This Entrepreneur Raised A Record-Breaking $660 Million In The MedTech Space To Pioneer Robots To Perform Keyhole Surgery

Mark Slack is a pioneer in medical robotics and one of the key figures behind CMR Surgical, a company now valued at over $3B. His incredible journey and path to entrepreneurial success was shaped by early challenges, military service, and a deep-seated commitment to improving healthcare through innovation.

In this interview, Mark talks about raising a record-breaking $660M in one funding round for his company. He also reveals the main motivations behind building it, the frustrations of being an innovator in a heavily regulated segment, and the challenges of unlocking government support.

Listen to the full podcast episode and review the transcript here.

Growing Up in South Africa During Apartheid

Mark’s story begins in South Africa, where he was born and raised during a turbulent period of apartheid. Reflecting on his childhood, Mark shared that his upbringing was shaped by his parents’ left-wing, anti-apartheid views.

“We were brought up complaining about the government,” he said, adding that it was a “difficult time” for many, especially for those marginalized by apartheid’s harsh racial discrimination. Despite these challenges, Mark excelled in sports, particularly middle-distance running.

Playing sports inculcated in Mark the competitive spirit he carried into this entrepreneurial journey. Even today, he prefers to hire people who come from ethnic, particularly Japanese backgrounds, because he knows they also have a competitive streak.

He became a champion athlete, with dreams of competing in the Olympics—dreams ultimately dashed by injury. This setback, however, proved to be a pivotal moment in Mark’s life, steering him toward a new passion: medicine. He stayed motivated and got into university to study medicine.

From Athlete to Aspiring Doctor

Mark’s transition from aspiring Olympian to medical student wasn’t straightforward. His focus on athletics meant his academic grades weren’t initially strong enough for medical school. But Mark’s competitive spirit kicked in once again.

“I settled down for my last year at school, worked incredibly hard, and got the grades I needed to get a first-class pass,” he recalled. Getting into medical school was just the first step. Mark quickly found himself drawn to the intricacies of medicine and the challenges it presented.

“You had to learn a lot, and to be good at it, you really needed dedication,” he explained. This drive and focus would become key traits in Mark’s later entrepreneurial ventures.

Combat Medic in Angola: A Defining Experience

One of the most transformative experiences in Mark’s life came during his time as a combat medic in Angola. In South Africa, compulsory military service was a reality, but he deliberately chose to volunteer in Angola, serving as a medic in conflict zones.

Mark flew in medivacs or helicopters to rescue injured soldiers, providing life-saving care on the front lines. He describes this period as one of immense personal growth. “I learned a lot about myself, about strength of character, and about discipline,” he said.

This experience not only honed his medical skills but also taught him valuable lessons in resilience—lessons that would later prove crucial in his entrepreneurial journey.

The Move to the UK and Cambridge: A New Chapter

Fearing that apartheid would end in violent conflict, Mark made the difficult decision to leave South Africa and relocate to the UK. Once there, he pursued research in the sub-specialization and landed a prestigious role at Cambridge University Hospital as Head of Gynecology.

Cambridge was a game-changer for Mark. Surrounded by Nobel laureates and some of the brightest minds in medicine, he found himself inspired to explore the intersection of medicine and business. Aside from research, he also spent time in pharmaceuticals and surgery.

Mark began working on innovations in surgery, collaborating with global giants like Johnson & Johnson to bring new medical products to market. “It was an inspiring place to be,” he reflected. “You can’t have an ego in Cambridge—there’s just too much talent around.”

A Frustrating Reality: Observing Failures in Medical Innovation

While Mark’s career in medicine flourished, he began to notice significant problems in the industry, especially with certain medical devices. He observed how plastic implants, initially used in hernia and prolapse surgeries, were causing complications.

Despite the widespread use of these devices, Mark’s observations and research led him to believe they were harmful. He remembers doing extensive work on animals and laboratory testing that confirmed his hypotheses.

