorrow you have bleeding? What if tomorrow you have a stroke and you cannot get there in time? We need to have access to quality care regardless of where you live in the U.S. or outside the U.S. The market is big. The unmet needs are very clear. Physicians want robotics, the question is why only less than 1% of all procedures in the endovascular space are done robotically. To understand how we're trying to answer this question, we need to understand the barriers. Many people saying the number one barrier is the price of the capital equipment. Actually, when you talk about endovascular, it's not. The number one challenge in endovascular procedure to adapt robotics is the extended setup time.
As I gave in my previous example, when you do hernia repair, when you do prostatectomies, hysterectomy, spine fusion, you can wait 30 minutes until you drape the robot, you clean the robot. When you have stroke, when you have a heart attack, when you have a bleeding, we have a bleeder, you don't have even two minutes. The extended setup time, it's actually the number one barrier to adapt robotics in the endovascular space. The next one on the list is actually the long learning curve. Nobody wants to give up 100- 150 patients just to learn a new technology. The large footprint. When you talk about Intuitive Surgical, for example, of course, we're not competing with them, we're not in the same space, but just as an example, they're playing in the OR space. The operating rooms are big.
There's enough real estate to accommodate for a big robot. For those of you who ever had a stent, a balloon, or you have been into a CT room, those room are very small. Within this room, you already have an X-ray machine, a CT machine, there is just not room to put this capital equipment. The capital expense, many of these robotic systems are going anywhere between $1 million-$2 million. Nobody wants to pay $1 million for a system that you haven't proved yet that it fits into your workflow. On top of the capital expense, then you need to have drapes, you have to pay for disposables, you have to pay for the cleaning materials and services, on top of this, you need to have dedicated infrastructure. Sometimes you need to remove walls.
You need to connect into your Wi-Fi of the facility. Sometimes it costs you more for the infrastructure than the robot. Those are the barriers. At Microbot, we thought, how do we overcome them? It was very simple. Let's just get rid for all of them. That's where the solution of LIBERTY came to life. As a first step, we took this big market called endovascular. When you look into development of robotics, you got to choose a segment. You can't just go over the entire endovascular. We started with a very attractive segment called the peripheral. About 2- 2.5 million procedures a year, practiced by around 6,000 physicians in the U.S., interventional radiologists, and vascular surgeons, although we see more and more cardiologists and neurovascular surgeons doing peripheral as well.
We started by focusing on this market. Some of the numbers are very attractive. We see 6,000 physicians that on an average doing about 400 procedures a year each. When you call on a physician, when you call on a hospital, you know you can go deep and get a volume within that account versus trying to always go wide and get more accounts in order to get your volume. The development that we had is to create a completely differentiated robotic solution. If you look at it closely, it's not just an endovascular robotic solutions. We're actually creating a whole new category. We're creating the first ever fully disposable robotic system. LIBERTY is a single-use, fully disposable without the need for capital investment. It also comes completely sterile off the shelf.
It takes less than two minutes to set up the robot, which is usually done by a technologist on the side. By the time the physician is ready to perform the procedure, the robot is ready to go with no delay. Go back again to all those life-saving, for example, procedures where you don't have any delay in getting to this. It empowers physicians to precisely steer guide wires and catheters using a handled remote control away from radiation. They can be anywhere inside the room, just away from radiation. They can be in the control room. We're using off-the-shelf instruments. We're not changing the workflow or the contract that a hospital may have with the big companies that providing the wires and catheters. We are agnostic to what they use, which adds another layer of confidence in our product.
A very small footprint fits into the palm of your hand. You can have it on the shelf and open it when you're ready. You don't have a dedicated room just for robotic procedures. You can have it anywhere you want within the hospital. There is no additional infrastructure. A simple intuitive setup. It says here five minutes, but now that we're in multiple accounts by multiple users, it usually takes less than two minutes. It's a very short learning curve. Usually, within couple of cases, we're offered to be there if they need us, but many times they just call us, say, "Hey, I did some cases yesterday. It was great." As I mentioned earlier, compatible with off-the-shelf guide wires and catheter.
If we're going back to what we did at Microbot, we got rid of all the barriers for adoption of robotics in endovascular by creating LIBERTY, which creates another advantage for us that we have the first-mover advantage. If you looked at what other robotic systems that are trying to be developed outside the U.S., in the U.S., or some of them even have approvals outside the U.S., or for example, a company that does have approval in the cardiovascular space, all of them have large capital equipment that require large capital investment, infrastructure. The procedure setup time is very long. The learning curve is very long. Usually, they have their own proprietary wires and catheters, which physicians don't like. They build trust in the instrument they have used over the years, from medical school to fellowship to when they are in their own practice.
