Breathing New Life into Surgical Robots

January 29, 2020

How can surgical robotics manufacturers deliver targeted innovations that dramatically improve patient outcomes and cost-efficiency in healthcare? It’s about developing procedural solutions that clearly surpass what humans can achieve. Clinical and financial benefits need to be tangible and measurable, so end-users can build a robust business case for investment.

Today’s healthcare providers are faced with complex, often conflicting, demands surrounding the need for efficiency and effectiveness. Patient volumes, demands and requirements are growing faster than budgets. So, there’s increasing pressure to improve clinical outcomes and patient-reported outcome measures (PROMs) while reducing the overall cost of the care cycle.

From a surgical perspective, robotics could represent part of the solution to this challenge.

Since achieving FDA clearance in 2000, Intuitive Surgical Inc.’s da Vinci Surgical System has been adopted by hospitals around the world. Initially used in prostate and gynecological procedures, it is now widely used in more general surgery. With an installed base in excess of 5,400, more than five million procedures have been performed using the system. Stryker Corp.’s Mako for knee replacement and Medtronic plc’s Mazor for spine surgery have also enjoyed some commercial success.

These first-generation surgical robots have largely been developed with surgeon performance improvements in mind. They tend to focus on factors such as accuracy, dexterity, and tremor removal.

Another approach has been to identify specific procedures with lower long-term success rates than others within a given field, then aim to improve them with robotics. This is evident in arthroplasty. Multiple studies suggest that around 10-20% of patients report some level of dissatisfaction following total knee arthroplasty.
How can surgical robotics manufacturers deliver targeted innovations that dramatically improve patient outcomes and cost-efficiency in healthcare? It’s about developing procedural solutions that clearly surpass what humans can
achieve. Clinical and financial benefits need to be tangible and measurable, so end-users can build a robust business case for investment. However, hip arthroplasty tends to be more successful, with better PROMs and overall clinical outcomes. It’s no coincidence that procedures related to the knee are gaining more attention from a robotics perspective than those related to the hip. If use of robot-assisted surgery significantly improves long-term patient outcomes and cost-efficiency of knee surgery, learnings may later be applied to robotic solutions for hip surgery.

The Need for Clinical Data

Uptake of surgical robots has increased steadily over the past two decades and anecdotal evidence of the associated benefits is readily available. However, clinical evidence of improved patient outcomes is harder to come by. Unless

this dichotomy is resolved, adoption of first-generation systems is likely to plateau.

Surgical robotic technology is expensive. It’s not easy for small hospitals, or those with limited budgets, to make a business case for such a significant capital investment. It’s harder still when there is a lack of tangible, robust evidence surrounding benefits for patients and overall healthcare efficiency.

So, what is the best way forward for surgical robotic innovation?