Contemporary robotic systems have come a long way since machines first started to appear in 400 B.C. Today, some of the most compelling advances in robotics can be seen in the surgical field.
Surgical robots have become standard for minimally invasive surgery (MIS) in almost all surgical areas. Today the surgical robot market is dominated by the da Vinci Surgical System from California-based Intuitive Surgical. The system has been used in more than 1.5 million surgeries, and the company has a market share of 68 percent, according to a recent report from WinterGreen Research.
The da Vinci has a vision system with a 3D image of the operating field, a patient-side cart with electromechanical arms that hold interchangeable surgical instruments, and a surgeon console for controlling the procedures.
Accuray, a radiation oncology company also based in California, holds 15 percent of market share, and was recently listed as one of the Top 10 Robotics Innovators by Fast Company for its slightly sinister sounding CyberKnife System.
Although not a surgical device per se, the CyberKnife System is the first and only robotic radiosurgery system; it delivers stereotactic radiosurgery and stereotactic body radiation therapy noninvasive throughout the body. Simply put, the system can deliver high doses of radiation with extreme accuracy in treatments that are individualized to each patient, reducing the amount of radiation needed dramatically.
According to the WinterGreen report, the robotic surgery industry is expected to grow four-fold in the next five years from $4.9 billion in 2014 to $19.9 billion in 2019.
Susan Eustis, co-author of the report and president of WinterGreen, says the growth is propelled by next-generation systems that will, among other things, decrease the number of ports needed in MIS. With increased accuracy and the ability to repeat processes, Eustis says that existing open surgery can soon be replaced in a large part by robotic MIS.
“The magnification is excellent and with greater visualization, there is less blood loss,” says David Albala, chief of urology at Crouse Hospital and medical director for Associated Medical Professionals in Syracuse, New York.
Albala also notes the much quicker recovery time seen in patients who’ve had MIS procedures. Patients generally experience less pain and more rapid healing while surgeons experience less fatigue, and hand tremors are reduced with greater control from the robotic instruments.
“Ten years ago this technology was a fad, but it’s not anymore,” Albala adds. “This technology is here to stay. It used to be industry driven, but now the baton has passed to the patients. They are coming in asking for it.”
No one knows for sure what the future will bring in this industry, but other companies around the world are working on next-generation surgical robots that are bound to shape the field.
“Systems from these companies are still years away, but in the meantime, what we’ll see next is modifications that will provide better dexterity and better visualization, Albala concludes.
Medical researchers are also focusing in on long-distance surgery (telesurgery) and surgical snakes, built to reach previously unreachable areas in the body.
The Flex System, developed by New England-based Medrobotics Corporation is already available in Europe, but not yet approved for sale in the United States. This robot-assisted flexible endoscopic platform can access and visualize hard-to-reach anatomical locations and deploy specially designed flexible surgical instruments to perform procedures.
Although some industry leaders believe that there may be a time when a robot can do surgery on its own, Albala says no. “Everyone’s anatomy is vastly different so I don’t agree with those that say it’s a possibility.”
Photo courtesy of Intuitive Surgical