The last thing is you don't want to go through complex integration. Cybersecurity is an issue today. Moving wires and moving walls within the hospital, it's not an easy thing to do, especially when you talk about walls that protect from radiation. With Microbot at LIBERTY, if you look at the right-hand side, removed all of those barriers. This is just a glimpse of some competitors that we have. Some of them already have approval outside the U.S., some of them are in processes to get approval outside the U.S., maybe even in the U.S., but none of them have what we have. It's a clear differentiators and a first-mover advantage that we have at Microbot. As I mentioned earlier, we're not only developing a new endovascular robotic system, we're creating a new robotic category, a completely disposable and single-use robotic system.
There's two layers of benefits. Obviously, the external benefits, meaning to our customer. The benefits to the customers are very clear. It's single-use disposable system that eliminates the capital and infrastructure cost. It's sterile, so no setup time. There's no capital investment and reduce the long-term risk because nobody wants to spend $1 million and then see how it works into their workflow. With LIBERTY, you can buy 12, 20, 30 units. You can start working with it, see how it fits into your workflow, and then decide, do I like it for this procedure? Do I like it to all of my procedure? Is it better in this account within my healthcare system, or should I move all of these procedures to another account? There is no service or annual service agreements required from the hospital.
Some other external benefits that we heard recently is, of course, marketing. They go out, they tell the world. We already know from a few accounts that based on their marketing, they already got some patients calling in and asking for the robotic procedures that they read. Another thing that it's very interesting, because of the shortage of staff, many of these accounts that we're using are leveraging the new technology to attract new staff by telling them, we care about you, we protect you, and we have the newest technology on the market. We can prove all of this because we have a pivotal study that gives the customers the confidence to adopt our LIBERTY system. Starts by showing them that in our study, we achieved 100% robotic navigation with the robot. We're able to reduce 92% of the radiation exposure.
We had no adverse events, and the satisfaction from the staff, physicians, and techs during the pivotal study was as high as it can get. Another very exciting things that happened over the last few months, it's what happening in the market. As you see, this is just a glimpse of a few things over the last six months, ranging from the American Medical Association to the Society of Interventional Radiology here in the U.S. or CIRSE, which is outside the U.S., going all the way to up to nine societies from neurovascular, cardiovascular. All of them are focusing on one thing only starting this year. How do we get rid of radiation exposure and physical strain? The nice thing is that noise is not only coming from the industry now, that noise is actually coming from the societies themselves.
Let's not forget what the benefit having a fully disposable and single-use robotic system has for the company. We spoke about the first-mover advantage. That is true, but on top of this, think about a razor and razor blades without the razor. We can have a predictable recurring revenue from hospital utilizations. We're already seeing a faster sales cycle. Within 90-120 days, we already have multiple accounts in key states. Disposable-only components reduce our inventory expenses. If you have a traditional robotic system and you have capital equipment, then you need to have very expensive inventory, you need to have expensive warehouses to keep those inventories, you need to keep service people, you need to keep parts. We don't have any of them. All those line items do not exist in our expenses, and all of those line items then can go into supporting sales and marketing.
Even internally, having this solution can help us drive adoption faster. Over the last few months, we had multiple pivotal company developments. In September 2025, we got our FDA clearance. Just to clarify, the FDA clearance we got is a 510(k), which is for any procedures in peripheral. We're not dedicated to one procedure, and we already see physicians using our system across multiple procedures, and I'll just mention a few. PAE, prostate artery embolization, for the treatment of BPH, which is enlarged prostate. GAE, which is a fairly new procedure, which is growing like wildfire recently. It's a procedure for pain management, genicular artery embolization. UFE, uterus fibroid embolization, that can potentially save future hysterectomies. We see them for Y90, which is cancer treatment for liver, Y90 mapping.
We also have a few procedures for below-the-knee occlusions, and we also see physicians from both interventional radiology and vascular using our system. In mid-November 2025, we commenced our limited market release. Being a Boston-based company, we focused on the East Coast. This is the responsible thing to do, first of all, for the patients, second for our customers, and third for the company, to go out and put it in the hands of commercial use, multiple physicians that are buying it and trying it, not under a clinical study. Over the last 90-120 days since we commenced the limited market release, we already feel very comfortable that we can move to the next stage of the full market release. Something that are public that I can discuss is, for example, Emory University, that were the first one to adopt our LIBERTY system, followed by Tampa General Hospital.
