Andromeda Surgical Raises $15 Million Series A for Autonomous Surgery

Andromeda Surgical, building the intelligence layer for surgery, led by Nick Damiano and Kartik Tiwari, has raised a $15 million Series A led by Standard Capital, with participation from Y Combinator, Vox Capital, Lingotto Innovation, Alumni Ventures, WestWave Capital, and others. Pioneer Fund has backed the company twice, starting at seed.

Urologists in three countries have used the company’s system to perform holmium laser enucleation of the prostate (HoLEP) in more than 40 patients. Andromeda reports enucleation times of as little as 30 minutes, compared with a published average of around 90 minutes.

Endourology covers several high-volume surgical conditions, including enlarged prostate, prostate and bladder cancer, and kidney stones. Co-founder and CEO Nick Damiano frames the opportunity around both surgical capacity and precision, citing a growing shortage of surgeons that has pushed waitlists beyond a year in many regions, alongside skill and efficiency gaps that he says contribute to more than one million avoidable deaths and $1 trillion in excess healthcare costs globally each year.

Nick Damiano said that five billion people globally lack access to safe, affordable surgical care when needed. The company aims to address the gap by helping surgeons treat more patients to a consistently high standard, while ultimately expanding access to expert surgical care in underserved regions.

Damiano previously founded Zenflow, which joined Y Combinator’s W15 batch, where Dalton Caldwell and Paul Buchheit, now at Standard Capital, were his group partners. Andromeda, part of the S23 batch, is his second YC medtech company. Co-founder and CTO Kartik Tiwari previously worked in autonomous vehicles, leading the team at Starsky Robotics that deployed a driverless truck on a public road.

That comparison sits at the core of the company’s thesis. While self-driving cars now operate on public roads, most surgical robots remain largely mechanical instruments with limited autonomous capabilities, according to Damiano. Andromeda is betting that the operating room offers a more manageable environment for advancing surgical autonomy.

Andromeda has regulatory clearance to launch in Canada and New Zealand, with additional approvals expected. The company plans to install its first commercial systems in hospitals within two months, followed by increased utilization, expansion into additional procedures, and further autonomous capabilities over the next year.

Nick Damiano, co-founder and CEO of Andromeda Surgical, said surgery represents a $3.7 trillion global market and could offer a more suitable application for autonomy than driving.

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