This realization fueled his desire to challenge the status quo. Mark began lecturing on the dangers of these implants, advocating for better, safer alternatives. He stresses the importance of safe innovations in medicine and medical introductions that won’t harm patients.

Mark’s stance, though not always popular, was vindicated when these implants were eventually found to be unsafe, leading to class-action lawsuits in the United States. His willingness to speak out and push for change demonstrated the thick skin required to be an innovator.

As Mark opines, to be an innovator, you need to be an observer and see things that are different from the normal. He also believes you must be willing to explore and see whether something can be done, particularly in an industry as heavily regulated as healthcare.

“You’ve got to be willing to challenge the norm and be different,” he said. This mindset would eventually lead to the founding of CMR Surgical.

Building CMR Surgical: Revolutionizing Keyhole Surgery

The idea for CMR Surgical emerged from a frustration with the limitations of keyhole surgery, which, while significantly reducing complications, was difficult for many surgeons to master.

Along with four other co-founders, Mark set out to develop a robot that could assist surgeons in performing keyhole surgery more accurately and efficiently. Robots can help because they provide a three-dimensional view, complete with magnification and instruments with articulated wrists.

The robots available in the market were too big or too expensive. Mark and his co-founders set out to build a builder robot that replicated the kind of surgery that doctors did with standard keyhole surgery. More surgeons can perform operations with accuracy and precision.

Their robot, now known as Versius, is small, highly precise, and easy to integrate into existing surgical theaters without requiring significant modifications. Unlike other surgical robots, Versius is affordable and fits seamlessly into hospital workflows.

Hospitals need not knock down walls, reinforce the floors, or raise the roof to install them. The robots fit easily into existing theaters. Training doctors to use it is relatively easy, thanks to the programs.

“One of the things we focused on was making sure the robot could fit into the flow of a hospital,” Mark explained. “Our robot is small, easy to train on, and can work five or six days a week, reducing costs for the health system.”

Raising $660 Million in a Single Round: A MedTech Record

As the company grew, so did its financial needs. Initially, CMR raised a small sum, which allowed the founder to quit their day jobs and start building. They went from a computer-generated image to operating in humans in five years.

At this point, Mark and his co-founders raised around $300M. They employed many more people, got buildings, and started building the robot. In 2021, CMR Surgical raised a staggering $660M in one of the largest med-tech funding rounds in history, bringing the company’s valuation to over $3B.

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The funding enables CMR to expand the robot to a more mature design and build the infrastructure to sell it in multiple countries. However, Mark points out this success wasn’t just a product of favorable market conditions. It was built on a solid foundation of research and results.

“We had a very credible story,” he said. “We could show the advantages of minimal access surgery and back it up with data. We put a registry in place from the beginning, tracking every patient operated on by the robot. By the time we went for the big raise, we had the evidence to support our claims.”

Mark and his team demonstrated that 60% of patients who still get open surgery have more complications. However, using robots to perform keyhole surgery can reduce these problems. Mark had the data from 2900 cases and published the results in a prominent American journal.

The robot’s designer, Lucas, successfully built a machine that is five foot six inches, folds up into a 38cms by 38cms footprint, and can sit against the wall. It had safety features and could demonstrate the advantages, including the X number of patients successfully treated.

Navigating the Complexities of Regulation

While the success of CMR Surgical is undeniable, Mark emphasized the challenges posed by regulation. As with many medical innovations, getting regulatory approval for new technologies is time-consuming and expensive.

“Regulations are designed to prevent disasters, but they also slow innovation and raise costs massively,” Mark noted. He points out that the disasters have happened because of bad behavior on behalf of companies, almost criminality.

Mark advocates for a more modern approach to regulation, one that leverages real-world data and more efficient ways of proving the safety of medical devices. “We need to think of modern ways of curating data and proving the safety of these devices,” he says.

Building medical devices has a high burn rate, and innovators with a certain amount of money find it hard to conduct trials. Trials are expensive and can run up to $3M easily. Mark also says there’s a misunderstanding between devices and drugs.

