This Startup Wants To Use Mini Robots To Treat Alzheimer's

Neurosurgeons in Florida, Connecticut, and New York are preparing for an experimental operation to treat Alzheimer's disease, which causes memory loss in about 7 million Americans. The surgery, which has been practiced on cadavers, uses microscopic robotic instruments developed by Jacksonville, Florida-based startup MMI to clear the brain's drainage pathway, allowing the body's lymphatic system to flush out toxins believed to drive the disease. These robots can hold needles the size of eyelashes and tools as thin as human hair to operate on lymph vessels that can be as small as 0.2 mm in diameter. MMI CEO Mark Toland likens the procedure to tying together a couple of strands of hair. The team planned to perform the first microrobotic surgeries on five patients in March. This trial builds on approximately 5,000 experimental surgeries conducted in China and other Asian countries over the past five years. These previous procedures, though largely anecdotal, suggest that surgeons may be able to slow Alzheimer's progression and, in some cases, move patients from moderate to milder stages of the disease. MMI received FDA approval in November to begin trials with 15 patients to evaluate safety. If successful, Toland hopes to expand to a larger trial of 200 to 300 patients later this year, with potential approval for the use of its microrobots to treat Alzheimer's by 2027. The approach is ambitious, as there is no known effective treatment once Alzheimer's advances beyond early stages, and many past efforts have failed. Dr. Andrew L. Bardicee, an MMI investor, notes that the disease has long been considered one of the most difficult in biology, with a "graveyard of failures." MMI's method is based on newer research into the brain's waste removal system, first identified in 2012. Alzheimer's is linked to amyloid plaques and tau protein buildup, and this surgery aims to improve natural drainage, which Toland describes as a "plumbing issue," comparing it to bypassing a clogged artery. MMI, founded in 2015 by three Italian roboticists, produces the Symani robot, which allows surgeons to operate on vessels smaller than 0.5 mm using magnified imaging. This robot is already used in procedures like nerve repair and breast reconstruction. Each robot costs about $1.5 million. MMI expects its revenue to reach $50 million this year, up from $20 million in 2025, and has raised $220 million from investors. Applying this technology to Alzheimer's is MMI's boldest bet, especially given that over 55 million people worldwide suffer from dementia, a number expected to rise to 78 million by 2030. The procedure itself was pioneered in 2020 by Chinese surgeon Qingping Jie, who performed it manually. Toland, initially skeptical, sent MMI staff to observe surgeries and follow patients, and they returned "more excited" each time. Within the scientific community, reactions remain mixed. Jeff Iliff of UW Medicine calls the idea "provocative and interesting" but notes a lack of definitive studies. Rosalind Bill of Aston University points to risks like brain swelling and expresses hesitation about undergoing the procedure at this stage. Regulatory caution has also been observed, with Chinese authorities pausing the surgery's use in 2025 pending further study. In the US, formal trials are just beginning. However, a recent review in the Journal of Prevention of Alzheimer's Disease concluded that, despite limited evidence, the procedure shows "promising therapeutic possibilities." Toland's goal is to prove that improving the brain's drainage system, particularly with microrobots, could offer a safe and effective treatment, stating, "if you fix the plumbing of the body, the body works well."