Just want to highlight two things about these two accounts. Emory University bought it for one hospital, but now they're using it across the system. To my knowledge, there are, I believe, three hospitals. To us, Emory University is an account. Within an account or a healthcare system, you will see multiple hospitals. Once we get approval into the Emory system or the account, any other hospital can use it, and we already see, I believe, three hospitals within the Emory account using it. The nice thing about Tampa General, for example, is that both the vascular surgeons and the interventional radiologists are using our system.
Overall, within 90- 120 days since commencing our limited market release, we're approved in multiple healthcare systems, which we call them accounts, in key states, Florida, Massachusetts, New York, Georgia, and they are representing in total around 30 hospitals, give or take. We have active pipeline in all limited market release regions, which is the East Coast of the U.S. Based on the feedback we had from multiple accounts, from users doing it across multiple procedures, we actually commenced our full market release this past week at the Society of Interventional Radiology, which is the largest U.S. interventional radiology conference. You can see some of the photos from our booth, how busy it was. Very busy three days. We had leads that exceeded our expectation, people that keep coming back to the booth, bringing their friends, understanding where it fits into their workflow already.
Starting today, basically, our team is out there. I arrived last night from Toronto. Starting today, the team is outside, full market release, which part of it is growing from four sales territories, which we had under limited market release, to eight territories currently, and we expect 12 territories by the end of the year. A high level, our go-to-market strategy. In the U.S., we expect to go direct sales team that we will supplement with distribution channel as needed. We are increasing manufacturing and build inventory levels as we are continuing with our full market release. Limited market release was done successfully, and just as expected, we commenced our full market release at SIR. Moving forward, we're building for comprehensive growth, and we call it comprehensive growth because we're looking at it from two aspects.
One of them is how do we go deep within an existing space, increasing the usability of the product within the peripheral, in parallel, how are we going to go into the cardiovascular and the neurovascular space to capture the entire 6 million procedures in the U.S. alone? We have ongoing projects in tele-intervention and autonomous robotics that are in progress. Some of them we discussed, some of them we rather keep to ourselves. With all the noise out there by some people that are trying to show that they have capabilities, we much rather prove it as we move forward. Our direct sales force already moved from four territories to eight territories, and 12 territories by the end of the year. We're focusing, the keyword is focusing the U.S. market.
However, we are in the process of getting MDR approval, which is a CE mark, which we expect toward the end of this year. Already putting the infrastructure outside the U.S., and over there, it is probably going to be more distributors. To do this, we need money. By limiting upfront capital and ongoing expensive equipment inventory and service, we are very lean on our monthly burn rate, which is about $2.5 million a month. As of the end of the year 2025, we had about $80 million in cash, and having $2.5 million a month burn rate through 2026, that gives us a favorable cash runway to execute against our commercial activities. Very unique technology needs to be protected.
We have 52 patents that are pending and 20 patents that are already issued worldwide, and a very strong leadership and commercial team with experience across corporate America in the vascular space, like Boston Scientific, Johnson & Johnson, mixed with people that come from startup companies that build commercialization organization, and a very strong commercial organization with the same mix. People that either worked in big organization and know how to build a commercial team as a growing company, but also people that were there from day one to build a startup company and enter a new market. To finish, the reasons to believe, we do have FDA clearance, we have all the infrastructure for commercialization in the U.S. We finished our limited market release, and we already have initial customers across multiple states.
We have a strong balance sheet that allow us to drive commercialization activities, and we commenced our full market release as planned this past weekend during the Society of Interventional Radiology. Mike, I send it back to you, and thanks for listening.
Yeah, thanks. That was great. A very comprehensive overview of the company and the product. I do have a few follow-up questions. Maybe you have gone through this limited market release, so can you share some of the feedback you have received and any surprises you have noticed during the limited market release?
Yes, great question. Surprises. I'll start with what we've seen. What we've seen is that all of our assumptions were confirmed during the limited market release, which gave us the confidence to move then into the full market release. Things that we saw was the short setup time, like it does not interfere into workflow. Pricing, we thought that people will accept the pricing, but we did not know. We literally don't get any pushback around pricing. It fits well within the reimbursement codes of the procedures, and the hospital sees the value. The procedures, if there's one surprise that I may call it a surprise, is the more complex procedures in our space is, for example, prostate embolization. The more low-hanging fruit is the uterine fibroids.
