Make the Second Use Repeatable

Series · Commercial Planning · Part 4 of 5

Implantica: reach, interest and activation

Implantica received FDA premarket approval for RefluxStop on August 20, 2026. In the announcement, the company reported close to 1,800 patients treated and more than 60 Centers of Excellence across nine European countries. It described the U.S. rollout as targeted, focused on selected leading centers and reflux surgeons, and said adoption was expected to build gradually because of the physician training and site activation each center requires. [1]

Both figures are cumulative company totals, so they describe reach. How often each center repeats the procedure is a separate measurement, and the announcement leaves it unreported. A team in this position would track it account by account.

In a September 29 announcement about the 2026 American Foregut Society meeting, Implantica reported a symposium with more than 120 attendees and nearly 30 one-on-one meetings between its CEO and surgeons or gastroenterologists interested in introducing RefluxStop at their institutions. [2] The company reports attendance and meetings. A team in that position would treat each interested institution as a prospect to qualify, and only a qualified account would need an owner, a training plan and a first scheduled case.

A June 2026 announcement gives an example of site activation. The company described a new Spanish center, its 20th in that country, where a RefluxStop procedure was performed with a proctor from another hospital. [3]

Move the account from founder to owner

Early accounts often belong to the founder or a clinical champion. A repeatable launch needs a handoff for each one. The handoff is a short written record of what the founder knows: who decides, who operates, which procedures qualify, what the site asked for and what was promised.

Name one owner per account, with a backup. Put the founder's promises in the record before the transfer. Introduce the new owner to the site's clinical lead and scheduler in person or on a call. After the introduction, set a date for the owner's first review of the account.

CMR Surgical: experience elsewhere, a starting point in each U.S. site

CMR announced on March 26, 2026 that more than 45,000 patients worldwide had been treated with Versius, in hospitals across more than 30 countries. It described the SAGES meeting as its formal introduction to U.S. surgeons, following FDA clearance of Versius Plus in December 2025 for cholecystectomy, and said it was building partnerships with hospitals and ambulatory surgery centers. The company also noted that the system's independent arms can move between operating rooms. [4]

Each fact suggests an operating question for a U.S. account. The global patient count is experience from other sites, and every U.S. site starts its own count. The cleared indication is one procedure, so repeat use depends on how many eligible cases the site schedules. A system that moves between rooms raises scheduling questions: which rooms, which days and who coordinates them. The release leaves these questions to each account.

Prepare the roles around the surgeon

Training that reaches only the surgeon leaves gaps. A first case can succeed with extra help from the company. A second case needs the site's own people to cover each role. A starting list for the readiness check:

• Surgeon or operator. Completed the training the site requires for independent use.
• Procedure team. Assistant and nursing staff who know the setup and the steps.
• Scheduler. Knows eligible cases, room and equipment needs, and lead times.
• Billing and coding. Holds the code path and documentation items from the Part 3 pathway.
• Supply and service. Knows how to reorder and whom to call.

These roles are a proposed framework. Record each role as ready or open for every account.

Investigate the gap between first and second use

When an account stops after the first case, ask what stopped it before offering more training. The pool of eligible patients may be exhausted. The schedule may lack an open slot. A team member may be missing. Billing may have raised a question. Supply may have been late. Each cause has a different owner, and the exceptions workstream from Part 1 is the place to record it.

Support burden belongs in the same review. Count the company hours each early case required. An account that needs the same level of help on its fourth case as on its first has a different problem from an account that needs less each time.

Practical asset: the account activation scorecard

Keep one row per account. Update it after every case and in the weekly review described in Part 5.

Use stage definitions the whole team shares. A starting set:

Set the repeat window per product before the first case. The right window for a monthly procedure and for a weekly one are different.

Which of your active accounts has a first case and still lacks a scheduled second?

Sources and evidence scope

Company releases checked October 13, 2026. Company statements are reported as company statements. The roles, stages, scorecard and window are a proposed operating framework. The sources report launch plans and interest, and leave repeat use at these sites unreported.

1. Implantica, "Implantica receives FDA approval for RefluxStop, Opening the U.S. market," August 20, 2026.
2. Implantica, "RefluxStop U.S. market launch kicked off at the 2026 American Foregut Society Meeting," September 29, 2026.
3. Implantica, "Implantica announces launch of 20th RefluxStop Center of Excellence in Spain," June 9, 2026.
4. CMR Surgical, "CMR Surgical Announces 45,000 Patients Treated Globally as Robotic-Assisted Surgery Company Makes Its U.S. Debut," March 26, 2026.

What comes next

Part 5, Run the Commercial Plan Every Week: cross-functional cadence and leading indicators, with a weekly commercial review template.

Catch up on Part 1, Part 2 and Part 3.