Ever hear of the respected bicycle manufacturer known as Cannondale? You probably have. Perhaps you even own one of their bikes. I actually do. Since 1971, Cannondale has produced among the most well-recognized and trusted, high-performance bicycle brands in the United States. But they don’t actually make everything their bikes comprise.

Plasma-welded 7×37 tungsten mechanical cable used to power a motion control system in the miniature actuators of a surgical robotics application. (Credit: Carl Stahl Sava Industries)

For that matter, most manufacturers selling a completed product, in this case, a Cannondale bicycle, don’t necessarily produce 100 percent of the components the product includes. Often, parts are produced by the maker’s supply chain partners, and thus, a completed unit is sold and delivered. Chances are quite good that the very paint used to beautify a Cannondale bicycle is purchased by a trusted supplier of Cannondale-quality bike enamel. The truth is that Cannondale makes some of the parts that go into a completed bike, while others are made by companies overseen by Cannondale’s strict quality standards and ultimately used to assemble a completed unit. Cannondale’s suspension fork, bike frame and a host of other components, produced by the bike staple, are wedded with those sourced through their stable of suppliers, and bam — a bike is made.

And even though Cannondale does not manufacture everything their finished bicycles contain, we still turn to Cannondale to sell us a whole bike — well, unless one is a cycling purest that assembles bicycles one part at a time. For the rest of us though, we’d prefer to just be given the entire bike.

The da Vinci Surgical System, currently among the world’s most popular surgical robots, is a veritable labyrinth of components. From plastics to wires, and from pulleys to cables, their robot is made up of countless parts. And just like Cannondale, the surgical robot’s maker, Intuitive, does not actually manufacture the smorgasbord of components contained within a single da Vinci robot. Similarly, as a manufacturer of some of the key motion control components of surgical robots, Carl Stahl Sava Industries likewise does not actually manufacture everything that a cable assembly may comprise.

In each of these scenarios — the bike and the shifters, or the surgical robot and the cables — turning to a single source for the completed product is the way these products are typically sold. So, like one buys a whole bike from Cannondale, one buys a whole robot from Intuitive. Unless one does not.

You see, unlike the aforementioned deeply respected bike and surgical robot makers, too often, customers purchasing precision components do not use a single source. Rather frequently actually, the makers of today’s most modern surgical robots, for instance, will use multiple component makers and have each section shipped to multiple sources and leave assembly to, well, multiple manufacturers. While necessary in some workflows, the objective should always be to limit the number of components changing hands in an urgent effort to outpace global competitors.

Said plainly, the more turnkey a supplier can be, the lower the exposure to increased costs, a lack of accountability, and ultimately painful delays. Taken individually, any of the three — cost, liability, or delay — is enough to put a device maker at the back of the line, because make no mistake, in the world of surgical robots, the market is proliferating, and how fast a robot goes to market is directly tied to how quickly a source can produce and assemble components.

Cost, Accountability, Delays: The Three Killers of Competitive Advantage

“If a tree falls in a forest and no one is around to hear it, does it make a sound?” This well-known metaphysical question has popularized a centuries-old debate. If the tree is capable of making a sound as it falls, would say some, then yes, the tree made a sound. If, however, no one is there to hear the sound of it falling, philosophically speaking, the tree didn’t actually make a peep. And were the tree a pint-sized sapling, or perhaps a mighty sequoia, the debate would rage on regardless. The point is, if a company is making the most revolutionary surgical robot the world has ever seen — the sequoia — but is mired in holdups, who cares? The possibly more pressing question is, who should care?

0.035 in. diameter balls being swaged to 0.024 in., 7x19 stainless steel mechanical cable used in a surgical implantable instrument. (Credit: Carl Stahl Sava Industries)

Surgical robotics is a booming and fast-paced marketplace. There is quite literally no time to waste. As a mechanical cable components manufacturer, customers order individual parts all the time — say, a fixed length of cable, cut to specific size, along with 1,000 of this and 500 of that. And if no questions are asked during these early and seemingly commonplace sourcing conversations, the parts are made, packed, shipped, and the transaction completed. In this case however, the buyer is charged à la carte piece part pricing and leaves the robot maker’s procurement teams to manage multiple vendors, multiple quality apparatuses, multiple deliveries, and consequently, multiple points of potential failure. Worse, when components don’t fit properly with mating parts, or there’s a burr in a fitting, who’s to blame?

Perhaps another party damaged delicate end-fittings meant to be crimped to a length of wire rope. Maybe parts were damaged in a press, revealing microscopic imperfections that prevent the smooth joining of components. While working without the benefit of a single point of accountability, prices start to soar, fingers start to point, and production starts to stop. When these are the prevailing characteristics of a sourcing transaction, the tree may have fallen in the woods, but no one’s going to hear a thing.

Vet the Whole Source

Surgical robots take years to bring to market and even when they do become widely available, makers like Intuitive are unrelenting in their focus on rolling out the next model. So, the production of tomorrow’s version is perpetually under way, while consumption of the current one grows.

Add to the lengthy exercise in simply advancing the prevailing technology, and there is the ocean of regulatory and quality certifications these sophisticated surgical instruments require. The fact is, it is easy to imagine how long it takes to produce a single prototype, let alone an entire family of robots, and get them into the hands of awaiting surgeons around the world. With such an interminable production cycle baked into the entire surgical robotics industry, any go-to-market delay can irreversibly damage market share potential.

These prodigious innovations in modern medicine therefore benefit from equally impressive innovations in the actual production of the devices themselves. Surgical robotics makers, for example, often ask component makers like Sava about the potential to deploy a cellular manufacturing environment surrounding the making of key components.

So, not only are components makers asked, “Can you make it?” But as critically, albeit less ceremoniously, they are also asked tough questions like, “how will you do it, who will do it, and how many can you do?” The list goes on and on, and maybe surprisingly so, these are among the most frequently asked questions on which components makers are pressed — and with good reason. Production can’t take a sick day because someone got the sniffles. A burr in a cable fitting cannot hold up the entire day’s productivity.

A dedicated manufacturing cell pledges materials and equipment, along with key and redundant skilled operations, finishing and quality personnel to production. As cellular production is streamlined, time is recovered, and production tempos improve. The coalescing of talent, technology, speed, and accountability represent an arrant recovery of time getting a surgical robot to market.

Seeing the Big Picture

There are many ways to do many things. No one is arguing that there is a single right and wrong way to source components for the latest in surgical robotics technology. Sources abound in a global economy today now designed to offer surgical robotics makers the freedom to choose from a massive pool of suppliers.

The question is therefore not necessarily what options are available, but rather what options give the robot maker a wider stride than their competitors? As a maker of the very motion control cable going inside these marvels, there is no single metaphor that should better characterize the speed of a robot maker’s go-to-market strategy than a “gazelle’s stride.” And if sourcing from multiple suppliers gets components purchased and assembled, yet at the hindrance of that stride, well then, a sequoia just came tumbling down without a sound. Where years have been spent, millions invested and billions at stake, a case can be made for reducing variability in every facet of production, despite the alluring availability of ubiquitous sourcing alternatives and methodologies.

This article was written by Scott Dailey, Vice President of Sales and Marketing, Carl Stahl Sava Industries, Riverdale, NJ. For more information, visit here .


Medical Design Briefs Magazine

This article first appeared in the January, 2021 issue of Medical Design Briefs Magazine.

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