Reflections on 2024 in the Surgical Robotic World.

In some ways when you look back at the year you feel that not much has really happened but when you scratch below the surface you see that so much has been occurring.,

Some themes that stick

Artificial intelligence is becoming more and more mainstream. For the first time the reality and promise of digital surgery is becoming clearer. A simple indication of this is how it is becoming incorporated into Scientific meetings. This started with @SAGES NBT where Erik Wilson always puts a great program together. Followed on with an overflowing session hosted by Andrew Hung at Society of Robotic Surgery | SRS   and then @Ai2Md meeting in September hosted by Filippo Filicori in Bologna. We have noticed this at the Vattikuti Foundation with 50% of the Agenda at the upcoming meeting  in Jaipur being dedicated to new technologies and AI will have a great role to play.

 It is therefore not surprising that Intuitive made such appoint of talking up the 10,000x increase in computing power in the da Vinci 5 as compared to the previous generation.  It is still too early to say what all this additional power is going to offer. However, feedback at AAGL would seem to imply a general increased smoothness in the OR as well as valuable data insights supported by the integration of the HUB into the system. We are still waiting of the software upgrade that will among other things switch on the simulation component, Given the new architecture this should give some interesting surprises.

 The other indicator is that companies such as Theator or are continuing to thrive showing that not all AI needs to be hype complicated.

 Telesurgery is another area where strong foundations are being developed. Twenty-three years after the transatlantic surgery with Michel Gagner gner  and Jacques Marescaux   it is really beginning to gain traction. It is clear that the Asian companies such as Medicaroid and MicroPort MedBot are taking a lead in this area. In those markets there is both scientific society and  government are fully in support of these ventures.  In India SS Innovations recently received approval for telesurgery and Telproctoring from CDSCO, the Indian regulatory body. In the US the Society of Robotic Surgery | SRS under Vipul Patel, M.D., F.A.C.S. l leadership is pushing for innovation. Companies like @Sovato with the experience of their founders are beginning to bring exciting opportunities to market. Much of the hype that we see on LinkedIn is the long-distance surgery . I really believe that this capability will take off not over long distances but over short distances within urban areas and within Hospital networks. 

 Stand outs

Virtual Incision have had a great year. From sending one of their MIRA systems up into space and being controlled from Lincoln Nebraska to getting FDA approval for their first indication. They are beginning to focus on their next generation system which will be smaller and more adapted to indications such as gynecology. I love connecting with them at trade shows as they have such a great team full of enthusiasm.

 One of the great discoveries of 2024 for me was SS Innovations . With the Mantra system and their focus on cardiac surgery they are setting themselves for long term success. I was really Impressed with the performance of the system when I was able to test drive it in New York earlier in the year. The now have over 40 systems installed in multiple countries and are north of 2,600 procedures. 

Intuitive continue to not miss a beat. From a pretty flawless launch of the da Vinci 5 to continued growth in their SP and Ion business they continue to set the standard that everyone else must live up to. It will take I imagine twelve to eighteen months to see the real power of the da Vinci 5 especially in terms of what it can offer in digital surgery enhancements. One  disappointed group were cardiac surgeons for which the da Vinci 5 is not indicated and does not have the instrumentation to support it,

Asensus Surgical did a great job in getting acquired by KARL STORZ . Not only have they been able to survive over the years but have been able to continually reinvent themselves through intelligent acquisitions and strong engineering. If they are given enough runway I believe with the Intelligent Surgical unit and the Luna platform they will re-emerge as an interesting force. This has clearly fed into the narrative that edoscopic companies need to get involved in robotics or see their lunch eaten by Intuitive,

 I would also like to give a shout out to the French surgical robotics industry in general not only because I am a member of the Académie Nationale de Chirurgie but because France is the country with the third largest number of start ups behind the US and China. This was clearly presented by Lucien Blondel at a recent med tech meeting with around 40 companies spread across the country with hubs in Paris, Grenoble and Montpellier with companies such as Quantum Surgical , Moon Surgical and many more. It makes complete sense that SRS 2025 should be in Strasbourg at IRCAD in July 2025.,

 The Vattikuti Foundation has continued its mission to promote surgical advances around the world. New ventures included a joint training course with John Hopkins, the development of the Vattikuti explorers program aimed at nurturing the next generation of surgical pioneers. The KS Innovation awards attracted again over a 100 submissions and has set up a strong “ Humans at the cutting edge of robotic surgery symposium” in Jaipur for 2025.  In 2024, fourteen national (Indian) and one international new fellowships were granted.

Other Activity

MicroPort MedBot received CE approval for the Tournai system . The first Chinese system to gain approval outside home market.

Distalmotion on with a new management team have been able to focus on breaking into the US market and recently had their first cases.

CMR Surgical are also now in the US market and are continuing to expand their footprint globally. They have recently had another change of CEO.

Medtronic Digital Surgery has said little about their program and have not receive approval as yet in the US.

Johnson & Johnson MedTech will be starting their IDE submission in 2025.

EndoQuest Robotics™ received IDE approval to start clinical trials in the US.

Medicaroid continues to work its way to both US and CE approvals hopefully sometime in 2025/2026

Levita Magnetics continues to slowly expand its footprint in Chile.

 If I look at my predictions for the year that you all voted on in December of last year I had some mixed resutls

 On the plus side

 Intuitive did launch a new system  with the da Vinci 5

Chinese manufacturers such as Microport and Ronovo are making waves

 On the negative side

Medtronic are still not in the US market

 I am not sure if a smaller player has left the market. The purchase of Asensus by Karl Storz has definitely changed the conversation. Avatera may have left at the end of 2023 as opposed to early 2024.

 Still so much to happen in this space I am sure 2025 will be another fascinating year,.