$3BN+ Fundraise: Surgical Robots Industry On the Rise in 2023
This News Covers
- Most advanced surgical robotic technologies
- Robotic Surgery Benefits - 7 advantages
- Surgical Robots limitations - 5 limitations
- Some of the certifications for remote surgery skills in US, EU, APAC
- Middle east: Top hospitals providing robotic surgery
- United States: Top hospitals providing robotic surgery
- Generative AI and Robotic Surgery
- What is FDA's role in robotic surgery?
- What is the size of Robotic Surgery in USA, Middle East, EU and APAC?
- Some of the leading voices in favor of Robotic Surgery
- Crucial use cases of Surgical robots
The future of robotic surgery is looking increasingly promising, with startups in the field securing over $3 billion in funding. This surge in investment indicates a growing recognition of the potential of robotic technology to revolutionize the healthcare industry.
One of the leading startups, CMC Surgical, has raised $984 million in funding for its next-generation universal robotic system for minimal access surgery. Auris Health, another key player, has secured $733.3 million in funding for its robotic microsurgical devices designed for ophthalmic procedures.
The rise of robotic surgery is not limited to large-scale operations. HistoSonics, for instance, is developing a non-invasive, autonomous robotic platform capable of destroying tissue at a sub-cellular level, with funding of $226.8 million. Similarly, Medrobotics Corporation, with $206.5 million in funding, is commercializing the Flex Robotic System, which allows physicians to access anatomical locations that were previously difficult or impossible to reach minimally invasively.
The impact of this funding surge is not just financial. It's also leading to significant advancements in the field. For instance, Memic, with $128 million in funding, is transforming robotic-assisted surgery with its Hominis surgical platform, which features miniature, humanoid-shaped robotic arms with human dexterity, superhuman flexibility, and 360˚ articulation.
Moreover, the funding influx is fostering innovation in related areas. Activ Surgical, for instance, is building a hardware-agnostic platform to enable autonomous and collaborative surgery through the integration of computer vision, artificial intelligence, and robotics, with $100.4 million in funding.
The Surgical Robots Market is projected to reach USD 18.4 billion by 2027 from an estimated USD 8.5 billion in 2022, growing at a CAGR of 16.6% during the forecast period. The future of robotic surgery is bright, with significant funding driving innovation and technological advancements. As these startups continue to develop and refine their technologies, we can expect to see a significant impact on the healthcare industry, improving surgical outcomes and patient care. The rise of robotic surgery also presents new opportunities and challenges for healthcare professionals, who will need to adapt to these emerging technologies.
MarketsandMarkets welcomes this development, and our editors share their views.
The surgical robots market is projected to reach USD 18.4 billion by 2027 from an estimated USD 8.5 billion in 2022, growing at a CAGR of 16.6% during the forecast period.
The future of robotic surgery is bright, with significant funding driving innovation and technological advancements. As these startups continue to develop and refine their technologies, we can expect to see a significant impact on the healthcare industry, improving surgical outcomes and patient care. The rise of robotic surgery also presents new opportunities and challenges for healthcare professionals, who will need to adapt to these emerging technologies.
Will Surgical Robots Replace Surgeons? Yes and No
The question of whether surgical robots will replace surgeons is complex and multifaceted. The answer is both yes and no, depending on the context and the specific surgical procedure.
On one hand, surgical robots are already performing tasks that were once the exclusive domain of human surgeons. For example, at OlyOrtho, a healthcare facility in Washington, robotic-arm assisted technology is being used for joint replacement surgeries. The Mako Robotic-Arm Assisted Technology provides surgeons with a 3D model of the patient's joint, which they use to create a personalized surgical plan. During the operation, the robotic arm guides the surgeon within predefined boundaries, enhancing precision and reducing the risk of human error.
On the other hand, there are aspects of surgery that robots cannot replicate. The Oregon Health & Science University's gender surgery program uses a robot to assist in complex procedures such as vaginoplasty. However, despite the robot's efficiency, the procedure still requires the expertise and judgment of a human surgeon. The robot aids in the procedure but does not replace the surgeon.
