New crop of robots to vie for space in the operating room

Asensus Surgical

28/07/2016 06:00

By Susan Kelly 
    CHICAGO, July 28 (Reuters) - Even though many doctors see 
need for improvement, surgical robots are poised for big gains 
in operating rooms around the world. 
    Within five years, one in three U.S. surgeries - more than 
double current levels - is expected to be performed with robotic 
systems, with surgeons sitting at computer consoles guiding 
mechanical arms. Companies developing new robots also plan to 
expand their use in India, China and other emerging markets. 
    Robotic surgery has been long dominated by pioneer Intuitive 
Surgical Inc  ISRG.O , which has more than 3,600 of its da Vinci 
machines in hospitals worldwide and said last week the number of 
procedures that used them jumped by 16 percent  urn:newsml:reuters.com:*:nL1N1A51MU in 
the second quarter compared to a year earlier. 
    The anticipated future growth - and perceived weaknesses of 
the current generation of robots - is attracting deep-pocketed 
rivals, including Medtronic Inc  MDT.N  and a startup backed by 
Johnson & Johnson  JNJ.N  and Google. Developers of the next 
wave aim to make the robots less expensive, more nimble and 
capable of performing more types of procedures, company 
executives and surgeons told Reuters. 
    Although surgical robots run an average of $1.5 million and 
entail ongoing maintenance expenses, insurers pay no more for 
surgeries that utilize the systems than for other types of 
minimally-invasive procedures, such as laparoscopy.   
    Still, most top U.S. hospitals for cancer treatment, 
urology, gynecology and gastroenterology have made the 
investment. The robots are featured prominently in hospital 
marketing campaigns aimed at attracting patients, and new 
doctors are routinely trained in their use. 
    Surgical robots are used in hernia repair, bariatric 
surgery, hysterectomies and the vast majority of prostate 
removals in the United States, according to Intuitive Surgical 
data. 
    Doctors say they reduce fatigue and give them greater 
precision. 
    But robot-assisted surgery can take more of the surgeon's 
time than traditional procedures, reducing the number of 
operations doctors can perform. That's turned off some like Dr. 
Helmuth Billy.  
    Billy was an early adopter of Intuitive's da Vinci system 15 
years ago. But equipping its arms with instruments slowed him 
down. He rarely uses it now. 
    "I like to do five operations a day," Billy said. "If I have 
to constantly dock and undock da Vinci, it becomes cumbersome."  
    
     
    SURGEONS' WISH LIST 
    To gain an edge, new robots will need to outperform 
laparoscopic surgery, said Dr. Dmitry Oleynikov, who heads a 
robotics task force for the Society of American Gastrointestinal 
and Endoscopic Surgeons. 
    Surgeons told Reuters they want robots to provide a way to 
feel the body's tissue remotely, called haptic sensing, and 
better camera image quality. 
    New systems also will need to be priced low enough to entice 
hospitals and outpatient surgical centers that have not yet 
invested in a da Vinci, as well as convince those with 
established robotic programs to consider a second vendor or 
switching suppliers altogether. 
    "That is where competitors can differentiate," said Vik 
Srinivasan of the Advisory Board Co, a research and consulting 
firm that advises hospitals. 
    Developers say they are paying attention. Verb Surgical, the 
J&J-Google venture that is investing about $250 million in its 
project, said creating a faster and easier-to-use system is a 
priority.  
    Verb also envisions a system that is "always there, always 
on," enabling the surgeon to use the robot for parts of a 
procedure as needed, said Chief Executive Scott Huennekens. 
    Intuitive said it too is looking to improve technology at a 
reasonable cost, but newcomers will face the same challenges. 
    "As competitors come in, they are going to have to work 
within that same framework," CEO Gary Guthart said in an 
interview. 
    Device maker Medtronic has said it expects to launch its 
surgical robot before mid-2018 and will start in India. Others 
developing surgical robots include TransEnterix Inc  TRXC.K  and 
Canada's Titan Medical Inc  TMD.TO . 
    An RBC Capital Markets survey found that U.S. surgeons 
expect about 35 percent of operations will involve robots in 
five years, up from 15 percent today.  
    J&J, which hopes to be second to market with a product from 
Verb, has said it sees robotics as a multibillion-dollar market 
opportunity. Huennekens said Verb's surgical robot will differ 
from another Google robotics effort, the driverless car, in one 
important aspect. 
    "There will always be a surgeon there," he said. 
 
 (Reporting by Susan Kelly; Editing by Michele Gershberg and 
Lisa Girion) 
 ((susan.kelly@thomsonreuters.com; +1-312-408-8134; Reuters 
Messaging: susan.kelly.thomsonreuters.com@reuters.net)) 
 
Keywords: HEALTH ROBOTS/