The cinematic connections to his work are no coincidence. Smith notes that he draws inspiration from both the pain and tragedy he’s witnessed among loved ones and personal connections and classic science fiction — from the unnerving ear-entering parasites of Star Trek II: The Wrath of Khan to the autonomous arm-equipped pods of the HAL-controlled ship in 2001: A Space Odyssey and the miniaturized journey in the 1987 sci-fi adventure film Innerspace.
“For an entire career of successful medical device startups, I was just making a copy of someone else’s device… You get to a point where you start to ask yourself, do you want to spend the rest of your life making other people’s dreams come true?”
His career spans multiple successful medical device innovations, each representing strategic market positions in interventional healthcare. His nine-year development of an atherectomy system for arterial plaque removal addressed a substantial market sector in cardiovascular intervention. Following this, he spent two years designing a vapor ablation device for endometrial procedures—a technology that would later become standard in minimally invasive gynecological treatments. His work on vascular closure systems tackled a critical need in catheterization procedures, where rapid hemostasis can reduce patient recovery time from hours to minutes. While commercially successful, these ventures followed an established pattern of strategic market entry. Smith notes this, pointing to a strategic pivot toward more disruptive innovation.
Shifting from incremental refinements to uncharted territory involves technological leaps and significant personal and professional risks. Early on, Smith knew that credibility would be hard-won when attempting to find press coverage for a swallowable robot. “Are these guys real? Are they just another set of jokers? I feel like we were on the razor’s edge,” he recalls. Armed with an unconventional vision, Endiatx didn’t have the luxury of a well-trodden path; instead, they built their reputation from scratch. Hard work, scrappy innovation, and the steady accrual of technical expertise have propelled the company beyond initial skepticism. Today, the team is no mere curiosity—they’ve transformed from a fledgling operation making incremental gains into a serious contender aiming to redefine what’s possible in medical robotics.
From Tesla coils in the desert to a swallowable robot and beyond
Thinking big is nothing new for Smith. Before founding Endiatx, he demonstrated his penchant for large-scale experimental projects in the Nevada desert. “I founded a Burning Man theme camp called ‘Sextant.’ We built a 30-foot, million-volt Tesla coil,” he recalls. “We had a big tower with a café halfway up, and from the top you could ride a zip line across a city block.” Those sizable installations taught him that turning impossible-seeming dreams into physical reality was more than an artistic thrill—it was a discipline he could wield professionally. “Doing all that, I realized there’s a difference between what you do as a hobby and as a professional,” he says.Another YouTube video featuring Smith describes his decision to create Sextant to unite “a group of doers—people who will go to great lengths to build insane things.”
That quest for crazy-seeming tech is present in Smith’s current focus beyond stomach endoscopy. One day, he contemplates an era of ultra-miniaturized surgical robots—tiny devices on the order of a grain of rice that could roam the body, performing interventions at a microscopic scale. “Maybe it could be like the 2001 space pod—little robot arms that come out,” he says. A compact future iteration of the PillBot could potentially target brain cancer, Smith predicts.
A vision of rice-sized robots and smaller
The drive to push the limits of robotic scale is evident in the vision for “Microsurgeon” devices, as Smith envisions them, which would rely on custom silicon chips and MEMS (micro-electro-mechanical systems) in place of standard circuit boards and batteries. Smith concedes that lithium-ion chemistry is not suited to this scale: “Lithium-ion is not going to scale like that.” Instead, he eyes nuclear beta-voltaic batteries—a technology that harnesses the steady trickle of electrons emitted by a tiny radioactive source. “What you need is a beta particle emitter… basically a nuclear solar cell,” he explains. “Some form of nuclear battery is on the horizon.”
Understandably, the idea of implanting a nuclear-powered micro-robot might raise concerns about radiation exposure. But Smith is quick to put it into perspective: “If we can … shield and trap [the radiation] so that it just turns into an imperceptible amount of heat,” he says, “hopefully it’d be able to say it’s like less radiation than eating a banana.” And the amount of fuel would just be a “fleck.” He points to established uses of radioactive seeds in oncology, which have been safely implanted in patients to treat prostate cancer. By comparison, a tiny, well-shielded nuclear battery could be no more dangerous than everyday environmental exposures.
Continuing to venture into uncharted endoscopy territory
For now though, Smith’s ambition is focused on a simpler yet still meaningful goal: rethinking the standard upper endoscopy. “Right now, for an upper endoscopy: you have stomach pain, maybe you go to the ER, then primary care, then GI, then maybe medication trials, multiple visits, and eventually you get an endoscopy that takes five minutes to diagnose something like gastritis. That’s tens of thousands of dollars for something that could be done in a few minutes,” Smith explains. By contrast, his vision is to make the diagnostic process a simple affair. “Could we maybe turn a couple of months of visits to the hospital into a Zoom call?” he asks.
