Here are 5 things that will shape surgical robotics in next decade

I believe 2024 will be remembered as the year when the surgical robotics sector — not just one company — planted both feet on the ground, slowly rose up and stood tall in the medical device industry.

Why? I’ll give you five reasons:

1. FDA approval of the da Vinci 5
The approval and slow release of the next-generation da Vinci 5 reasserted Intuitive’s dominance. It may have also changed the business.

In our DeviceTalks Weekly interview (available on our website or our DeviceTalks YouTube channel), Joe Mullings, chair and CEO of The Mullings Group (an executive search firm that’s done extensive work in the sector), says competitors building large surgical robotic units will have a difficult time keeping up with the da Vinci 5’s new features.

But the bigger impact may be a smaller footprint and new leasing arrangement that could open up markets in smaller health care facilities to Intuitive.

“Robotic-assisted-surgery-as-a-service is what Intuitive is pushing here,” Mullings said.

2. The emergence of smaller consoles
Intuitive’s move isn’t likely to impede surgical robotics companies that have built — and are obtaining regulatory approval for — smaller systems that open up the market for surgical robotic systems.

On May 2, I’ll talk with the senior executive team at CMR Surgical — CEO Supratim Bose, CMO Mark Slack, and CTO Luke Hares — about their commercial plans for Versius, a modular and portable robot that can be moved from one operating room to another. It’s been used to perform more than 20,000 surgical cases across seven specialities.

Co-founders Slack and Hares “created a system that could be adapted to any operating room,” Bose told MassDevice. “The hospitals, in terms of resources and investments overall for the life of this system, find Versius more of a value to them.”

Virtual Incision, earlier this year, grabbed national headlines by sending a version of its MIRA mobile surgical robotic system to the International Space Station. The publicity surrounding this news focused attention on the company’s true goal of making every operating room a surgical robotic suite.

In a DeviceTalks Weekly interview, Virtual Incision CEO John Murphy says his system’s robotic arm, which is fastened to the surgical table and doesn’t require a base console like other systems, will make surgical robotics possible for integrated delivery networks (IDNs) and ambulatory surgery centers (ASCs) that can’t currently afford or accommodate a standard surgical robotic system.

Similarly, Distalmotion is poised for success with its Dexter robot, which doesn’t require a dedicated room and has disposable instruments that don’t require sterilization after use. CEO Greg Roche, who will speak at DeviceTalks Boston, says the smaller robotic system puts the company in position to go where patients are seeking care.

3. The drive for remote connection
Virtual Incision’s space excursion aside, surgical robotics companies recognize the importance of remote connection. At DeviceTalks Boston, we’ll have presentations from Intuitive and Medtronic focusing on the long-distance reach of their systems.

But we’re also seeing the emergence of an infrastructure built to support remote surgery. To some, 5G presents the conduit for steady connection. But serial entrepreneur Yulun Wang, who could be described as the founder of the surgical robotics sector, co-founded Sovato Health to develop a different network employing existing infrastructure of fiber optic cables.

Wang’s got a knack for getting ahead of trends. He founded Computer Motion in 1990, five years before the launch of Intuitive. The companies would merge 13 years later as a resolution of a patent dispute, freeing Wang to co-found telehealth company nTouch, which was acquired by Teladoc in 2020.

Wang and Sovato co-founder and CEO Cynthia Perazzo say patients are comfortable with remote care thanks in part to the pandemic. Regulators and hospitals also see the need for surgeons to extend their reach.

“A third of U.S. counties don’t have a single surgeon,” Perazzo said in a recent DeviceTalks Weekly interview.

On the technical side, Sovato execs say the current telecommunication network can handle the traffic. Wang recalls the world’s first transatlantic surgery performed (on a Computer Motion system) in 2000 ran on an ATM line monitored by 15 engineers. Today, fiber optic cables are plentiful.

Finally, robotic surgery companies are building systems that can be controlled remotely. In a DeviceTalks Boston keynote, Intuitive EVP and Chief Digital Officer Brian Miller will cover many of da Vinci’s 5’s new features, including its potential for remote surgery.

At the close of the conference, Medtronic VP and GM of Surgical Robotics Rajit Kamal will demonstrate the remote functionality of Hugo RAS in a joint keynote for attendees of DeviceTalks Boston and our co-located Robotics Summit & Expo.

4. The power of AI
The ongoing adoption of artificial intelligence will certainly accelerate the development of surgical robotic systems. AI already has made a massive impact on the medical device industry. Semiconductor chip giant NVIDIA added a tanker of gasoline to that fire at its 2024 GPU Technology Conference (GTC), launching close to two dozen new AI-powered, healthcare-focused tools and announcing partnerships with GE Healthcare and Johnson & Johnson.

NVIDIA already had been working with Asensus Surgical and Medtronic.

Intuitive’s Miller and Medtronic’s Kamal both intend to cover AI-powered functionality in their DeviceTalks Boston talks.

5. Experienced competition emerging
The surgical robotics sector has been around enough to produce executives who have enjoyed successful outcomes. Now they’re back for more.

Former leaders from Auris Surgical, for example, are leading startups like Moon Surgical and Noah Medical.

Before becoming Distalmotion’s CEO, Roche served as global president for robotics and technology at Zimmer Biomet, where he led the successful global launch of the ROSA Robotic Knee System.

Quantum Surgical CEO Bertin Nahum led an earlier part of the ROSA story. Nahum founded one of the first successful surgical robotics companies, Medtech S.A., which was sold to Zimmer Biomet in 2016.

Nahum will speak at DeviceTalks Boston about Quantum’s Epione system, an open robotic system that brings image-guided precision to minimally invasive cancer ablation.

Finally, Stryker, one of the more experienced players in surgical robotics and the leader in hard-tissue surgical robotics, could consider a move into soft tissue robotics. In an upcoming StrykerTalks podcast, Spencer Stiles, Stryker group president for orthopaedics and spine, answered the question about a move into soft-tissue this way.

“We believe we are a great robotics organization,” Stiles said. “We remain a passionate M&A company. And so you can imagine our adjacencies, that’s an area that we continue to assess. There’s some neat technology out there for sure.”

Erik Todd, VP and GM of robotics & enabling technology at Stryker, will give an update on the MAKO System at DeviceTalks Boston.

So this is why we focused so much of DeviceTalks Boston on surgical robotics but even I’m surprised at the pace at which the space is moving

If you had asked me in January, I’m not sure I would have said we’d see a new da Vinci approved by the FDA, a surgical robotics system launched into space, and a mid-tier player like Karl Storz looking to change the game by buying a small, but tested, surgical robotics company like Asensus Surgical. Medical Design & Outsourcing