Opportunities and Challenges in the Future of Robotic Surgery

Technological advancements in robotic surgery

Technological advancements in robotic surgery are marked by significant milestones, such as over 1 million robotic knee procedures by Stryker and the integration of AI in surgical planning by Medtronic. Companies are increasingly standardizing robotic programs due to their clinical benefits and economic attractiveness, indicating robust growth in the sector.

"In March this year, Dr. Nicole Linares from the University of Texas Southwestern, along with colleagues from other hospitals and data support from the Intuitive Health Economics Outcomes Research Team, reported outcomes describing the use of robotic technology in emergency general surgery cases." --- (ISRG, earning call, 2024/Q1)

"And we see that continuing over the next several quarters here. And as Geoff mentioned, it's a combination of this technology portfolio, including AI surgical planning, including robotics, including power and surgical instrumentation imaging and navigation, putting that all together is creating this very attractive place where very good teams and reps and groups of people want to come together to work with Medtronic." --- (MDT, earning call, 2024/Q2)

"Also in the quarter, we reached over 1 million robotic total knee procedures performed to date with Mako and Triathlon. We expect the growing momentum in installations and utilization will continue to drive sustained growth in our hips and knees businesses." --- (SYK, earning call, 2024/Q1)

"It's one of the fastest growing navigation platforms in the U.S. So I would say the combination of triple taper stems, surgical impactors, and three different modalities of navigation put us in a position to regain market share in the U.S. and outside of the U.S. Outside of the U.S., we're going to be launching a second generation of robotics, hip posterior robotics, and that's another driver of share regaining." --- (ZBH, earning call, 2024/Q1)

"And you can see that grew by 52%. And this is where we see many of our customers moving from their operationalizing their robotics program to their standardizing now on robotics in surgery. And it's a function of their understanding of the clinical benefit and the fact that it's economically attractive because you get low complication rates, because you have lower length of step." --- (ISRG, event transcript, 2024/04/25)

Market growth potential for robotic surgery

The market for robotic surgery is poised for significant growth, driven by advancements in technology and increased procedure demand. Companies like Johnson & Johnson and Intuitive Surgical highlight strong system placements and expanding capabilities, indicating robust future potential in this sector.

"present value of greater than $100,000,000 And I am particularly excited about the progress in our robotics and digital ecosystem, including advances in our OTTAVA general surgery robot, the recent approval of the Monarch platform for bronchoscope in China and the continued market expansion for our Velis robotic assisted solution for total knee replacement." --- (JNJ, event transcript, 2024/04/25)

"I know U. S. System placements were strong last year and again that's tied to procedure growth in some sense. The procedure growth that we saw last year drove the need for expanded capacity in many international markets." --- (ISRG, event transcript, 2024/04/25)

"So look, I think the future for pulsed field ablation, we're just getting going, but this is going to be a really robust growth market for a long time to come." --- (MDT, earning call, 2025/Q1)

"But that is a gift that will keep on giving. We've seen this in every market where you have large installations, it is a precursor for significant high-growth quarter-after-quarter." --- (SYK, earning call, 2024/Q1)

"We also advanced more than 20 pipeline programs that each have an expected net present value of greater than $100,000,000 And I am particularly excited about the progress in our robotics and digital ecosystem, including advances in our OTTAVA general surgery robot, the recent approval of the Monarch platform for bronchoscope in China and the continued market expansion for our Velis robotic assisted solution for total knee replacement." --- (JNJ, event transcript, 2024/04/25)

Cost implications of robotic surgery

Robotic surgery, particularly the da Vinci system, requires a substantial capital investment ranging from $0.7 million to $3.1 million. However, Intuitive Surgical is exploring strategies to make these systems more accessible to price-sensitive markets, potentially broadening their customer base and addressing cost concerns.

"The da Vinci surgical system generally sells for between $0.7 million and $3.1 million, depending on the model, configuration, and geography, and represents a significant capital equipment investment for our customers when purchased." --- (ISRG, sec filing, 2024/Q2)

"And being able to offer those systems to maybe more price sensitive customers or more price sensitive economies, where we can really make a difference by applying a, let's say, a multi quadrant surgical device, Xi, to be able to serve those local communities or those communities." --- (ISRG, conference, 2024/05/15)

Operational challenges in robotic surgery

Operational challenges in robotic surgery include managing patient throughput and capacity constraints in surgical suites, as highlighted by HCA's focus on operational excellence and Stryker's acknowledgment of capacity issues. Additionally, staffing shortages post-pandemic and the need for improved training through force feedback are critical factors impacting efficiency.

"But first and foremost was operational excellence. And so we've had initiatives around that and that's throughput, rival degree ensuring that we can get the patients out of the ER and up into a hospital bed, which obviously having workforce to open those beds has helped." --- (HCA, conference, 2024/05/28)

"We believe that force feedback and looking at force feedback through case insights, can improve their time to proficiency on the robot. When it comes to kind of longer term clinical outcomes and what force feedback and the data surrounding it, it's what Gary described." --- (ISRG, earning call, 2024/Q2)

"Kevin, I wanted to follow up on a comment you just made about capacity in the hospital and the prioritization around certainly whether it's acuity cases or other dynamics influencing how hospitals are managing capacity constraints in their surgical suites." --- (SYK, earning call, 2024/Q2)

"That's been a challenge. But we are seeing some shifting of procedures to lower acuity settings to make room." --- (MDT, earning call, 2025/Q1)

"I think from a staffing standpoint, obviously, you know about some of the challenges that many providers faced during and right in the aftermath of the pandemic. And so, we've been very focused on addressing nurse" --- (HCA, conference, 2024/05/28)

Competitive landscape in robotic surgery

The competitive landscape in robotic surgery is evolving, driven by innovations like Medtronic's AiBLE ecosystem, which enhances market share and dynamics in the Spine sector. Intuitive Surgical is also advancing with 3D modeling technology, promising augmented vision for surgeons, further intensifying competition.

