Paris, April 2020. The Covid-19 pandemic had reached France and hospitals were filling up rapidly. Alarmed by the spread of the disease, the government had ordered a national lockdown. Paris' streets were eerily quiet, a silence only broken by the loud sirens of ambulances. Looking out the window of her apartment in the 10th arrondissement, Sophie Cahen was wondering whether her young company, Ganymed Robotics, would survive this extraordinary storm, and if so how. An engineer by background, Cahen did not have the most traditional journey to entrepreneurship. After graduating from Paris' cole Centrale, a top Engineering Grande cole, she chose to go to Amman, Jordan, to learn Arabic and work on various development projects. She then spent a few years in consulting before enrolling for her MBA at INSEAD in 2016. Ganymed was born shortly thereafter when Cahen met Orthopedic Surgeon Michel Bonnin, a prolific clinical researcher and former President of the French Hip & Knee Society, and Bruno Maisonnier, a well-known serial entrepreneur and expert in robotics. Both Bonnin and Maisonnier became early investors in the new venture. Cahen had no background in surgery or in robotics, but she was enthused by the challenge of solving an important problem. The growing and aging world population meant that the demand for orthopaedic surgery was increasing rapidly. For example, the market for total knee arthoplasties - the segment that Ganymed was initially focusing on-was projected to grow from 2.2 Million procedures in 2019 to 5.7 Millions by 2030 in the OECD. The market for surgical robotics was growing even faster from USD4.7bn in 2018 to an estimated USD15.4bn by 2029. Despite the complexity of orthopaedic surgeries, 95% of procedures were still performed without any technological assistance in part because the first generation of robots in this space were expensive, invasive and generally difficult to use. With Ganymed, Cahen and her team wanted to build an entirely new generation of robots that would deliver better patient outcome and surgeon experience in a cost-effective manner. The technological challenges, however, were daunting and the firm's resources were limited. Cahen had just raised 2,000,000 in seed investment earlier in the year. She would have to spend those resources very astutely to maximize the venture's chances of survival. Now that her employees were stuck at home, the challenge had yet grown. How could they possibly build the next generation of surgical robots while working from home? Cahen felt that something had to give. She reasoned that by being too ambitious, she ran the risk of losing everything. Instead of developing the full robot from scratch, she could start by finalizing and commercializing the software part, which could already be useful to assist surgeons during the procedure. After all, the Ganymed team had already developed a ground- breaking piece of software which uses the latest machine vision technology to allow bone detection and localization within the operating theatre in a non-invasive, non-radiation based way. Developing a Software-as-a-Service (SaaS) type of offering would be much simpler from a technical standpoint. Bonnin agreed but Maisonnier and other investors didn't. They argued that Ganymed had been founded to be a robotics company. A pivot to software would be a significant departure 1 Surgical procedure aimed at resurfacing a knee damaged by arthritis from the firm's original vision. The market for surgical navigation software was much less vibrant than that for surgical robots. Moreover, the firm might lose key robotics-focused employees and-worse perhaps-the wow-factor with surgeons. From their perspective, the Ganymed team had only one shot at getting it right. It was all or nothing. Cahen was unsure how to proceed. She would not have become an entrepreneur if she had been risk-averse, but this was a lot. Moreover, whichever decision she made, she would have to bring other investors on board. Unlike her first group of backers, most investors focus primarily on financial returns, not on changing the world. As the founder and CEO, she had to make the final decision. Appendix The Total Knee Arthoplasties (TKA) Procedure Source: Ganymed Robotics Sophie Cahen (left) and the Ganymed Robotics Team in June 2020 GANYMED ROBOTICS Source: Ganymed Robotics RT @PBS Cochin/ 26-06-2020