Rivelino Montenegro

Be bold first, then realistic.

 

Dr. Rivelino Montenegro is a serial entrepreneur and expert in medical devices, materials science, biomimetics and nanotechnology. Dr. Montenegro has many patents and dozens of papers in international scientific journals. He helped to raise millions of euro in venture capital and public grants for startups. He actively works for several companies in the biomedical field helping them to invent, develop and approve devices, raise capital and market new technologies.

Dr. Montenegro is co-founder and CEO of Monarch Bioimplants, a Swiss Medtech company, focused on the development of technologies for the peripheral nerve repair. Such technologies are extremely important since our peripheral nerve system is vital for it connects our brain to the rest of the body. An accident, a tumor or even a surgery can lead to nerve damage. Depending on the location and severity of the injury, the consequences can vary from numbness to loss of movement or to sexual impotence.

Monarch’s flagship product is a chitosan-based membrane, NeuroShield already cleared by the FDA for peripheral nerve repair that has been tested in hundreds of patients in Europe and proved to be effective. NeuroShield is implanted during surgery and accelerate the recovery of the damaged nerves.

Besides his scientific and business activities, Dr. Montenegro is an author, sought-after international speaker and philanthropist acting as vice-president of L’ESPERANCE, a German Christian non-profit organization which has orphanages and schools in many countries in Africa and South America.

Where did the idea for Monarch Bioimplants come from?

After working in the development of medical devices for many years, my business partner, Dr. Freier and I decided it was time to make something much bigger than what we had done so far. We founded and managed startups in the past where we invented, developed, approved and marketed medical devices in areas from neurology to dermatology and dentistry. But we knew Monarch was special, for it combined all our experience and know-how to solve a big problem in men’s health, mainly sexual impotence after prostate cancer surgery.

Prostate cancer is the second most diagnosed cancer among males worldwide. Erectile dysfunction is the first thing that comes to mind when a man hears that he has prostate cancer. Many patients will avoid surgery, risking their own lives because of this issue, since sexual impotence is the number one side effect of prostate cancer surgery (also known as radical prostatectomy). Impotence is caused by the damage done to the nerves during surgery which can last for weeks or as in 70% or more of the cases up to one year or longer. Long term impotence will most likely cause penis shrinkage. Overall 71% of patients who stay impotent for longer than six months after surgery, will have penis shortage, and 48% more than 1 cm. This alone can lead a lot of men into depression. This is such a traumatic issue that we have seen cases of doctors who were killed by patients who never recovered their potency. This is a problem that any man understands immediately. We knew we could tackle it.

Our previous experience in developing technologies for nerve repair, our deep knowledge of natural polymers and our collaboration with world leaders in medicine such as Prof. Porpiglia and Prof. Geuna from the University of Turin, was a perfect combination to develop a world-class solution for a big problem. In 2016 we founded Monarch Bioimplants in Switzerland. We quickly moved with patent submission as well as raised the seed capital from Fasttrack Venture Capital Funds, and we collected the data we needed for a 510(k) submission in the US and for CE approval in Europe. Meanwhile we have gained important key-opinion-leaders who started using our flagship product, NeuroShield on their patients. NeuroShield is a breakthrough chitosan-based membrane already cleared by the FDA for peripheral nerve repair that has been tested in hundreds of patients in Europe and proved to be effective. NeuroShield is implanted during surgery and accelerates the recovery of the damaged nerves.
Monarch is consolidating itself as the innovative nerve and tissue repair company.

What does your typical day look like and how do you make it productive?

Answering hundreds of emails is part of it, therefore it is crucial to prioritize and execute the activities that have the highest potential to bring the company to a higher ground. Clearly spoken, I ask myself which activities can bring more value to the company and I go for it.

How do you bring ideas to life?

As a trained scientist in the development of medical solutions I always start with the question “where does it hurt?” I know wherever there is pain there is a need, then I try to understand and observe the problem from different angles, from the patient’s side, doctors’, nurses’ and hospital’s perspective. Only then I move to literature review and experimentation. I love to experiment, to go to the lab, to try new things and ask multiple times “what if…?” and “who else could benefit from this idea?” However, the life of an entrepreneur is not very romantic, especially if you work in a very regulated area, such as medtech. There are many regulations that must be strictly followed and a lot of documentation to be prepared.

What’s one trend that excites you?

Artificial intelligence and its potential to revolutionize medicine. Unfortunately, we are behind schedule in most areas of medicine. We need a lot more researchers, funds and technologies to solve some long-lasting problems such as malaria, cancer, etc. We still have a long way to go. Artificial intelligence will surely be of great help.

What is one habit of yours that makes you more productive as an entrepreneur?