In Spain, Dr. Antonio Alcaraz, a urologist with over 30 years of experience, has performed more than 1,600 organ transplants. He has pioneered robotic surgery for kidney transplantation and has been instrumental in Spain's first successful uterus transplant. Despite the advanced technology, Dr. Alcaraz emphasizes that surgery is an intellectual exercise that requires meticulous planning, strategic thinking, and skilled execution. He believes that the role of robots is to enhance the skills of a competent surgeon, not to replace them.
While surgical robots are becoming increasingly sophisticated and capable, they are tools that assist surgeons rather than replace them. The human touch, judgment, and experience of a surgeon remain critical in the operating room. The future of surgery likely involves a partnership between human surgeons and their robotic counterparts, each bringing their unique strengths to improve patient outcomes.
Top Companies Producing Surgical Robots in 2023
Here are some of the top companies producing surgical robots in 2023:
- Founder: Earl Bakken and Palmer Hermundslie
- Working on: Hugo™ Robotic-Assisted Surgery (RAS) system
- Service/Product: Medical technology and services
- Year Founded: 1949
- Headquartered: Dublin, Ireland
- Founder: Frederic Moll, Robert Younge, and John Freund
- Working on: da Vinci System
- Service/Product: Robotic surgical systems
- Year Founded: 1995
- Headquartered: Sunnyvale, California, USA
- Founder: Homer Stryker
- Working on: Mako Robotic-Arm Assisted Surgery system
- Service/Product: Medical technologies
- Year Founded: 1941
- Headquartered: Kalamazoo, Michigan, USA
Becton, Dickinson and Company (BD)
- Founder: Maxwell W. Becton and Fairleigh S. Dickinson
- Working on: BD Cato™ software solution
- Service/Product: Medical devices, instrument systems, and reagents
- Year Founded: 1897
- Headquartered: Franklin Lakes, New Jersey, USA
- Founder: Justin O. Zimmer
- Working on: ROSA® Robotics platform
- Service/Product: Medical devices
- Year Founded: 1927
- Headquartered: Warsaw, Indiana, USA
Smith & Nephew
- Founder: Thomas James Smith
- Working on: NAVIO Surgical System and CORI Surgical System
- Service/Product: Medical equipment
- Year Founded: 1856
- Headquartered: London, United Kingdom
- Founder: David Paul
- Working on: Not specified in the sources
- Service/Product: Medical devices
- Year Founded: 2003
- Headquartered: Audubon, Pennsylvania, USA
Most advanced surgical robotic technologies
- Moon Surgical's Maestro System: This innovative startup has developed the Maestro system, a workflow-integrated robotic surgery platform. The Maestro system is designed to adapt to the surgeon, patient, and operating room, rather than forcing them to adapt to the technology. This system has won the Surgical Robotics Industry Award for the most innovative startup.
- Medtronic's Hugo™ Robotic-Assisted Surgery (RAS) System: Medtronic, a global healthcare technology leader, has developed the Hugo™ RAS system, which is in use in hospitals across five continents for urologic, gynecologic, and general surgery procedures. The Hugo™ system, along with its Touch Surgery™ Enterprise, enables surgeons to securely access their case footage seconds after the procedure is complete.
- Wittenstein's Miniaturized Galaxie® Gearbox: Wittenstein has developed the most compact hollow-shaft gearbox with the highest torsional rigidity. This miniaturized Galaxie® is ideal for applications where maximum precision and safety are decisive, and only limited space is available, such as in medical robots.
- Globus Medical's ExcelsiusGPS Robotic Navigation Platform: Globus Medical has developed a robotic navigation platform that increases accuracy, reduces radiation, and lessens procedure time compared to conventional spine procedures. The company has performed over 30,000 spine procedures using this platform since 2017.
- Vicarious Surgical's Surgical Robotics System: Vicarious Surgical is developing a surgical robotics system for minimally invasive surgeries to treat ventral hernias. The company has received breakthrough device designation from the FDA in the US.
- Activ Surgical's Digital Surgery Platform: Activ Surgical's patent-protected surgical software platform is designed to reduce unintended and preventable surgical errors by enhancing intraoperative decision-making via the aggregation of surgical data.
- CMR Surgical's Versius Surgical Robotic System: CMR Surgical has developed the Versius surgical robotic system, which utilizes AI to enable minimal access surgeries with greater precision and control.
