Rethinking the Principles of Surgical Robotics

The design parameters of some surgical robots are self-limiting and have even contributed to increased criticism and seemingly skeptical revenue results.

Bruce Lichorowic

March 5, 2021

3 Min Read
Aliaksandr Marko -

While the level of innovation and contribution from surgical robots is well established, until recently they have been, in many ways narrowly focused one-trick ponies. The design parameters of some surgical robots are self-limiting and have even contributed to increased criticism and seemingly skeptical revenue results.  These deficiencies are not a categorical fault of surgical robots in general; they are only a reflection of the design assumptions and the specific implementations.

As medical and technological pioneers continue to develop the next generation of surgical robotics, there are a number of areas that should be reassessed to change the way that robots are used and the impact they produce. Rethinking many of these principles could broaden use cases, increase accessibility and even increase the level of surgical techniques, and speed up the training for surgical residents.

Rethinking, the way robots are designed is the first step. Today’s surgical robots are very expensive pieces of equipment requiring a capital expenditure that can limit the hospital’s ability to afford one. Creating a have and have-not condition, these surgical robots result in business dynamics that have the potential to influence medical decisions. For example, the decision to refer some procedures to a larger hospital. The price of such large capital purchases also puts more pressure on equipment utilization to cost-justify.  

Rethinking the way, surgical robots are procured today can substantially influence the ability of hospitals to acquire one. As an example, today’s cloud-based computing and infrastructures have shifted to more of a pay-as-you-go model and offered “everything-as-a-service.” Businesses today no longer have to purchase expensive computer equipment to host enterprise applications, such as those for finance and accounting, customer relationship management, or data analytics.

This same dynamic could apply to surgical robots. Of course, there is real hardware, but what if we could charge per patient usage pricing models with no capital expense outlay? What if, a from-the-ground-up design made surgical robots inherently less expensive to produce? What if, maintenance was also factored into usage, thereby lowering fixed costs and reducing the need for hospitals to have trained personnel? What if the robots were designed for lowing surgical procedural costs to begin with?

Another dimension in re-thinking the principles of surgical robotics might be in terms of design versatility. Perhaps surgical robots could be designed to accommodate an array of different tools, implants, scopes or cameras? What if tools could be interchangeable, allowing greater flexibility and versatility within each procedure using different tools for different procedures all the while using the same robot? Design could broaden versatility in other ways, such as in the primary tasks the robot is suitable to address and the value it brings to procedures. For instance, if the robot was designed as a 3rd hand surgical assistant to supplement surgical skills, the robot could help provide tool stabilization, offset fatigue for long procedures and ultimately provide for hands-free guidance.

Rethinking surgical robot design could also add new dimensions to it. What if one considered the robot to be a perfect receptacle for surgical data? What if the robot that plays an assistive or augmentative role could capture the surgeon’s experienced hand movements?  These could be gathered from a large number of surgeons and procedures to provide “best practice” guidance to other surgeons, while providing potential suggestions in real-time. Such a data collection of talent could help raise the level of proficiency for all surgeons and help to continually increase their effectiveness. It might also be possible that the collective knowledge could be effective for training new surgical residents. Rather than traditional teaching methods of observing surgeons at work as well as critiquing residents in the operating room or surgical suite, residents could learn in the most hands-on way possible.

The early pioneers of surgical robots broke important ground and paved the way for everyone by improving surgical techniques, increasing surgical proficiencies once reserved for the gifted surgeons, and teaching the general population the benefits of robotic surgery. New generations of robots will greatly broaden these horizons to advance medical practices and bring new benefits, applicability, and dynamics.


About the Author(s)

Bruce Lichorowic

Bruce Lichorowic, president and chief executive officer of Galen Robotics, has made a career of focusing technology on problems and opportunities to drive substantial change and improve or save lives. His blend of vision, leadership, and bringing ideas to meaningful, innovative results has produced critical improvements in surgical robotics. He has also pioneered the commercial use of adaptive agents for simplifying data systems and real-time analytics for providing clarity and understanding. At Galen Robotics, Lichorowic leads the company in the development of ultra-precise robots designed to advance new frontiers of microsurgery combined with the application of learned knowledge and guidance based on real-time data.

Lichorowic has served as president and chief executive officer of Trak Surgical, and, earlier, Dynaptics Corporation. He has also served as managing director for BlueFire Capital Partners, focused on growing mid-market companies and helping them achieve their greater potential. Lichorowic has continued his ongoing managing director role at Madison Lane Consulting Group by directing a model of “business engineering” to bring together technology and medicine for breakthrough treatments and capabilities.

Lichorowic is a frequent speaker at industry conferences, and both his counsel and vision are commonly sought by technology and business professionals.

Sign up for the QMED & MD+DI Daily newsletter.

You May Also Like