I pray and read the Bible daily. I know some people would rather read that I meditate, but I actually pray and read the old Bible. Entrepreneurship is about understanding and serving people’s needs and in my opinion no other book gives better lessons and provides us with so many enlightening stories as the Bible. Think about the amazing first words of Jesus in his famous sermon on the mount “blessed are the poor of spirit.” (Matthew chapter 5). I don’t know any language where “poor of spirit” is a compliment. However, by starting with these words Jesus was able to grab the attention of all listeners. Besides its spiritual lesson, the beginning of his sermon is a message to any public speaker: grab the attention right in the beginning! Think about the lessons one can learn from the little David defeating the giant Goliath. To fully understand the power of the story you need to pay attention to the details. Why did David collected 5 stones to fight the giant? Why does the text say the stones were smooth? One has to read and ask questions and only then you will be able to grow, while seeking for answers and raising more questions. There are countless things to learn from the biblical stories. And I believe prayer is the best way to free myself from all negative thoughts and fears and the best way to ask God to inspire me, which He does through the pages of the Bible.

What advice would you give your younger self?

Be bold first, then realistic. Also read more psychology and business books. Most people who study engineering, physics, chemistry, biology or mathematics don’t understand the value behind psychology, business and financial books until they have to earn money.

Tell us something that’s true that almost nobody agrees with you on.

“There is nothing new under the sun.”
I have to admit however that I didn’t come to this conclusion by myself. King Solomon noticed that long before. Thus at least two people agree with this thought.

As an entrepreneur, what is the one thing you do over and over and recommend everyone else do?

Jogging almost every day. In principle any sport would prove beneficial, but jogging is very affordable, and it has the advantage that you do it by yourself. You are usually alone. You move and think about your ideas at the same time. Science has proven that we think better when we move. Most of us will skip physical activities for it looks like a waste of time, but few things are so refreshing, low cost and important for mental and physical health as movement.
Think about yourself first. If you fall sick everyone loses: you, your family and your business too.

What is one strategy that has helped you grow your business?

Asking for a favor. We are bootstrapping. We are still a startup with a very modest budget. But we were able to develop a medical device, get the FDA clearance and have the first patients in roughly two years while working in one of the most regulated, expensive and competitive industries in the world, the medtech sector. We face a hell of regulations and are competing against giants that have billions of dollars, but we still made ourselves known and have been approached by some of these giants to discuss potential mergers & acquisitions. This would never have happened if we were not willing to ask people for favors. By doing so we were able to obtain precious help, help that would otherwise have costed a lot of money.

What is one failure you had as an entrepreneur, and how did you overcome it?

I had many, but I will comment on one case that taught me a very important lesson. We spent almost four years in our previous company developing a special fiber. Our goal was to replace the sutures that exist in the market. This new fiber we invented had all properties that make the ideal suture: it was biodegradable, but could be removed before degradation if needed without causing pain, it reduced scar formation and it was bacteriostatic. But it was not as strong as regular sutures. With all research we were not able to improve the mechanical properties. We had to abort this project. We lost a lot of time and a considerable amount of money. We were frustrated and our investors angry. Then I had the idea that someone could be searching for such a fiber as the one we had. The issue was to find this person. I wrote a newsletter and placed in our website saying we started to commercialize that specific fiber and I listed all the properties. For our surprise, next day I got an email from a company requesting samples. It was a company from a sector I had not considered before. It was a match and we were able to sell kilometers of this new fiber. Lesson learned, I should never limit myself to what I see and know.

What is one business idea that you’re willing to give away to our readers?

Medical devices produced in Africa for the African countries. Most people outside Africa have a very distorted idea of the African continent. I am the vice-president of group (www.lesperance.de) that has schools and orphanages in Ethiopia, Ruanda and Uganda. So I know a bit about it. The economy in most African countries is developing very quickly. With that a lot of new opportunities. I believe starting now will bring fruits soon.

What is the best $100 you recently spent? What and why?

I helped to pay for the school fees of a child in a third world country. I grew up in a poor country, therefore I understand how much of a difference education can do.

What is one piece of software or a web service that helps you be productive?

Kanban Flow. It has helped me a lot to keep focused on the tasks that I must do.

What is the one book that you recommend our community should read and why?

I have mentioned the Bible before, but for those who have read it already or don’t want to, then I recommend “Thinking, Fast and Slow”, Daniel Kahneman. Another one I would recommend is the “Ministry of Healing” from Ellen White. These books have little in common, the authors have very different backgrounds and styles, but teach very important concepts and can bring amazing ideas to life. They both deal with the mind and body and how simple things can have major impact in our mental and physical health as well as how we make decisions.

What is your favorite quote?

“The electric light did not come from the continuous improvement of candles.” – Oren Harari.
This quote says a lot. We need revolutions, not only slight improvements. A lot of things will only get really better if we are open for a whole change. From what we eat to how we live, heal the sick, generate electricity and recycle our waste. We have to be open for radical changes, but I know it is hard.

Key Learnings:

• Ask for favors
• Read your Bible and psychology books
• Go jogging
• Be bold first, then realistic
• Ask questions, keep experimenting and don’t limit yourself