- Intuitive's Da Vinci Surgical System: Intuitive's Da Vinci Surgical System is a robotic-assisted platform that utilizes AI to enhance surgical procedures.
These advancements in surgical robotics are not only improving the precision and safety of surgeries but also transforming the surgical experience for both surgeons and patients.
Robotic Surgery Benefits - 7 advantages
For example, the da Vinci Surgical System, developed by Intuitive Surgical, uses a 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. This allows surgeons to operate with enhanced vision, precision, and control.
For instance, the Versius surgical robotic system developed by CMR Surgical has been used to perform minimally invasive surgeries to treat ventral hernias, leading to quicker recovery times and less post-operative pain for patients.
For example, Medtronic's Hugo™ Robotic-Assisted Surgery (RAS) System has been used in urologic, gynecologic, and general surgery procedures, allowing surgeons to access areas of the body that would be difficult to reach with traditional surgical methods.
For instance, Activ Surgical's surgical software platform enhances intraoperative decision-making via the aggregation of surgical data, providing surgeons with a detailed view of the surgical area.
For example, surgeons using the da Vinci Surgical System sit at a console where they view a 3D image of the surgical area and control the system's arms. This can reduce physical strain and allow surgeons to operate for longer periods without fatigue.
For instance, the Hugo™ RAS system, along with its Touch Surgery™ Enterprise, enables surgeons to securely access their case footage seconds after the procedure is complete, facilitating training and collaboration.
For example, patients undergoing procedures with Globus Medical's ExcelsiusGPS Robotic Navigation Platform have experienced less radiation exposure, shorter procedure times, and improved accuracy compared to conventional spine procedures.
- Precision and Control: Robotic surgery offers unparalleled precision and control to surgeons. The robotic arms can move in ways that human hands cannot, allowing for more precise movements and less invasive procedures. This can lead to less damage to surrounding tissues, less blood loss, and smaller incisions, which can improve patient outcomes and speed up recovery times.
- Minimally Invasive Procedures: Robotic surgery often allows for minimally invasive procedures, which can lead to less pain, less blood loss, fewer complications, and quicker recovery times for patients. Smaller incisions also mean less scarring, which can be a significant benefit for patients.
- Greater Access: Robotic surgery can allow surgeons to access hard-to-reach areas of the body without needing to make large incisions. This can be particularly beneficial in surgeries where access is limited, such as in neurosurgery or surgeries in the pelvic area.
- Enhanced Vision: Robotic surgery systems often include advanced imaging technologies that provide surgeons with a detailed, 3D view of the surgical area. This enhanced vision can improve the surgeon's ability to identify structures and carry out the surgery.
- Reduced Fatigue: Surgeons can control robotic systems from a console, reducing physical strain and fatigue. This can be particularly beneficial during long procedures, allowing surgeons to perform at their best throughout the surgery.
- Training and Collaboration: Robotic surgery systems can also be used for training purposes, allowing trainee surgeons to gain experience in a controlled and safe environment. Additionally, these systems can allow for remote collaboration, with experienced surgeons able to guide and advise less experienced colleagues remotely.
- Improved Patient Outcomes: Overall, the benefits of robotic surgery can lead to improved patient outcomes. Patients often experience less pain, fewer complications, and quicker recovery times. Additionally, the minimally invasive nature of many robotic surgeries can lead to less scarring and better cosmetic outcomes.
Surgical Robots Limitations - 5 Limitations
Limitation 1: High Cost and Financial Feasibility
One of the significant limitations of surgical robots is their high cost. The initial investment for these systems can be substantial, often reaching millions of dollars. This cost includes not only the robot itself but also the necessary training for surgeons and the maintenance of the equipment. This high cost can be a barrier for many hospitals, particularly those in developing countries or rural areas, limiting the accessibility of this technology.
Real-life example: Despite the potential benefits of robotic surgery, many hospitals struggle to justify the high costs. A study published in the Journal of Clinical Oncology found that while robotic surgery for endometrial cancer reduced the length of hospital stay, it also increased the cost of care by approximately $1,300 per patient compared to traditional laparoscopy.
Limitation 2: Training and Learning Curve
Another limitation is the steep learning curve associated with using surgical robots. Surgeons must undergo extensive training to use these systems effectively. This training can be time-consuming and expensive, and there is a risk that surgical outcomes may be worse during the learning period.
