The future of robotic surgery in healthcare has finally begun to take shape. Despite having existed for over 20 years, this technology is still in its infancy as far as acceptance goes. However, as multiple med-tech behemoths enter the market and new technology enables improved robotic surgery advances, the industry appears to be on the verge of a dramatic shift.
According to a study, robotic surgery usage rose nine percent in the first four years after hospitals began using it, while laparoscopic procedures fell from 53% to 51%. Before the adoption of robotic surgery, the rate of laparoscopic surgery had risen by 1.3% every year.
According to the same study, robot-assisted procedures accounted for 15.1% of all general surgeries in 2018, up from 1.8% in 2012.
The rise in robotic surgery procedures (2012 vs 2018)
In terms of revenue, the surgical robots market generated USD 5.46 billion in 2020 and is expected to reach USD 16.77 billion by 2031. Meanwhile, the worldwide surgical robotics market is expected to grow at a CAGR of 10.2% over the forecast period of 2021-2031.
Recent M&A activity in the robotic surgery market
Recent years have seen a flurry of activity in this area.
Vicarious Surgical:
In the first quarter of 2021, Vicarious Surgical, a surgical robotics firm, agreed to merge with D8 Holdings Corp., a special-purpose acquisition company (SPAC). Vicarious aims to develop robotic technologies that will enhance surgical efficiency, improve patient outcomes, and reduce healthcare costs. According to the companies, the private investment in public equity of USD 115M will increase the company’s value to USD 1.1B.
Medtronic:
In 2020, med-tech giant Medtronic acquired London-based Digital Surgery, an Artificial Intelligence (AI) firm, to use for its upcoming surgical robotics platform. The company also debuted its surgical robot in 2019 with a practical demonstration of a cadaver surgical operation using the surgical robot, as well as a surgeon panel discussion.
Johnson & Johnson:
Johnson & Johnson acquired the remaining stake in the Verb surgical robotic joint venture with Verily Life Sciences. They also revealed details about their Ottava surgical robotic platform, which is said to provide unmatched flexibility and control in comparison to the rest of the market. The new technology is intended to provide more control and flexibility in surgery, allow patient access, enhance operating room space, and improve workflow.
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Robotic surgery: what it is and how it works
While laparoscopy is the most common form of minimally invasive surgery, robotic surgery is also making its way to the frontlines. Robotic surgery boasts increased precision and accessibility to surgical areas when compared to laparoscopy. When the surgery is conducted by robots, it aids surgeons in operating with less damage to the body, gives access to even the most remote location without major incisions, ultimately resulting in less discomfort, fewer complications, and shorter hospital stays.
The difference between robotic surgery and laparoscopic surgery
Typically, robotic surgery involves a physician sitting at a console with hand and foot controls. This allows them to operate surgical instruments coupled with robotic arms remotely and accurately. Advances in robotics, however, have led to novel types of robotic surgery. In March 2019, a doctor in Sanya, China, implanted a stimulation device into the brain of a Parkinson’s patient in a hospital 1,900 kilometers away.
The positive success rate of robotic surgical procedures is also spurring innovation in this field. According to published data on robot-assisted pyeloplasty, success rates range from 94% to 100%. According to a meta-analysis, there are no differences between the open and minimally-invasive approaches (robotic and traditional) in terms of success and complication rates. Currently, more than 30% of surgeons in the world use a robotic system to some extent in their surgeries.
The benefits of robotic surgery
There are several advantages to robotic surgery for both the patient and the surgeon performing it.
Most common uses for robotic surgery
According to a report, the use of robotic surgery for inguinal hernia repair increased the most, rising from 0.7% in 2012 to 28.8% in 2018. Among the other procedures where the robot is used more frequently are ventral hernia repairs, colectomy, reflux surgery, and proctectomy. Smaller increases were seen for cholecystectomy and complex cancer resections.
Three recent advances in robotic surgery
As technology advances, robot-assisted procedures are becoming even more popular. Following COVID, the healthcare industry has fully embraced digitization. Here are three recent innovations in this field.
1. In-vivo robots
Developed by Virtual Incision and Center for Advanced Surgical Technology (CAST), in vivo robots offer a revolutionary approach to robotic surgery wherein the entire minimally invasive surgical platform can be inserted into the peritoneum. Robots like these have two arms with a variety of functions and many joints for maximum flexibility. They enable surgeons to examine the surgical region from a variety of perspectives and conduct surgery on-site or remotely. These are affordable and easily transportable, allowing the surgery to be performed at any moment, from outer space to battlefields or distant medical emergencies.
2. Nanobots
Nanobots are micro-scale robots that combine cutting-edge nanotechnology with robotics and essentially serve as miniature surgeons. They can be inserted into the body to repair and replace intracellular structures. Additionally, they can replicate themselves to correct genetic deficiencies or even eradicate diseases by replacing DNA molecules. This property is still under development. Current tests on nanobots involve inserting a microscopic needle into the retina to perform eye surgery. Using a specialized magnetic field, surgeons can direct this needle.
3. Capsule robots
These are little endoscopes that can be utilized in a variety of diagnostic testing, operations, and medicine administration. These devices can be controlled by magnetic interactions, allowing untethered movement and a diverse range of motion. Their small size means they cause less tissue damage and allow for easier access.
Regulatory concerns
Despite the widespread use of surgical robotics, certain challenges hinder its increased use. Such surgeries continue to have adverse events such as death, patient injuries, and device failures. However, most are avoidable occurrences that must be addressed in the design of surgical robotic platforms
Robotic surgery is usually criticized for not delivering adequate haptic feedback to surgeons, which consists of force feedback and tactile feedback that promotes the sensation of touch. For a surgeon to recognize and correct excessive or insufficient force during surgery, haptic feedback is crucial.
Furthermore, the FDA has warned against the use of robotically-assisted equipment in the treatment or prevention of cancer, which it claims some healthcare practitioners are doing without FDA-approved indications.
There are 10,624 reports reporting adverse events for robotic surgery across 20 specialties from 2000 through 2013, with 144 of these reports alleging patient death. An agency review revealed that the regulatory authority received 32 reports of adverse events mentioning cancer, carcinoma, or tumor and the use of robotically assisted surgical instruments between January 2016 and December 2018.
The road ahead
The healthcare system has undoubtedly progressed beyond traditional methods of treatment, thanks to innovations that have led to tailored medicines and technology-enabled care. However, the industry still has a long way to go before fully embracing hi-tech procedures like robotic surgery.
The stability of networks and cybersecurity remain a concern. To achieve consistent patient outcomes, robotic surgery platforms must have rock-solid networks that do not have interruptions. In addition to data integrity and security, healthcare companies need to ensure that information from emergency rooms, intensive care units, and surgical suites is protected from hacking attacks.
We are seeing robotic surgery evolve to include both front-end applications and back-end IT support in the future. As a result, it could alleviate personnel shortages as well as expand access to specific types of care. From assistive robotic solutions to completely automated robotic surgery, this type of technology is allowing doctors to provide improved treatment at any time and from any location.
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