Johnson & Johnson MedTech Global Head of Robotics & Digital R&D Neda Cvijetic [Photo courtesy of J&J]
“These teams have built a category-defining, soft-tissue surgical robot, and our regulatory pathway is a testament to that. There is no precedent here,” J&J MedTech Global Head of Robotics & Digital R&D Neda Cvijetic said in a Medical Design & Outsourcing interview.
“A category-defining path on something so sophisticated and technologically complex, it’s never a purely linear path,” Cvijetic continued, saying it took “ingenuity to solve these problems that are unprecedented, it took determination, discipline, commitment, functional excellence in every single area of engineering.”
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After getting our first good look at the long-awaited robotics system, we discussed Ottava’s design, features and product development journey with Cvijetic. The following has been lightly edited for space and clarity.
Johnson & Johnson MedTech’s Ottava is the world’s first table-integrated soft-tissue robotics system. [Photo courtesy of Johnson & Johnson]
MDO: You’ll never get too technical for the engineers in our audience. Do you have any examples you could share of a solution to a particularly hard problem during Ottava’s development?
Cvijetic: “If we think about that category-defining aspect of it, the first thing that comes to mind is that table-mounted architecture. What’s really challenging in achieving that is simultaneously being able to fully stow the robotic arms under the table while at the same time when they are deployed, ensuring they achieve the full reach and access that is needed for clinical procedures. That is a very challenging engineering problem and we’re incredibly proud we were able to solve that and bring this incredible robot to the market.
Johnson & Johnson MedTech’s Ottava table with the robotic arms stowed [Photo courtesy of Johnson & Johnson]
“… It’s a lot of different technical challenges, not only one. But the motors part is really, really important because we did make the decision as we were solving that problem to also motorize every single joint of every single arm. And that now solves that problem also from that digital dimension, because once the arms are fully motorized and once we also empower them with sensors that provide a very high degree of spatial precision and spatial awareness, we are not only able to stow them underneath the table and have them deploy and have proper reach and access, but we open up a whole universe of digital and software capabilities. From day one, that is manifested in the form of our predefined procedure poses, where at the push of a button the arms can deploy and not only deploy but get into a predefined procedure pose, whether that’s related to setup, a portion of the clinical workflow or teardown. And that is incredibly empowering for clinical teams. We hear this all the time. What’s also inspiring about that design decision is that it sets up a foundation for continuous innovation. So think about a cadence of future software releases at pace. That design decision to not only design for stowage and for reach and access, but for motorization, for spatial awareness, gives us the ability to create over time a cadence of differentiated software releases that are very compelling.”
J&J says Ottava’s robotic arms and software enable streamlined setup for procedures. [Photo courtesy of Johnson & Johnson]
What kind of sensors is Ottava equipped with, and what are they collecting?
Cvijetic: “The sensors provide spatial awareness. It’s incredibly important that the arms understand where they are with respect to each other, with respect to the table, with respect to the patient, and then with that spatial awareness data we’re able to use both real-world data and simulation data to compute this set of predefined procedure poses. It’s that spatial awareness, spatial information that we’re able to obtain from the from those sensors.
“And then in terms of the Polyphonic digital ecosystem, I’m at SRS and so much of the conversation at the robotics conference has been about digital capabilities. We hear from surgeons and from our clinical partners all the time that they want more access to their data, and this is now available with Ottava from day one, that ability to curate data, to access metrics, to access metadata, and it’s open. Monarch is part of the Polyphonic digital ecosystem, Ottava too, and it’s open to other devices as well.”
J&J says its Polyphonic digital ecosystem “connects Ottava insights, video, telemetry, and procedural data with other sources across the surgical pathway” to offer “postoperative access to synchronized case video, metrics, and robotic data for independent analysis, download, and research.” [Image courtesy of J&J]
What kind of sensor are you using to track that spatial location? Does it have a particular name?
Cvijetic: “It’s a sensor that provides spatial awareness [but] in the interest of intellectual property protection, I am not able to discuss at that level of detail.”
How else are you collecting case data to feed into Polyphonic? Cameras and microphones?
Cvijetic: “We have advanced visualization capabilities and a camera, as you might expect in a surgical robotics system and then the system has audio capabilities as well.”
The Ottava surgical robotic system’s instrument lineup [Photo courtesy of Johnson & Johnson]
What about haptic feedback or some form of force indication? Does Ottava have it, and what was the thinking about whether to include it?
Cvijetic: “We listen to our customers a lot and we pay attention to the new technologies that are out there in the field, and that’s going to continue being the case. We’re going to continue listening, continue innovating based on their feedback, and continue prioritizing how we innovate based on their feedback. On the instrumentation in general, we have a full intention to make our full Ethicon pipeline available on Ottava, and that listening to our customers and experience from Ethicon all comes together in that way.”
What were your customers saying about force feedback? There’s an interesting conversation in robotics right now about whether it’s needed.
Cvijetic: “You’re exactly right. What you’re hearing is similar to what we’re hearing, and we continue listening, we continue really closely understanding what is most important to them compared to some other aspects and challenges they’re facing in the OR, other types of innovation they would like to see, and that directly informs our innovation roadmap.”
Does Ottava have the ability to be upgraded with haptic feedback later?
Cvijetic: “We have that capability.”
I’ve been reading about your team’s work with expert sound designers on this system to create calming sounds in the OR. Can you tell me more about that?
Cvijetic: “For us, no matter the type of technology — whether it’s automation, digital ecosystem, or sound — it’s about empowering that human clinical expert in the OR. Sound can be very soothing for humans. It’s a very calming sound. The OR can be a very busy, noisy environment. I would describe it as a calming, reassuring sound that that instills confidence in our system. … To me, it sounds like a very soothing, high-tech spa.”
We’ll have more from this interview at Medical Design & Outsourcing. Subscribe to our free newsletter to watch for the next part.