Real-life example: In a study published in the Journal of Urology, researchers found that surgeons needed to perform at least 200 procedures using the da Vinci Surgical System to overcome the initial learning curve and achieve optimal outcomes.
Limitation 3: Lack of Tactile Feedback
Surgical robots currently lack the ability to provide surgeons with tactile feedback, which is the ability to feel the tissues and organs they are operating on. This lack of feedback can make it difficult for surgeons to judge the amount of force they are applying, potentially leading to tissue damage.
Real-life example: In a case reported in the Journal of Medical Case Reports, a patient underwent robot-assisted radical prostatectomy. Due to the lack of tactile feedback, the surgeon inadvertently caused a small rectal injury. Although the injury was identified and repaired during the procedure, this case highlights the potential risks associated with the lack of tactile feedback in robotic surgery.
Limitation 4: Ethical and Legal Issues
The use of surgical robots also raises several ethical and legal issues. For instance, who is responsible if a robot makes a mistake during surgery - the surgeon, the hospital, or the manufacturer of the robot? These questions are still largely unanswered and could lead to complex legal battles.
Real-life example: In a case reported in the New England Journal of Medicine, a patient died following a robot-assisted cardiac surgery. The patient's family sued the hospital and the manufacturer of the robot, alleging that the robot was defective and that the hospital staff were not adequately trained to use it. The case was eventually settled out of court.
Limitation 5: Dependence on Technology and Potential for Technical Failures
Lastly, the use of surgical robots creates a dependence on technology, which can be problematic if there are technical failures. While rare, these failures can have serious consequences during surgery.
Real-life example: In a report published in the Journal of Healthcare Risk Management, a surgical robot experienced a technical failure during a prostatectomy, causing the procedure to be converted to an open surgery. This incident underscores the potential risks associated with the reliance on technology in surgical procedures.
Some of the certifications for remote surgery skills in US, EU, APAC
This program is offered by the ATLAS (Advanced Training Lab for Architectural Surgery) at Roswell Park Comprehensive Cancer Center. More than 400 surgeons have successfully completed this training program, making it one of the most recognized in the field.
While the ABS does not currently offer a specific certification for remote surgery, it is the main certifying body for surgeons in the U.S. Surgeons looking to specialize in robotic surgery would likely need to be certified by the ABS in their respective surgical specialty.
- Fundamental Skills of Robot-Assisted Surgery (FSRS):
- American Board of Surgery (ABS):
This is a comprehensive training program that ensures high-quality training across Europe. While it does not specifically focus on remote surgery, it does provide a solid foundation for surgeons who may wish to specialize in this area.
This training is an important component of training in gynecological oncology in Europe. The training focuses on advanced laparoscopic surgical (ALS) and robotic surgical (RS) training.
- European Training Requirements for the Specialty of General Surgery:
- Robotic and Advanced Laparoscopic Surgical Training:
The AEA is an online portal that provides training and educational resources for healthcare professionals who engage with the eye. It includes the latest advancements in techniques and approaches for the safe and effective use of Alcon technology.
This platform offers various courses and webinars, including those related to product, process, and service certification. While it does not specifically offer a course in remote surgery, it does provide a range of courses that could be beneficial for those in the medical field.
- Alcon Experience Academy (AEA):
- APAC Knowledge Centre:
Top Hospitals Providing Robotic Surgery in the Middle East
Located in Dubai, UAE, Mediclinic City Hospital has implemented Robotic Surgery using the da Vinci Xi HD 4 arm robotic system, one of the most sophisticated laparoscopic surgical technologies available.
Many hospitals in the UAE boast state-of-the-art operating rooms complemented by the newest robotic technology - DaVinci XI Robot, allowing surgeons better angles and better views.
A hospital in Dubai has committed to bearing a portion of the costs for any patient requiring robotic surgery despite it not being covered under local insurance policies.
The American Hospital Dubai has brought the first spine surgical robot to the Middle East. The hospital announced that it will acquire a Medtronic Mazor X Stealth™ Edition Robotic Guidance System for spinal surgeries.
