Dr. Fred Moll left the practice of medicine more than four decades ago. However, he is responsible for about 3 million surgeries a year, performed by robots he helped invent as co-founder of Intuitive Surgical, the leader in robotic surgeries with more than 10,000 machines deployed and $8.4 billion in revenue by 2024.
Now, three decades after its founding and nearly 25 years after leaving Intuitive to start new ventures, Moll has invested about $100 million of its own funds in the next generation of surgical robotics startups. Colonoscopies. Cataract surgeries. Heart valve replacements. One day, he bets that these and other medical procedures will be performed by robots, improved over time by artificial intelligence that analyzes what has and hasn’t worked in similar situations in the past. The goal is to bring the best healthcare to everyone, whether in New York or Nagpur.
“I’ve spent my career watching others do surgeries. The difference between a good surgeon and an average one is huge,” Moll, 73, told Forbes. “My ambition is that the robot can do procedures that people have difficulty doing. Its impact is to raise the level of ability from average surgeons to very good surgeons in procedures that not everyone is good at doing.”
One such operation is brain surgery, which requires extraordinary precision. Moll is president and investor in Houston-based XCath (valued at $62 million, according to PitchBook), which performed the first robotic brain aneurysm procedure on a human in Panama this November. XCath CEO Eduardo Fonseca said Moll has been helpful in making sure its robot didn’t become overly complex for doctors. “If you want your technology to be successful, you listen to what Dr. Fred says very seriously, and time will prove him right,” he said.
Moll has also invested in Neptune Medical (valued at $387 million, according to PitchBook), which makes robots for gastrointestinal procedures, and its spinoff company, Jupiter Endovascular; ForSight Robotics (valued at about $500 million), an Israeli firm that is developing robots for cataract surgery; and Vitestro, which is based in the Netherlands and performs autonomous blood collection. He also sees potential in Santa Cruz, California-based Capstan Medical (valued at $367 million, according to PitchBook), which is developing a robot-assisted method of performing mitral valve replacement, an extremely complex procedure. All of these projects are in early stages, in development, or in some cases available for sale outside of the US.
“He’s been a visionary thinker about where (robotics) can go,” said Capstan CEO Maggie Nixon, who worked at Intuitive earlier in her career. “I think his strength is in that early phase.”
The largest company it has backed is SS Innovations International, based in Gurugram, India, a publicly traded firm with a market capitalization of $1.2 billion that builds robots for a variety of surgeries, including cardiac, urological and gynecological. The company’s technology also allows surgeons to operate remotely. In November, SS Innovations founder Dr. Sudhir Srivastava performed a robotic-assisted coronary bypass from his home in New Delhi on a patient 185 miles away in the Indian city of Jaipur – one of many recent cases of telesurgery overseas that could help people in remote areas access healthcare. Although “some people might worry about this,” Moll said, “I’ve gone from being a skeptic to a believer.”
For founders, Moll’s involvement in a company, whether as an investor, advisor or board member, is a kind of seal of approval. He invests personally and through a small venture capital firm, Sonder Capital, where he is a co-founder and partner, focused on early-stage medtech startups. Forbes estimates Moll’s fortune at more than $500 million, and calculates that if he had never sold any of his Intuitive Surgical shares, they would now be worth $3.3 billion.
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The success of Intuitive—publicly traded with a market capitalization of $200 billion—is due to its first-mover advantage. It launched its da Vinci robots in 2000, long before any other company. To operate one, a surgeon sits at a console and views the surgical site on a high-definition 3D screen. The robot, equipped with surgical tools that can pass through small incisions in the human body, mimics the movements of the doctor’s hands precisely.
However, Moll wasn’t there for most of that growth. He left Intuitive in 2002 after a stint as CEO and returned to building companies. That year, he launched Hansen Medical, which developed robots for vascular procedures. Then in 2007, he co-founded Auris Health, which developed a robot-assisted system for diagnosing lung cancer. It later purchased Hansen for $80 million, before being acquired by J&J in 2019 for $3.4 billion upfront and another $2.35 billion upon reaching certain business and regulatory milestones. (That deal resulted in accusations and litigation due to J&J’s efforts to reach those milestones. In 2024, the Delaware Court of Chancery ordered J&J to pay more than $1 billion for violating its merger agreement.) Moll, who spent a few years at J&J as chief development officer after the acquisition, left the company in 2023, allowing him to once again focus on early-stage inventions.
In 2023, Dr. Srivastava, founder of SS Innovations, sought out Moll as an investor. As one of Texas’ top heart surgeons, Srivastava was an early customer of Intuitive—and estimates he has performed about 1,400 heart surgeries with the help of robots, primarily the da Vinci. But when he moved to India in 2011, Srivastava said he “very quickly realized that the cost of the da Vinci was prohibitive.” He decided to build his own, more accessible surgical robot. “All Indian surgeons know about robotics, but they don’t use it because they can’t afford it,” said Moll, whose 11% stake in SS Innovations is now worth $120 million.
After a rocky start, SS Innovations is now growing rapidly: its revenue more than doubled in the first nine months of this year (to September 30) to $28 million, up from $12.5 million in the same period last year. A big reason is the price. Today, Srivastava said, SS Innovations robots sell for as little as $600,000, versus $2 million or more for the da Vinci’s newest model. “Some buy a Cadillac or Rolls Royce and some buy a Ford,” Srivastava said. The company now plans to file an application with the FDA for approval in the US before the end of the year.
Most of Moll’s other bets are focused on robots that can improve care in complex or repetitive procedures where specialists are scarce. One potential area for XCath, focused on neurovascular surgery, is responding to stroke. Moll sees the opportunity to use robots to reduce the time between when a person suffers a stroke and when the clot that caused it can be removed – crucial, since every minute of delay causes the death of almost 2 million brain cells. A big advantage of a robot for a brain surgeon is that the person can make large movements with their hands and the machine can translate that movement into a small space where submillimeter movements make a difference. “It can translate coarse movements into fine movements, and in aneurysm surgery, that’s exactly what you need,” he said.
Robots are also very good for high-volume, repetitive tasks. To that end, Moll invested in ForSight Robotics, an Israeli firm that is developing robots for cataract surgery, one of the most common medical procedures in the world, with more than 4 million of them a year in the U.S. alone. With there being a shortage of doctors to meet that demand, ForSight raised a total of $195 million at an estimated valuation of $500 million earlier this year. Moll joined as an investor and strategic advisory board member in June, because, as he said, “he’s addressing a massive opportunity.” ForSight has been testing its robot on pig eyes.
And now, with the advent of artificial intelligence, a new layer of opportunities opens up for surgical robotics, especially in the use of large amounts of data to improve its capabilities. “I feel like there’s an opportunity to use what we started 30 years ago to leapfrog the capabilities we have,” he said.
This article was originally published on Forbes US
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