Medical Technology Review: Surgical Robots

​Robotic surgery is not a new topic in the medical field; however, it is expanding in ways that warrant a closer look. Innovations around surgical robots are beginning to provide value in reducing overall healthcare costs, while providing greater access of care to remote or mobile-limited patients. In fact, over one third of all hospitals in the United States house at least one surgical robot.

Intuitive’s da Vinci line of surgical robots is known as a market leader and has held the industry standard for many years. However, last year, some of their patents began expiring. The field of surgical robotic innovation, competition, and the overall drive for market share is growing and there are some new players that should be on your radar in 2019.

Surgical Robotics at a Glance

Robots have been used in surgery from as early as 1985. One of the first surgical robots was the Kawasaki Puma 560 that had the ability to insert needles at different angles and depths for biopsies of the brain. 

In the nineties, DARPA began mixing robotic technology with computer networking to remotely treat injured soldiers on the battlefield. 

The first da Vinci surgical robot came out of these DARPA prototypes. Strong medical device patents were established just before the turn of the century and in 2000, da Vinci became the first robotic-assisted surgical system to be approved by the FDA.

During 2018, more than five thousand robots—in over one million procedures—were used in the following fields:

• Orthopedics 
• Urology 
• General surgery 
• Gynecology 
• Neurology 
• Thoracic surgery 
• Otolaryngology 
• Bariatric surgery
• Rectal and colon surgery
• Other oncology (i.e., dental implants and hair transplants)

Da Vinci Surgical Robots

​Intuitive’s da Vinci surgical robots have performed over six million surgeries globally in the better part of two decades. Their most common surgical robotic system has four mechanical arms that is controlled by a surgeon, seated near the operating table. With a camera that provides hi-def, magnified, and 3-D views of the surgical site  it is no surprise that this robot is affectionately known as the “800lb. Gorilla in the Room.”

Intuitive Surgical and the da Vinci’s success has spurred stakeholders to apply robotics to every surgical specialty. Some of the new devices compete with the da Vinci, while others reach entirely new specialties. The result has been more than a dozen robotic surgical devices in use today, with at least another three dozen entering the market in the next five years. Robotic assistance is becoming the norm for all surgical procedures, rather than the exception.

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Surgical Robotics Risk and Advantages

​The Mayo Clinic outlines several risks and advantages to consider when talking about robotic surgery. Risks include infection and other complications that are typically associated with open surgeries. The advantages include fewer complications, less pain, less blood loss, faster recovery times, and smaller incision sites. 

Surgical Robotics Companies to Watch

Big fish eat little fish and the same is true for MedTech companies. So, while Intuitive is working to remain relevant while its patents expire, companies like Medtronic, Johnson & Johnson, Zimmer Biomet, Stryker, Smith & Nephew and others are coming out with their own competing medical robotic systems. Some are creating devices where Intuitive showed weakness—Smith & Nephew has a robotic knee replacement system and Stryker came out with a total joint replacement robotic system. Some are creating their own models, hoping their brand recognition alone will sell the system. And others are purchasing smaller companies with innovative robotic systems—like Medtronic’s announcement that they were launching their own robotic line by 2020 and their recent purchase of Mazor Robotics.

Some of the smaller fish have some pretty impressive skills though—or are giving off the impression that they have them. 

• Verb Surgical: A joint venture between Google’s company, Verily, and J & J’s company, Ethicon Endo Surgery, most of their projects have yet to be revealed, but are highly anticipated. 
  
  
• CorPath System: Imagine being 20 miles away from the surgeon that is performing surgery on your heart? This happened in India recently (thanks to CorPath), where living in remote and medically understaffed areas can potentially be fatal for those lacking access to urgent care. 
  
  
• The Monarch Platform: Their main focus is on robotics to perform lung cancer surgeries. Developed by Auris Health Inc., the Monarch is a surgical robotics platform that incorporates flexible robotics, micro-instrumentation, data science, and other technologies for therapeutic and diagnostic bronchoscopic procedures.

From a Surgeon’s Perspective

​How good is robotic surgery? Quite simply, it is as good as the surgeon operating the system. The surgeons that have mastered the machines and the techniques are able to perform less invasive surgeries with fewer infection rates and shorter hospital stays. 

One limitation of robotic surgery has to do with shadow learning—a term surgeons use to describe residents who taught themselves how to use robotic technology through unsupervised struggle. The technology is there, but there is a need for residents and surgeons to be better educated, equipped, and comfortable to use it.

Surgical Robots Signal the Future of MedTech

​The healthcare surgical robotic field is going to experience many changes in the next couple of years as the industry opens up to competition and fights for market share. As machines get smaller and newer technology begins to filter into the sometimes outdated healthcare field, expect to see many more exciting innovations.

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About the Author

Carevoyance contributor Sarah Pike, M.B.A., is a freelance marketing copywriter based in San Diego. She enjoys writing about business, fashion, food, healthcare, leadership, motivation and technology.