Robotic surgery with digital components is starting to surge in use – and medtech companies are taking note. In 17 years after the introduction of the da Vinci robot in 2000, 2,800 hospitals invested in the technology, with the biggest jump in utilization for inguinal hernial repair, which changed 38.1% from 2012 to 2018. Studies demonstrated that using da Vinci resulted in superior patient outcomes compared to conventional surgery in terms of recovery time, pain, and blood loss. However, weighing 200 pounds and designed mainly for general surgery, this robot is starting to see some competition. Pure-play surgical robotics businesses like Intuitive and Verb Surgical, medtech suppliers Johnson & Johnson, Medtronic, and Stryker, orthopedics giant DePuy Synthes, and high-capital large entrants like Apple, Tesla and IBM are all moving quickly to enter this space and develop niche competency. Since procedures assisted by robots accounted for 15.1% of all general surgeries in 2018 – a 13.3% increase over 6 years –these companies want to integrate medical devices and other products with robotic surgery, eventually taking part in every step of the treatment process.
Recent Acquisitions and Investments in Digital Surgery
Johnson & Johnson CEO Alex Gorsky sees the rise in robotic surgery as a major shift in this industry. The company recently acquired robotics company Auris to support bronchoscopic diagnostic and therapeutic procedures, and they also hope to introduce an orthopedics robotics platform in mid-2020 with their 2019 acquisition of Orthotaxy. GE Healthcare also indicated their interest in this area, recently participating as a minority investor in a $240 million funding round for CMR Surgical’s Versius robotic system. This system is designed to alleviate the treatment process by reducing patient recovery times and trauma, and it competes directly with da Vinci as a smaller system with modular parts. Medtronic acquired surgical data and analytics company Digital Surgery, which uses AI to create process efficiency with the robotic-assisted surgery platform, which will also have further use in other areas of medtech. These acquisitions and investments are just a few of the many that are occurring, with increasing competition to become a major player by overcoming the challenges of developing surgical robots.
Challenges to Medtech Companies
Though research has proved that aspects of the patient treatment process are benefitted by the use of robots in surgery, studies are still inconclusive about the effectiveness of robotic surgery in terms of technique compared to conventional surgery. Contributing to this perception, hospitals that use robotic surgery for non-complex, common, or low-risk procedures is sometimes inefficient compared to laparoscopic surgery, and the FDA has also warned healthcare professionals against using robotics for certain types of diseases, such as breast and cervical cancer. However, these issues can be solved with continued innovation and testing. Yet, two other major challenges are still prevalent: cost and data sharing.
Hospitals often focus on innovation as a point of competitive advantage. However, innovation often translates to cost, and hospitals are also concerned with keeping costs as low as possible. Currently, robots used in surgery have major faults limiting sustainability for medtech suppliers. Designing robots with high specialization are often large in size and expensive for hospitals. Hospitals may be reluctant to make the purchase decision due to the high investment and recurrent costs associated with purchasing a surgical robot, as exemplified in da Vinci. Not only is this robot difficult to set up with weaknesses in its features, it also has very high system and instrument costs. Medtech companies that want to effectively compete in this market need to design their products to be as cost efficient as possible, or else make up for expenses in other ways such as quality or associated positive externalities.
Current challenges in sharing data also reduce the ability of surgical robots to operate at maximum efficiency. Some robots require manual data pulls, which makes data management and use difficult. Most robots are not able to synchronize with existing hospital systems, which also limits the impact that data could have in assisting with patient outcomes. It is also unclear which party owns data collected by robots, since the patient, surgeon, and medtech suppliers are all involved with the data creation. With the complexity of the data collected by robots, there is no easy way to solve these issues. However, medtech companies can focus on connectivity, large-scale data management and analytical capabilities, and pre-operative and post-operative data sharing to provide the best care for the patient. They can also partner with hospitals and EMRs to navigate IT systems and data sharing structures.
Key Aspects to Capitalize On
The main benefits of robotic surgery are that it can reduce OR and recovery times, leading to greater OR and hospital capacity, which can make up for any costs associated with the robots. There is also high value in the data collection process that can be applied to improving surgical techniques, both robotic and conventional, especially when comparing data across multiple hospitals, surgeons, and procedures. This has led to growing demand from surgeons and patients – after robotic surgery programs are brought to hospitals, they often see a dramatic increase in robotic surgeries and a decrease in laparoscopic ones. Growing demand shows the potential of this market for medtech suppliers, since healthcare professionals are increasingly noticing how robotic surgery can provide many unique benefits that conventional surgery cannot compete with.
Why Robotic and Digital Surgery Technology Beats Conventional Surgery
Data collected during robotic-assisted surgery can help analyze various ways of performing a procedure to optimize future techniques. The robots can assist human error in consistency and manual dexterity, and they can also keep track of the patient in a standardized way throughout every step of the treatment process. Some healthcare professionals see robots as an assistant that can step up in a surgeon’s weaker areas. Digital Surgery products can be used to help a surgeon prepare for a procedure with practice, research, and study tools. With the limits of laparoscopy, such as the limitations of instrument maneuverability, poor visuals, and a steep learning curve, robotic surgery can be more successful and easier for healthcare professionals to learn. With benefits of minimal invasiveness, long-term outcome quality, and shorter recovery times, robotics have strong potential to become a hospital standard.
Going forward, medtech companies need to focus on key features in order to optimize their chance of success in this industry. Multifunctionality for a variety of procedures will help add value and justify costs for hospital investment, ease of use and portability can save time and increase capacity, and digital integration capabilities can help many publics benefit from the use of robotic and digital surgery.
Coauthor and contributions by Courtney Loughran.