Manisha
Shah-Bugaj

Giving surgeons a second set of eyes

Inside operating rooms, surgeons make decisions on what they can see. Blood vessels, tissue perfusion, and the exact boundaries of an organ are not always obvious to the naked eye. Manisha Shah-Bugaj runs the company trying to change that. As chief executive of Activ Surgical, a Boston-based medical technology firm, she leads the commercialization of ActivSight Intelligent Light, an imaging module that clips onto existing laparoscopic and robotic systems and feeds surgeons enhanced, real-time visual information without asking them to buy an entirely new tower of hardware.

The premise is deliberately practical. Activ Surgical builds hardware-agnostic surgical software, meaning its technology is designed to work with the equipment hospitals already own rather than replace it. That approach shapes Shah-Bugaj's day-to-day work: partnerships with device makers, conversations with surgeons about how the tool fits real operating-room workflows, and the slow, unglamorous business of turning a compelling demonstration into equipment a hospital will actually adopt. Her mandate covers the ongoing development and commercialization of Activ Surgical's products, along with the relationships that keep a venture-backed company moving - partners, customers, and investors.

She took the top job in December 2022, less than a year after arriving. Shah-Bugaj had joined Activ Surgical the previous January as chief operating officer, brought in to run business operations and drive the commercial rollout of ActivSight. When founding chief executive Todd Usen stepped aside, she moved up. It was a fast promotion, but not an unfamiliar kind of jump for someone whose career has been a series of expanding remits.

She built a business from zero before

Long before Activ Surgical, Shah-Bugaj did the hardest version of what she does now. At Olympus, the Japanese medtech giant, she architected the U.S. gynecology business unit from the ground up. That is not a figure of speech in her case. She took a category the company was not seriously competing in and constructed the plan, the team, and the product portfolio around it, then helped push the business internationally. She rose to General Manager and Global Vice President, accumulating more than two decades of experience across the messy middle of medical technology, where clinical need, engineering, regulation, and commercial reality all collide.

Her path into that role is worth noting because it did not start where most medtech executives claim theirs did. Shah-Bugaj began in corporate strategy at ACMI Corporation, then moved into product management and marketing with steadily increasing responsibility at Gyrus ACMI, which she joined in 2005. When Olympus acquired the surgical instrument maker in 2008, she came along with it. Ten of her first thirteen years in the field were spent in gynecology, a specialty she came to know deeply from the inside out.

That grounding matters for the company she now runs. Activ Surgical's technology lives at the intersection of imaging, artificial intelligence, and robotics, aimed at helping minimally invasive systems collaborate with surgeons rather than operate around them. Selling that vision requires someone who understands both the engineering and the operating room, and who has already proven she can scale a business to meet the needs of very different customers in very different markets.

What she has done

The advice that redirected a career

Shah-Bugaj did not always plan to run companies. Early on, she aspired to become a physician. The redirection came from a family friend who encouraged her to pursue work with broader global impact, to do something that could reach beyond a single exam room. She took the advice seriously. Instead of medical school, she studied engineering and business, blending the technical and the commercial in a way that would define the rest of her career.

The choice reads, in hindsight, like a thesis about scale. A physician helps patients one at a time. A medtech leader building the right product can help far more, in operating rooms she will never stand in, in countries she may never visit. That logic runs straight through to ActivSight, a tool designed to travel into any compatible operating room and give the surgeon there a clearer picture. Shah-Bugaj measures her work by patient outcomes, and she has been open about how directly medical technology has shaped her own life, which gives her mission a personal weight that a résumé alone would not.

From strategy desk to the corner office

Connections and context

Shah-Bugaj is the second consecutive Olympus alum to run Activ Surgical, following Todd Usen, whom she succeeded. It is a small but telling detail about how leadership talent flows through the medtech world: the operators who scaled products at the large device makers are exactly the people early-stage companies want to turn promising technology into revenue. Activ Surgical, backed by a mix of venture and strategic investors, has raised roughly $100 million to pursue its vision of software-driven surgical autonomy and enhanced visualization.

Within the industry she is recognized less for a single headline achievement than for a way of operating - a track record as a global medtech executive who builds and holds together teams through the strain of commercialization. In a field where the science is often further along than the go-to-market, that reputation is the asset. Her job at Activ Surgical is to keep the two moving in step.

A few things worth knowing

• Her career began not in the operating room but at a strategy desk, before she moved into product and general management.
• She trained as an engineer at Dartmouth, choosing a blend of engineering and business over the traditional pre-med path she once considered.
• She is the second Olympus veteran in a row to lead Activ Surgical, part of a well-worn pipeline from big device makers to surgical AI startups.
• Ten of her first thirteen years in medtech were spent in gynecology, a specialty she helped Olympus build a business around.