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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/