The biggest med-tech companies in the world, like Medtronic, make $20B a year and have 800 products. The return on investment in a tech company is much less than in a pharmaceutical company.

Although the government is trying to put the same regulatory framework on tech as on pharma, it may not be a practical solution. Academics are proposing more efficient, affordable, and better regulations driven by real-world data sourced from databases and registries of outcomes.

Mark points out that researchers can treat thousands of patients relatively affordably, not just in traditional clinical trials. We need to think of modern ways of curating data, keeping data, and proving the safety of these devices.

Unlocking Government Support: A Missed Opportunity in the UK

Despite CMR Surgical’s success, Mark expressed frustration with the lack of support from the UK government. While countries like the United States offer incentives and supplementary funding for building factories and creating jobs, the UK has been less forthcoming.

“We built a factory in the UK that will provide employment and bring in revenue, but we got no help building it or selling it to hospitals,” Mark laments. “Governments should think about supporting homegrown businesses more so they can get started and compete internationally.”

Mark’s Vision for CVR

Mark talks about how when he started, he wanted to prove you could build a very successful med-tech company that could profit ethically and safely for the patients. His inspiration is the biggest robotic company in the world, an American company called Intuitive.

Intuitive occupies about 4% of the minimal access market worldwide and a higher percentage in the US. It has a market cap of around $180B. That’s the kind of success Mark wants to replicate. CVR would supply a significant percentage of the robotic market for keyholes, just 10%.

Mark would like to see CVR with a market cap of $200B, building robots internationally and selling to high-income and low and middle-income countries at the right price. Their robots are affordable for improving health care, so making a profit is not a problem.

Mark reveals how the busiest CVR robot in the world is in Pakistan, a low and middle-income country, and how it works satisfactorily in a low-income setting. Likewise, CVR has robots in England, France, Germany, and high-income countries.

Ultimately, Mark’s dream is a significant worldwide footprint, delivering outstanding health care and, at the same time, supporting and funding excellent medical research so the robots get better and better both medically and engineering-wise.

Mark’s Advice for Aspiring Entrepreneurs

Mark advises upcoming founders to get a mentor who can advise them on the nuances of building and running a successful business.

Coming from a non-business background, he was often clueless about business terms, and having a senior business mentor on board would have been advantageous. Mark also suggests keeping an incredibly close eye on the spending and expansion.

Keeping the company small, consistently earning ahead of spending, and keeping an open mind are crucial strategies. Most importantly, founders should try as far as possible not to lose control of the company to investors, which most have to do. Significant investments typically mean losing control.

Conclusion: The Road Ahead for CMR Surgical

As CMR Surgical continues to expand globally, Mark remains committed to pushing the boundaries of medical innovation.

His journey—from growing up in apartheid-era South Africa to leading one of the world’s most exciting med-tech companies—is a powerful reminder of the importance of resilience, observation, and a willingness to challenge the norm.

In a world where regulation often stifles innovation, Mark Slack has managed to navigate these challenges while building a company poised to transform surgery’s future. And with CMR Surgical’s continued growth, it’s clear that Mark’s story is far from over.

Listen to the full podcast episode to know more, including:

• Mark Slack’s journey from South Africa to building a $3B company was driven by resilience, discipline, and a passion for innovation.
• Competitive sports and a career-ending injury pushed him toward medicine, shaping his entrepreneurial spirit.
• His military experience as a combat medic in Angola taught him invaluable lessons in discipline, character, and observation.
• Slack’s observations in the medical field led to breakthroughs in surgery, influencing his decision to create innovative solutions like CMR Surgical.
• CMR Surgical’s success is built on creating accessible, affordable, and safe robotic surgery solutions for hospitals worldwide.
• Fundraising success was bolstered by rigorous research, clinical evidence, and a clear value proposition, raising $660M in 2021.
• Navigating complex regulatory frameworks remains a significant challenge for medical innovators, but modern approaches to data curation can help streamline processes.

 

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