The surgical robotics market will experience an impressive 17 percent CAGR, from US $3.4 billion in 2016 to US $8.8 billion in 2022. According to market research firm Yole Développement, each participant in the chain sees added value in this technology: minimal invasiveness for the patient, enhanced microsurgery and precision capabilities for the surgeon, and cost optimization for the healthcare system, due to patients’ shorter recovery time.
In the field of surgical robotics, the robot functions are the surgeon’s hands and eyes. Surgeons want technology that allows them to “feel” the body’s tissue remotely, a process called “haptic sensing,” as well as better camera-image quality. Both issues can be addressed using new sensor types: haptic sensors and high-resolution CCD3 or CMOS4 cameras.
“Haptics is probably the technical feature most requested by physicians in the surgical robotics field,” explains Dr. Villien. “Of the five senses, touch is the most proficient, the only one capable of simultaneous input and output. Touch is at the core of personal experience. Despite persistent effort, reliable solutions for haptic feedback in robot-assisted minimally invasive surgery have yet to find their way into practice.”
Dozens of sensors are required for a robot to function and respond to its environment: position and torque sensors for articulations, gyroscopes and accelerometers for positioning and moving parts, pressure sensors, image sensors, etc. These sensors can be divided into two groups:
- Key enabler sensors at the interface between the human and the machine.
- Other sensors not specifically developed for medical robotics applications.
TransEnterix is the first to propose a surgical robot with haptic feedback capabilities, and it is beginning the commercialization of the product.
Another trend, already observed in the endoscopy market is the move toward disposable image sensors to achieve a disposable laparoscope. This trend is not yet visible in the surgical robots market, but will probably surface in the future as regulations evolve toward more disposable scopes. This would completely change the number of cameras sold to surgical robot makers, shifting from a single camera per robot to as many as one camera per surgery.
In the more distant future, Yole says a breakthrough will come from software development with automation of some aspects of the procedures.
The medical robotics supply chain is mainly organized in four segments: the sensor providers, such as AMS, Sony, Panasonic; the manufacturers of the mechanical part, where the main player is Kuka; the integrators, such as Intuitive Surgical, Stryker, Accuray; and the distributors, such as Medtronic.
In 2000, the field’s current main player, Intuitive Surgical, was one of the first firms to bring a surgical robot to market. According to Yole, it is still difficult for newcomers to compete with Intuitive Surgical directly as they already have a solid installed base, over 33,000 surgeons trained in its use, and are used by 100 percent of the top-ranked U.S. hospitals in the key specialty they are targeting. But newcomers are arriving with new features asked for by physicians, such as haptic feedback introduced by TransEnterix.
The neurosurgery surgical robotics field has evolved a lot since 2016 with major changes in the leaders’ corporate strategies. Medtronic, a giant of the medical device industry, is investing a lot in Mazor Robotics, whereas MedTech was sold to Zimmer Biotech.
Indeed, since 2016, Medtronic has made two major moves into surgical robotics: its acquisition of Covidien for US$50 billion, and its emergence as Mazor Robotics’ lead investor. Medtronic-Covidien owns an extensive patent portfolio in the surgical robotics field, and the company should be watched closely over the next few years since they are probably working on a new product. They could also make a big splash by acquiring one of the leading companies in the field.
"Another threat for Intuitive Surgical is coming from the collaboration of Johnson and Johnson, a giant from the biopharmaceutical industry, with Google, a leader in the data science field. Verb Surgical is very secretive about the technologies it is developing, but we can be sure that the surgical robots developed through this collaboration will make a significant impact in the field," says Yole.