"This sustained share capture is being driven by our AiBLE ecosystem. AiBLE's differentiated features and the sheer scale around the world is -- it's a winning formula for our Spine business.It's good for patients and surgeons, and it's changing the competitive dynamics in Spine." --- (MDT, earning call, 2025/Q1)

"An area that we've talked a little bit about is around 3 d modeling. Being able to take a preoperative image and do a high create a highly colorized 3 d model where you can over time, at some point in the future, overlay as surgery is being done during surgery to be able to get let's say augment the vision for surgeons." --- (ISRG, conference, 2024/05/15)

Patient outcomes and satisfaction in robotic surgery

Robotic surgery is enhancing patient outcomes and satisfaction, with early results showing significant improvements in recovery and quality of life. Companies report high excitement from both physicians and patients, emphasizing the importance of overall patient experience alongside clinical results.

"And we're excited to ramp this technology up and make it available. The -- I will say that the level of excitement we're getting from physicians and from hospital systems about this new service line they can offer, as well as patients and the early outcomes for patients that have been treated on the sort of case-by-case basis have been really phenomenal." --- (MDT, earning call, 2025/Q1)

"You look for a better patient experience and that's not just clinical outcomes, but their experience in going through the office visits to the surgeon they see to how they're pressed and how they actually recover and leave hospitals." --- (ISRG, event transcript, 2024/04/25)

"So it's really a remarkable effort by our teams. Our patient satisfaction has improved." --- (HCA, conference, 2024/06/05)

"The trial also demonstrated a highly favorable safety profile, with 98% of patients being free of major adverse events through 30 days, and a significant improvement in quality of life." --- (ABT, press release, 2024/04/02)

"Its proprietary technology, OptiMesh sets the company apart from traditional fusion procedures enabling surgeons to optimize outcomes, while minimizing tissue disruption and enhancing patient recovery." --- (SYK, press release, 2024/04/04)

Future trends in robotic surgery technology

Future trends in robotic surgery technology indicate a significant increase in adoption, particularly for hip and knee surgeries, as highlighted by Stryker's growing usage rates. Intuitive Surgical's focus on next-generation da Vinci technology showcases ongoing innovation, while Medtronic reports strong demand for new robotic technologies, signaling a robust future for the field.

"And every quarter, the percent of hips and knees on the robot is actually increasing." --- (SYK, earning call, 2024/Q2)

"Colorectal, general, bariatric, and HPB surgeons gathered today at #IntuitiveConnect2024 to explore the next generation of da Vinci technology. We’re transforming surgery together. Again." --- (ISRG, Twitter, 2024/04/11)

"Sean Salmon: Thanks, Larry. First of all, the business is doing exceptionally well in the sequential growth that we've seen and the demand and interest coming out of both HRS and ERA for our new technologies is really astonishingly great." --- (MDT, earning call, 2024/Q4)

"Experience the benefits of two Stryker products in one new technology. SurgiCount+ powered by Triton is designed to help you feel confident in your surgical sponge count and blood loss measurement." --- (SYK, Twitter, 2024/04/19)

"Gynecologic and urologic surgeons gathered today at #IntuitiveConnect2024 to explore the next generation of da Vinci technology. We’re transforming surgery together. Again." --- (ISRG, Twitter, 2024/04/10)

Impact of robotic surgery on healthcare efficiency

Robotic surgery enhances healthcare efficiency by improving surgeon and staff ergonomics, reducing complications, and shortening hospital stays. It offers convenience for patients and supports labor cost management, ultimately creating value for both healthcare providers and patients.

"improved efficiency for surgeon and staff, improved ergonomics, and they are exploring the potential of force feedback where early surgeons are excited to test hypothesis about its procedural, clinical, and learning value." --- (ISRG, earning call, 2024/Q1)

"Non-invasive or minimally invasive surgery procedures are resulting in fewer complications, shorter hospital stays and faster return to normal activities.Honor your needs – Ensure your doctor knows what's important to you—attending a special event, continuing an activity you enjoy, or simplifying your care." --- (MDT, press release, 2024/04/17)

"But for the patient in particular, it provides a level of convenience and efficiency and our belief is that we need to take the care to the patient." --- (HCA, conference, 2024/05/14)

"And then we think about how do we create value for surgeons who use our products routinely, how do we make it easy for them to use, how do we make it efficient, how do we listen to their feedback and create value for them in their practice?And of course, we care about the hospitals that actually then employ the surgeons and treat the patients and they have financial constraints." --- (ISRG, event transcript, 2024/04/25)

"But that 2% drop in length of stay and the ER efficiency that Sam mentioned earlier also supports our labor costs and the efficiency in the way we're managing our labor. So, I wanted to add that as well." --- (HCA, earning call, 2024/Q2)