Intuitive Surgical CEO: How to Get It Right in Surgical Robotics

Here's some advice for all the newcomers vying for a place in the sun in the field of robotic-assisted surgery.

Gary Guthart

Twenty years after the first robotic-assisted surgical device was wheeled into an operating room, more than a dozen companies are heading to hospitals with new robotic systems. This is a truly remarkable development given that many--including some of the companies that are now working on robotics programs--have previously discounted the technology as a passing fad in healthcare. But new entrants need to keep a few things in mind to succeed.

Having the benefit of the past twenty years and as we gaze into the future, it is clear that robotic-assisted surgery has become far too important to ignore. 

Roughly every minute of every day, a da Vinci robotic-assisted surgery begins. Significant growth in the use of this technology has resulted in more than 3 million procedures having been performed globally to date. While the field has seen tremendous growth, it is still early in its evolution, with independent analysts expecting the use of surgical robots to more than double by 2020.

Still, despite the adoption of robotics over the past decade, many patients who are candidates for minimally invasive surgery still undergo open surgeries that come with large incisions and long recovery times. Expanding high-quality minimally invasive surgery as an option to more patients remains our primary goal. 

Numerous studies have demonstrated that robotic-assisted surgery can offer clinical benefits to appropriate patients--smaller incisions, less blood loss, fewer complications, shorter hospital stays, lower likelihood for readmission and faster recovery when compared to open surgery. In a healthcare environment where we are all focused on value, these clinical benefits for patients translate into economic advantages for hospitals.

Yet success in the field of robotic-assisted surgery is not a given. More surgical robotics companies struggle than thrive.

How can new entrants improve surgical outcomes and build value for patients, surgeons, hospitals and payers?

First, the surgeon needs to sit at the center of the system. Why? Surgery is often the best tool for treating a disease but it isn't administered with the push of a button.  While new automation technologies hold the promise of decreased variability in surgery, it's important to stress that the surgeon is the captain of the ship and will remain so for years to come--they determine the course of action and guide the procedure. 

Burdening surgeons with poor ergonomics or counterintuitive controls is taxing and takes the field backwards.  Working within a system that is built for the surgeon allows them to focus on the patient, navigating anatomy more naturally and precisely.

Building an innovative device for surgeons is just the first step. A robotic platform is but one element in a sophisticated, interconnected ecosystem of clinical professionals, products and processes. That means companies will have to build a comprehensive network of instrumentation, imaging technologies, training programs, peer learning opportunities, clinical validation and customer service tailored to meet the individual needs of surgeon and hospital customers. 

As we survey the landscape, the opportunity to improve surgery is still substantial and requires a commitment to continued innovation. Collectively, our field needs to remain focused on making surgery more effective, less invasive and more precise - all of which is aimed at making surgery easier on patients. This can be achieved by bringing together surgeons, engineers and design experts to identify challenges and new approaches for tackling them. Long used in prostatectomy and gynecologic procedures, there remains significant opportunities to tackle a growing number of robotic-assisted surgical procedures in thoracic and general surgery.

The most pressing challenges that our industry needs to address are rooted in what surgeons need most. Expect to see advances in imaging technology that make the surgical field easier to visualize, lower-impact ways to introduce instruments into the body, technologies that are more precise in interacting with tissue, "over the shoulder" analytics that bring surgeons insights into the surgery, and new technologies that enable faster and deeper learning. 

Together, these advances can help robotic-assisted surgery move towards better outcomes and lower total cost to treat per patient.

While the impact of the arrival of new participants in the surgical robotics field remains to be seen, their entry signals what we have long known: That robotic-assisted surgery and the benefits it offers surgeons and their patients are here to stay.

Dr. Gary Guthart, President and CEO, Intuitive Surgical 

[Image courtesy of INTUITIVE SURGICAL]