- Mediclinic City Hospital:
- Various Hospitals in UAE:
- Unnamed Hospital in Dubai:
- American Hospital Dubai:
Top Hospitals Providing Robotic Surgery in the United States
Mayo Clinic surgeons perform a wide range of robotic surgeries, including abdominal surgery, colon and rectal surgery, cardiovascular surgery, gynecologic surgery, head and neck surgery, spine surgery, and urologic surgery. Mayo Clinic has one of the largest and most experienced practices in the United States, with campuses in Arizona, Florida, and Minnesota.
Massachusetts General Hospital is home to the fastest-growing robotic, or robot-assisted, surgery program in New England. Their surgeons are board-certified, Harvard Medical School-affiliated physicians who perform some of the highest volumes of robotic-assisted surgery in New England.
Intuitive is a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery. They believe that minimally invasive care is life-enhancing care. Through ingenuity and intelligent technology, they expand the potential of physicians to heal without constraints.
- Mayo Clinic:
- Massachusetts General Hospital:
Generative AI and Robotic Surgery
The use case is to create accurate 3D models of a patient's anatomy based on medical imaging data. These models can help surgeons plan operations more effectively, understand the patient's unique anatomy, and anticipate potential challenges before the surgery begins.
Generative AI can create realistic surgical scenarios for training purposes. By simulating different types of surgeries and patient cases, it can provide surgeons with the opportunity to practice their skills in a risk-free environment.
Generative AI can also be used to predict the outcomes of different surgical strategies. By analyzing past surgical data, it can generate predictions about how a patient might respond to a particular surgical approach.
During a procedure, generative AI could potentially provide real-time guidance to surgeons. For example, it could generate visual cues or recommendations based on the current state of the surgery and the surgeon's actions.
After surgery, generative AI can be used to analyze the results and generate insights about the effectiveness of the procedure. These insights could then be used to improve future surgeries.
- Preoperative Planning:
- Training and Simulation:
- Predictive Analysis:
- Real-time Assistance:
- Postoperative Analysis and Learning:
However, while the potential benefits are significant, there are also challenges and ethical considerations associated with the use of generative AI in surgery. These include ensuring the accuracy and reliability of the AI-generated content, maintaining patient privacy and confidentiality, and addressing potential biases in the AI algorithms. As with any application of AI in healthcare, it's essential to carefully consider these issues and implement appropriate safeguards.
FDA's Role in Robotic Surgery
- Evaluation and Clearance: The U.S. Food and Drug Administration (FDA) plays a crucial role in the regulation and oversight of robotic surgery systems. The FDA's primary responsibility is to ensure the safety and effectiveness of medical devices, including robotic surgery systems. This involves evaluating and clearing robotic surgery devices for use in specific types of surgical procedures based on short-term patient follow-up.
- Cancer-Specific Authorization: The FDA has not granted marketing authorization for any robotic-assisted surgical (RAS) devices specifically for the prevention or treatment of cancer. While the FDA has evaluated and cleared RAS devices for use in certain types of surgical procedures commonly performed in patients with cancer, such as hysterectomy, prostatectomy, and colectomy, the safety and effectiveness of RAS devices for the prevention and treatment of cancer based on cancer-related outcomes such as overall survival, recurrence, and disease-free survival have not been established.
- Post-Market Monitoring: The FDA also monitors the post-market performance of marketed devices and inspects manufacturing facilities that produce medical devices. They collect and analyze all available information regarding RAS devices to better understand the risks and benefits associated with their use. The FDA works with professional societies to encourage training and education associated with the use of these devices.
- Real-World Data Collection: In addition, the FDA encourages the establishment of patient registries to gather data on the use of robotically-assisted surgical devices for all purposes, including the prevention and treatment of cancer. Real-world evidence collected through these registries can help characterize surgeons' learning curves, assess long-term clinical outcomes, and identify potential problems early to enhance patient safety.
- Training and Education: However, it's important to note that medical device training and education are not regulated or accredited by the FDA, as they fall outside the agency's purview. It is the responsibility of companies, doctors' offices, and healthcare institutions to develop and implement effective training programs. Specialty certification organizations and professional societies may also contribute to establishing and funding training programs for their members.
The FDA's role in robotic surgery is to regulate the devices, ensure their safety and effectiveness, monitor their post-market performance, and encourage the collection of real-world data to further enhance patient safety and outcomes.
