Episode breakdown:
00:00 – Tech Problems, AV Chaos, and Starting the Conversation
00:50 – Meet Adrian Mendes, CEO of Perimeter Medical
01:27 – How Perimeter Got on the Radar (and Chamath’s Backing)
02:17 – Chamath Explains the Breast Cancer Surgery Problem
04:47 – AI + Imaging to Eliminate Repeat Surgeries
06:34 – FDA Trials, Labeling, and the Road to Approval
07:23 – The Emotional and Clinical Impact of Re-Excisions
08:35 – How Surgeons Use Perimeter’s Current FDA-Cleared Device
09:52 – $700M Wasted Annually on Repeat Surgeries
10:59 – Cutting Re-Excisions to 5%: Hospital and Patient Benefits
12:07 – Why Medtech Needs Both Clinical and Economic Pathways
12:58 – Adrian’s AI Hardware Background and Move to Medtech
14:55 – How Optical Coherence Tomography (OCT) Works in the OR
16:27 – Imaging Comparison: OCT vs. Ultrasound vs. MRI vs. Pathology
17:59 – Building an AI + OCT Platform and Tissue Registry
19:22 – The Scale of the Market Opportunity Beyond Breast Cancer
20:55 – Why Breast Cancer Was the Beachhead Market
21:53 – Perimeter’s Business Model: Capital, Disposables, and AI Software
23:33 – Adoption, Workflow Integration, and Surgeon Response
25:49 – Confidence, Data, and Surgeon Feedback
27:02 – Demand Creation and Word-of-Mouth Growth
28:59 – Workflow Demo: How the Device Is Used in Surgery
30:49 – Patient Impact: Rural Access and Reduced Delays
32:31 – AI Levels the Playing Field for Community Hospitals
33:53 – PMA Submission and AI Clinical Trial Results (88.1% Accuracy)
35:57 – The Emotional Benefit of “First-Time-Right” Cancer Surgery
37:20 – Regulatory Progress and Commercial Updates
38:44 – Chamath’s Involvement and Why AI Differentiates Perimeter
40:05 – Quality Data vs. Big Data: Building a Proprietary Library
41:13 – Predictive Health, Earlier Detection, and Future Applications
42:24 – TechMed vs. Medtech: Why Perimeter Is a True Hybrid
43:07 – Looking Ahead: More Indications and Expanding Applications
43:53 – Closing Thoughts and Call to Action
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