If you can call something that’s been on the market for 16 years a trend, then robot-assisted surgery is one of the hottest in medtech. Pioneered by Intuitive Surgical’s da Vinci abdominal surgery device, which hit the U.S. market in 2000, today almost no medical specialty lacks an entrant with a robot-assisted platform.
As with most robotic surgery systems, the da Vinci’s motor-actuated technology allows a surgeon’s hand movements to be scaled, filtered and translated into precise movements inside the patient’s body. The device uses DC servo-motors made by Maxon Motor, which says Intuitive’s engineers have built more than 30 of its motors into their devices.
Today there are at least a dozen companies working on robot-assisted platforms.
Seeing the technology’s potential in other applications, Intuitive Surgical co-founder Dr. Frederic Moll founded Hansen Medical in 2002 with an eye toward the intravascular space. (Moll, a serial entrepreneur, also co-founded Mako Surgical, acquired in 2013 by Stryker Corp.; Restoration Robotics and its Artas hair restoration platform; and Auris Surgical.)
Mountain View, Calif.-based Hansen has a pair of platforms on the market: The Sensei system for electrophysiology procedures and the Magellan system for peripheral vascular interventions. Another EP player is Stereotaxis, with its suite of products aimed at cardiac ablations to treat arrhythmias.
Corindus Vascular Robotics is also developing an intravascular system, the CorPath, for percutaneous coronary interventions such as balloon angioplasty and stenting. Cleared in the U.S. since 2012, the CorPath platform won an expanded clearance last year for radial-access PCI procedures.
Medtech, a French company, has its Rosa neurosurgery device on the market in Europe, the U.S. and Canada. Designed to replicate the movement capabilities of the human arm, the device also features haptics designed to improve the surgeon’s “feel” during neurological procedures.
Trend: Abdominal surgery
Intuitive Surgical has a sizable lead in abdominal surgery, but a pair of up-and-comers are readying to compete. TransEnterix this year completed its response to the FDA for its single-port SurgiBot, designed to be wheeled to the bedside (rather than requiring its own surgical suite). Based in Research Triangle Park, N.C., TransEnterix has said the SurgiBot could win FDA clearance this year.
Toronto-based Titan Medical is gearing up for first-in-human trials of its Sport ‘bot, another mobile, single-port offering featuring 3D imaging and interactive instruments. Assuming all goes well with the trials, the Sport system could be on the market by mid-2017, Titan has said.
The orthopedic space is no stranger to robot-assisted surgical devices, with Stryker and Smith & Nephew entering the space via acquisition in recent years.
Stryker paid $1.68 billion for Mako Surgical’s Rio device for knee and hip replacement procedures. The system uses a 3D model derived from CT scans to customize the implant’s size, orientation and alignment before the operation. Now called the Mako arm, the platform is designed to be used with Stryker’s panoply of knee and hip implants.
British arch-rival Smith & Nephew put up $275 million for Minneapolis-based Blue Belt Technologies and its portable Navio system. Unlike the Mako device, which is solely used with Stryker products, the Navio system is designed to pair with knee implants from eight different manufacturers, plus the London-based company’s Zuk and Journey Uni devices.
Mazor Robotics is also in the orthopedic space, with its Renaissance spine surgery system, designed for open, minimally invasive and percutaneous posterior thoracolumbar approaches. And Medtech, the French company that makes the Rosa neurosurgery system, also makes a Rosa Spine version for this space.
Trend: Large-caps late to the party
Google and Johnson & Johnson grabbed headlines late last year when they joined forces to form Verb Surgical.
Details are scarce, but the companies have said the Verb Surgical platform will incorporate leading-edge robotic capabilities. Their Verily joint venture, headed by former Volcano CEO Scott Huennekens, is a collaboration between Verily (formerly Google Life Sciences) and J&J’s Ethicon subsidiary. Ethicon is on tap to develop the instrumentation for the as-yet-unnamed Verb Surgical system.
Medtronic is another big name in medical robotics (along with seemingly everything else). The world’s largest pure-play device maker brought on a significant robotics program when it acquired Covidien for $50 billion last year, with CFO Gary Ellis later telling analysts that Covidien was “farther ahead even than ourselves” on the road to a robotics offering. Fridley, Minn.-based Medtronic plans to integrate some of the interventional surgical devices it got from Covidien with a robotics system developed in-house – although with billions to spend there’s always the possibility that Medtronic will buy its way into the space.
Trend: Inside the body
Virtual Incision’s twist brings the robot inside the surgical cavity. The company reported 1st-in-human proof of concept in March, when its miniaturized robotically assisted surgical device (RASD) was used in a colon resection procedure.
Spun out from the University of Nebraska (the company is based in Lincoln, Neb., and Pleasanton, Calif.), Virtual Incision’s device is designed to be inserted through a single incision into the abdomen, to work entirely within the body of the patient.
Here’s a look at some of the players in the robot-assisted surgery space:
|Intuitive Surgical||da Vinci||Abdominal surgeries|
|Hansen Medical||Magellan||Peripheral vascular|
|Corindus Vascular Robotics||CorPath||Percutaneous coronary interventions|
|Titan Medical||Sport||Abdominal surgeries|
|Auris Surgical Robotics||?||Ophthalmology|
|Smith & Nephew (Blue Belt)||Navio||Orthopedics|
|Google/J&J (Verb Surgical)||?||?|
|Virtual Incision||RASD||Abdominal surgeries|