Surgical robotics is stuck in the horse-and-buggy era. That’s how Andromeda Surgical CEO Nick Damiano sees it - and he’s betting software alone can pull it into the future.
On This Week in Startups, Damiano argued that while self-driving cars have flooded the streets, surgery remains stubbornly manual. Andromeda isn’t building its own robots. Instead, it uses off-the-shelf Kuka arms and focuses entirely on the intelligence layer - the same way Tesla skipped Detroit’s hardware legacy and won on software.
The bottleneck? Data. Surgical kinematics and force metrics are locked in private clinics. Andromeda’s edge, Damiano says, is its proprietary dataset from 45 live procedures - a collection so rare it forms a defensible moat. Early features include Google Maps-style landmark tracking and force auto-pivoting, currently deployed in HoLEP procedures for enlarged prostate.
"We're shipping software updates to the clinic every week. That doesn’t happen in MedTech."
- Nick Damiano, This Week in Startups
Regulatory paralysis often kills fully autonomous medical systems. Andromeda sidesteps it by keeping surgeons in the loop - not at the scalpel, but in an air traffic control-style hub. The vision: one surgeon overseeing ten robotic procedures at once, with AI handling routine motions.
The goal is ubiquity. Damiano predicts autonomous surgery bots will be standard by 2035, starting in urology and abdominal procedures. The transition, he says, will take a decade - but once the platform is proven, adoption will accelerate.
"Surgery is one of the last high-stakes fields untouched by AI. We’re moving past the horse and buggy."
- Nick Damiano, This Week in Startups
Andromeda’s software-first model bets that precision robotics, like cloud computing or AI models, will eventually become a general platform - not a bespoke machine in a single OR.