The journey from prototype to medical device is rarely smooth. Smith acknowledges that the current generation of robots is easier to control in a fish tank than in a human stomach. Smith himself has swallowed these prototypes repeatedly—71 times. Two days after my first interview with him, which took place the day before Thanksgiving, he would swallow three more in a single session under the guidance of Vivek Kumbhari, M.D., Ph.D., a prominent gastroenterologist and Endiatx co-founder. Gastroenterologist and hepatologist Treta Purohit, M.D., and ER physician Benjamin Bonnes, M.D., also took turns controlling the swallowable robot.
A potential ‘fountain of data’
Now, as 2024 draws to a close, Endiatx has ongoing clinical trials for PillBot 1.0 in New Zealand. Meanwhile, development of PillBot 2.0—what Smith calls its “racehorse” model—is accelerating, focused on dramatic size reduction through new battery technology and smaller motors. The goal is to achieve neutral buoyancy, unlike the current negatively buoyant version. By integrating improvements from PillBot 1.0 with these advanced capabilities in 2.0 by late 2025, Endiatx aims to redefine gastrointestinal diagnostics. With $9 million raised, the company is positioning itself for what Smith describes as a “Google of healthcare-level opportunity.”
PillBot builds on established trajectories in ingestible medical device technology. The field dates back to the first radio-frequency capsule in 1957, which transmitted basic physiological data. A key milestone was Given Imaging’s PillCam, FDA-approved in 2001, the first commercially viable capsule endoscopy platform. Market consolidation followed as Covidien acquired Given Imaging in 2014 for $860 million, and Medtronic ultimately integrated those assets after merging with Covidien in 2015. This lineage validated capsule endoscopy for visualizing the small intestine and diagnosing conditions like gastrointestinal bleeding and inflammatory bowel disease. Endiatx now enters a robust and evolving market segment that includes established players such as Medtronic’s PillCam and newer magnetically actuated systems like Navicam.
Scenario/Facility Type | Average Cost | Price Range | Source |
---|---|---|---|
General Average | $2,750 | $1,250 – $4,800 | New Choice Health |
Outpatient Centers | $2,550 | $1,286 – $2,850 | New Choice Health |
Hospitals (Inpatient) | $4,350 | $3,500 – $10,000 | New Choice Health |
Uninsured Patients | N/A | $1,500 – $10,000 | GI Endoscopy Practice |
California (Outpatient) | $1,850 | $1,286 – $2,850 | Sidecar Health |
With Insurance (Patient Share) | Depends on Plan | Deductibles & Co-insurance | GI Endoscopy Practice |
The evolution of Endiatx’s operations
To achieve these goals, Endiatx has invested heavily in in-house capabilities. The team operates its own clean room, performs RF analysis, and even acquired an Arburg injection molding machine off eBay—an arduous, year-long journey of part replacements and learning electro-mechanical nuances. Now, the company is building its own tooling. “We were basically working out of houses,” Smith recalls of the early days. Today, Endiatx’s increasingly sophisticated facility reflects the company’s progression from ad hoc prototyping to genuine manufacturing readiness. Controlling production processes will be critical as they scale, ensuring both quality and cost-effectiveness.
From conference spotlights to Amazon’s MARS
Strategic outreach and public demonstrations have amplified the company’s trajectory. An invitation to Amazon MARS, an elite Jeff Bezos–hosted conference focusing on Machine learning, Automation, Robotics, and Space, proved a turning point. A live demonstration—in which Endiatx co-founder Alex Luebke, MD swallowed a PillBot onstage—impressed attendees sufficiently that word reached TED organizers just weeks before their conference. TED quickly offered Endiatx a slot, enabling another live demonstration that led to increased investor engagement. Someone in Smith’s inner orbit relayed that a family member had died from stomach cancer after avoiding conventional endoscopy. “There’s no real loser here except stomach cancer,” Smith says.
The company’s more futuristic-sounding concepts, from nuclear-powered surgical robots to bio-inspired interventional devices, might seem distant, but they align with the company’s — and much of Silicon Valley’s — penchant for questioning the status quo. If the company succeeds in one day making robots the size of a grain of rice, it is unlikely to stop there. “Someday, there will be nanobots,” Smith says. “It’s inevitable — it’s just a question of when and who’s going to do it.”
In recent years, Silicon Valley has lost some of its innovation power with VC funding cooling in recent years while cities like Austin, Miami and Seattle lure startups. But the region continues to be a force to be reckoned with thanks in part to its educational acumen and engineering talent. “We built Endiatx in my living room and I’m determined to show the world that magic still exists in Silicon Valley,” Smith said.
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