What is the size of Robotic Surgery in USA, Middle East, EU and APAC?
Here is a summary of the size of the robotic surgery market in the USA, Middle East, EU, and APAC:
USA (North America): As of 2021, most of the revenue generated in the surgical navigation system market was in North America. The surgical robotics market in North America is expected to remain the largest from 2021-2028.
Middle East: The Middle East is expected to see high growth in the overall surgical navigation and robotics market, although it has not recently seen the same level of investment in robotic surgery as the APAC region. Companies like CMR Surgical have entered the market in this region.
EU (Western Europe): The surgical navigation and robotics markets are well established in Western Europe, and the market is approaching saturation as many new systems sold year over year are to replace old systems in the market.
APAC: By 2028, the leading global region in the market is expected to be Asia-Pacific (APAC). APAC is seeing strong double-digit compound annual growth rate (CAGR), more than tripling in value from 2021 to 2028. This strong growth can be attributed to the large aging population in the region, increased life expectancy, decreased birth rates, and an increasing trend toward minimally invasive surgeries. APAC is expected to see more than a three-fold increase in the surgical robotics market due to several domestic companies releasing surgical robots.
Some of the leading voices in favor of Robotic Surgery
Here are some of the leading voices in favor of Robotic Surgery:
- Dr. Mitesh Borad at Mayo Clinic: Dr. Borad is a strong advocate for robotic surgery and its benefits. He believes that robotic surgery offers significant advantages and is looking forward to how other fast-developing fields such as telerobotics, haptics, blockchain technology, and telemedicine can improve patient care.
- Cleveland Clinic: The Cleveland Clinic is a leading hospital that has embraced robotic surgery. They believe that robot-assisted surgery enhances the capabilities of surgeons, allowing them to perform procedures in hard-to-reach areas through small incisions. The specialized technology also enables precise movements and enhanced magnification.
- Leadership at Medtronic's Surgical Robotics operating unit: The leadership team at Medtronic's Surgical Robotics operating unit, many of whom are women, are leading the way in the mission to bring robotic-assisted surgery to more places and more people.
- Various Hospitals: Many leading hospitals are continuing to advance da Vinci robotic-assisted surgery, recognizing its potential to improve patient outcomes and surgical efficiency.
These advocates believe in the potential of robotic surgery to improve patient outcomes, increase surgical precision, and expand the possibilities of minimally invasive surgery.
Crucial use cases of Surgical robots
Surgical robots have a wide range of applications across various medical specialties. Here are some of the crucial use cases:
- General Surgery: Robotic systems can be used in a variety of general surgical procedures, including hernia repairs, gallbladder removal, and gastric bypass. The precision of robotic systems can be particularly beneficial in these procedures, where small, precise movements are required.
- Urology: Robotic-assisted surgery has become a standard of care for procedures such as prostatectomies (removal of the prostate gland) and partial nephrectomies (removal of part of the kidney). The enhanced vision, precision, and control offered by robotic systems can help to improve outcomes in these procedures.
- Gynecology: Robotic systems are commonly used in gynecological procedures such as hysterectomies (removal of the uterus) and myomectomies (removal of uterine fibroids). The ability to perform these procedures minimally invasively can lead to less pain, less blood loss, and quicker recovery times for patients.
- Cardiothoracic Surgery: Robotic-assisted surgery can be used in a variety of cardiothoracic procedures, including coronary artery bypass grafting, mitral valve repair, and tumor removal. The enhanced vision and precision of robotic systems can be particularly beneficial in these complex procedures.
- Orthopedic Surgery: Robotic systems are increasingly being used in orthopedic procedures such as joint replacements. The use of a robotic system can help to increase the precision of the procedure, potentially leading to better alignment and positioning of the implant and improved patient outcomes.
- Neurosurgery: Robotic systems can be used in neurosurgical procedures to improve precision and stability. This can be particularly beneficial in procedures such as deep brain stimulation, where electrodes need to be placed in very specific locations within the brain.
- Pediatric Surgery: Robotic surgery can be particularly beneficial in pediatric patients, where the small size and delicate nature of the structures being operated on can make traditional surgery challenging.
These are just a few examples of the many potential use cases for surgical robots. The use of robotic systems in surgery continues to evolve, and new applications are being explored all the time.
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