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What Intuitive’s limited da Vinci 5 launch can teach other device developers

July 19, 2024 By Jim Hammerand

A photo of the Intuitive Surgical da Vinci 5's surgeon console.

Intuitive Surgical plans updates to the da Vinci 5 — including capabilities for surgeons using the console (pictured) — before fully launching the next-generation surgical robotics system. [Image courtesy of Intuitive Surgical]

Intuitive says it can’t make enough of its new da Vinci 5 surgical robotics system to meet customer demand.

But that’s part of the plan for what executives are calling a “measured rollout” so Intuitive can tweak the next-generation system based on feedback from early adoptors like those who partnered with the company on the DV5’s development.

Related: The Intuitive da Vinci 5’s top design changes: ‘This is groundbreaking for robotic surgery’

“Really strong start. … It looks like a strong launch,” Wells Fargo analyst Larry Biegelsen said, citing the 70 placements of DV5 in the second quarter.

There are three main items on Intuitive’s checklist ahead of a full-scale DV5 launch, Intuitive executives said on their second-quarter earnings call, offering a blueprint for other device developers to take the same approach with their own product launches.

1. Expanding manufacturing capacity

A portrait of Intuitive Surgical CFO Jamie Samath.

Intuitive Surgical CFO Jamie Samath [Photo courtesy of Intuitive Surgical]

With DV5 systems accounting for nearly half of Intuitive’s U.S. system placements in the last quarter, the device manufacturer is ramping up production as part of the limited launch.

CFO Jamie Samath said DV5 placements will “increase modestly quarter to quarter” and “will be constrained through the first half of 2025.”

About half of the 550 employees Intuitive hired in the quarter were in manufacturing operations to help meet customer demand, Samath said.

“We are maturing our supply chain and our manufacturing capacity so that we’re able to get to the quality, to the cost, to the yields that we expect as we approach a broad launch,” Intuitive President Dave Rosa said.

2. Updating hardware and software

A portrait of Intuitive President Dave Rosa.

Intuitive President Dave Rosa [Photo courtesy of Intuitive]

Samath said Intuitive is planning a hardware and software update for da Vinci 5 in the second half of this year.

“You have to organize how you do that build plan through the factory carefully for that update,” he said.

Some of the first updates include the integration of Intuitive Hub capabilities, allowing surgeons to access and manipulate anatomical 3D models while they’re in the surgeon console, Rosa said, as well as access to intraoperative video for replay.

“We’re trying to get that integrated into our systems and balancing the factory output,” Rosa later added, noting that more updates will come as a result of feedback from early DV5 users.

“Then if you look a little further out, some intraoperative technology building blocks that we’re working on such as procedure step mapping and 3D-depth mapping that will use some AI and [machine learning] algorithms and leverage this compute power of da Vinci 5,” Rosa said. “Those things will set us for some more advanced features in the future.”

Related: What’s next for surgical robotics? Medtech vet Mark Toland bets on intraoperative assistance

3. Gathering customer feedback

A photo of the Intuitive Surgical da Vinci 5 surgical robotics system.

Intuitive Surgical’s da Vinci 5 includes new features and equipment like a built-in insufflator. [Image courtesy of Intuitive Surgical]

Other updates are coming as a result of requests and input from surgeons and healthcare organizations that are already using DV5, executives said.

“As these placements happen, we’re listening to our customers and responding to their feedback,” Rosa said. “We’ll be releasing some software updates along the way here in order to respond to that feedback, so we want to get that in place before we get to launch.”

Rosa said customer feedback is indicating improvements in precision, imaging, ergonomics and integration — all of which add up to improve overall efficiency, and possibly the ability for surgeons to perform one more procedure per day.

“We launch new products thoughtfully, centered around outstanding customer experiences as our customers pursue operational and clinical excellence,” Rosa said. “We continue monitoring several key metrics across our measured rollout of da Vinci 5.”

Related: Intuitive plans to use da Vinci 5 data to drive innovation and improve surgical outcomes

Customer feedback is not only helping Intuitive polish the DV5’s performance and features before a full launch, but helping the company determine how much demand there is from surgeons and healthcare systems.

“In the early phase of a launch, you have a tendency to see early adopters look for the latest technology, and also the larger institutions, the large IDNs (integrated delivery networks),” Samath said. “You have to give it some time to see the full set of customers in terms of what that interest will be.”

Customer feedback also helps generate data and anecdotes in support of the DV5 system to generate more demand and convert those who are DV5 curious into customers.

“Many customers will want to evaluate da Vinci 5, they’ll want to see evidence grow over time in terms of the capability and feature set,” Samath said. “And of course, their desire for da Vinci 5 will depend on their their individual program and what they see the value of that, in part given the higher pricing or lease costs for da Vinci 5.”

“As we move through our measured launch, we’ll continue to have to underscore and reinforce the value that it brings and communicate that to executives and their teams,” Rosa later added.

A portrait of Intuitive Surgical CEO Gary Guthart.

Intuitive Surgical CEO Gary Guthart [Photo courtesy of Intuitive Surgical]

Intuitive expects DV5 to be evaluated not by cost compared to other systems, but with the quadruple or quintuple aim in mind, CEO Gary Guthart said. (The quintuple aim refers to five goals: better patient outcomes, better patient experience, better care team experience, lower total cost of care, and equitable access to care.)

“We’re confident that we’re going to get there. I think we’re going to develop the data to support that perspective,” he said. “The apples-to-apples price differences aren’t that great once you add the insufflator and some of the other things that are built in, and we’ve just got to justify that difference.”

“On first reflection and on case insights, these are powerful, foundational, new capabilities that are going into the market,” he later continued. “I think that’s really interesting, and we will work with leading customers to start evaluating where do they make sense and where don’t they. We, of course, believe there are going to be procedures and patient populations where they make a ton of sense and they generate real value. So early, it’s about data generation and research and feedback. And later, we’ll start to drive that through clinical publications and other things. … What you get today: You get precision, you get imaging, you get ergonomics, you get throughput, and there’s some things that in this platform, you get to participate in its research and development. And that will come later. And then it’s a core technology platform upon which we can build. … That set of sequences gives us some confidence to keep pushing hard.”

Medtech pay analysis: Intuitive pay increases for executives, drops for median worker — but its top-paid employee wasn’t the CEO

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