We thought that they will start with the low-hanging fruit to see how it feels in their hand, and we're surprised to see that they immediately went to their hardest part. For example, a left radial access, which is in your left wrist, going all the way to the prostate. On one hand, we said, "No, we didn't think it's going to happen." On the other end, seeing how successful the procedure were, it gives you a lot of confidence that if in the most complex procedure it worked, then it will work in the more, let's say, low-hanging fruit. We saw that it allows them to stay away from radiation. The smile on the face of physicians when they're done sitting down and no more back pain, it's priceless.
We saw all this stuff, and we cannot confirm it yet, we cannot say that this is proven, we cannot prove it yet, but we start collecting data. We saw multiple cases where the robot increased efficiency dramatically by either reducing the time of the procedure or reducing the amount of catheters and wires that they're using, which coupled with the radiation exposure and the physical strain, if we can then combine it with efficiency, that's probably the holy grail of adoption.
Yeah. Okay. What about interest from hospitals that typically wait for new technologies, just given the single-use kind of disposable nature, is that accelerating the adoption?
I think we have the perfect timing to discuss this, because if we had spoken last week, I will have a different answer, potentially. Just last Friday, the last two weeks, we closed three accounts, and I'm not going to mention the cities because I don't want to offend anybody. We closed it in two cities in the Northeast that traditionally are the last one to adopt new technologies. Florida was always the first one to adopt new technologies, the Southeast, Georgia, so that wasn't a surprise. To see three accounts in two cities that traditionally were planning probably six to nine months, and they bought it within 90 days, that shows you the adoptions, because again, A, there's no barrier for adoptions. They can get their own experience.
There's no upfront commitment. The noise that's coming lately around radiation exposure, physical strain, and staff shortage really allows us to go through the adoption and the sale cycle, and that's another thing that we're happy to see that. Even if they don't buy it from the operating budget of the department, even when it goes into the value analysis committee in the hospital, it goes into the non-capital equipment value analysis committee, which is way shorter than the 9- 18 months when you try to sell capital.
Okay. What about recent guidelines from medical societies? Do you think that'll contribute to the adoption of LIBERTY?
Absolutely. I think this is a great question. I think the opportunities we have, and I show that in my slide, the noise is coming now, not from the industry. It's coming from the societies. A, it's empower now the physician to go to their administration and to say, "It's not Microbot telling me this, it's the societies." Right? I feel it every day, but now I have the societies. Number one, it empowers physicians to go and fight for their, sorry to say that, for their life with administration. A second thing is we don't have reimbursement code for our robotic system. Actually, there is no robotic system out there, even Intuitive, with a robotic code.
Being able to potentially harness all of the societies behind you, as we started the process to look into what they call an NTAP code and then go all the way to a fully reimbursed code, I think that having the societies knows will help us push CMS, and other government offices, hopefully, into looking into reimbursing the product or the procedure to keep physician and staff safe. Absolutely, we already see the effect it has.
Okay. Then you're focused on the interventional radiologist population, at least initially. Can you talk about why that's the right specialty versus some of the other, like interventional cardiology, for example, that also uses a lot of catheter-based procedures?
Number one, it's one of the largest population in terms of volume. If we look again, there's only 250,000 neurovascular versus 2.5 million procedures in peripheral. A second thing is, when we develop the product, we also look into the different mix of development parts. One of them is regulatory, it's probably a lower hanging fruit to go after the peripheral space first, then you become your predicate device as you develop it then for the cardiovascular. The second thing is it's a large group. We have about 3,000 interventional radiologists in the U.S., probably even more, the unmet needs are very clear there. The procedures they are doing, they're using the tools that we decided to integrate into our robot from day one.
As we go into the cardiovascular, we may need to add a couple of additional sizes into our robotic system, which is not a big hurdle, it will require definitely test and a regulatory process.
Sure. Then maybe just talk about your balance sheet. I know you announced the ATM this week, so maybe talk about how much cash you have, the ATM, kind of your cash burn, et cetera.
Absolutely. As I mentioned earlier, as of the end of 2025, we have $80 million in cash. We have no debt. The burn rate, the expected burn rate for 2026, and this is before revenue, is about $2.5 million a month. About $30 million. As you can see, we have plenty of cash to execute against our commercial activities for 2026 and beyond. From our perspective, ATM is just a good business practice. It's not a transaction that we're doing today, right? It allows for a potential future flexibility if and when we can see an opportunity to increase shareholder value by expedite and accelerate growth. That's the ATM. It's there just in case we have this opportunity. I believe it's just a good business practice.
Okay. All right. Well, that's it for my questions. I don't see any from the viewers. I think we're going to have to wrap up there. Thank you so much, Harel.
Thank you, Mike, for your time. Appreciate it.