For many of us, hit shows like Grey’s Anatomy didn’t just entertain us. They brought us greater awareness of medicine and surgery, even though we can’t vouch for the authenticity of the medical content shown (though one would assume it has been vetted). Anyway, here is a short primer on surgeries to help you get a sense of what the the Robotic Surgery industry is actually like. While it is worth $10 bn, it is expected to grow at a CAGR of 11% to become $14 bn by 2026.
First, some necessary context on its evolution. The history of Human Surgeries can be divided into three stages:
Discovery of Anaesthesia and Sterile Aseptic Techniques: This made surgeries plausible and allowed patients to both endure (due to anaesthesia) AND survive (aseptic techniques reduced the risk of post operative infections) surgeries.
Minimally Invasive Surgeries: The advent of video cameras and endoscopic microscopes made it possible to conduct surgeries through a few small incisions. This lead to less pain and shorter recovery times. It was, however, difficult for surgeons to master.
Computer Assisted Technology: Easier to perform that minimally invasive surgery, it simplifies control and provide more dexterity and manoeuvrability. It has been around since 1990s.
Types of Robots
Essentially, robotic surgeries can be divided into three categories depending on the type of organ or body part they’re treating or investigating. These include:
Image Guided Robotics: These are used in hard tissue surgeries involving spinal or orthopaedic surgery.
Laparoscopic Robotics: These are tele-operated, have real time video and 3D visualisation, and generally used for abdominal and chest surgeries.
Endoluminal Robotics: Long slender instruments based on catheter technology that pass through a patient’s lumens. Lumens are basically openings inside a tube- think large intestine, small intestine, veins, and arteries.
There are over a 100 companies with various systems either available or in the pipeline. While Intuitive is the market leader in this space, it has attracted multiple players and significant investments, and the punt is that the technology will improve dramatically over the next few years since it is far far away from commoditisation.
Surgical Robotics Market, Company Share
The Future: Convergence of transformational technologies
It is highly likely that surgeries as we know it will transform over the next 30 years. Multiple technologies that contribute to Surgical Robotics are in a transformational state, and the impact on robotic surgeries industry would be exponential. These include:
Robotics Systems and Instruments: Robotic cranial surgeries, or small robots that can be swallowed or ingested to actively perform surgeries, or using catheter based technology to not only diagnose but eventually conduct treatments. Technology enablers would be Advanced Compute for Robotic control, Edge Compute and Wireless Low latency communications.
Visualisation and Sensing: Image technology is continuing to evolve. We now have technology that allows us to detect dyes injected in patients and see skin structures or tumours. There are also advancements in 3D Ultrasound, which shows organs in great detail. Haptics brings a sense of touch to surgeons. This technology can measure swallowing pressure, and quantify the sense of touch. Technology enablers are Real time image processing, CloudXR, Neural Networks, Intelligent Machines and Sensors.
Data Analytics and AI: Surgery is a complex procedure with many steps and tasks. Intelligence guiding systems can help preoperative planning with patient specific models, track progress during the procedure, and adjust plans and notify surgeons of any critical structures or hazards. Technology enablers are Intelligent video analysis, Scalable AI, NLP, AI accelerated analytics and GUI Graphical Overlays.Data Analysis will allow surgeons to integrate data over various surgeries and allow for improvements.
User Interfaces and Human Centred Design: This part of the experience allows surgeons to get the right information in the right way at the right time. During a surgery, Audio and video displays, UV overlays, sounds, buttons, haptics, warning messages are all competing with the surgeon’s attention. These need to be optimised and communicated to the surgeon in a seamless and intuitive way, otherwise it can affect surgical navigation. Technology enablers are Intelligent video analysis, NLP, AI accelerated analytics and GUI Graphical Overlays.
Summary
The immediate issues limiting the uptake of Robotic surgeries are cost, training of surgeons and limited evidence on clinical benefits. However, demand for minimally invasive procedures remains high post Covid and there is plenty of space for innovation. Features like portability will open up new increase use cases, and a sincere application of AI holds immense potential for advancements!
Future innovation will come from cross collaborations between academic institutions, startups and large corporations like Nvidia- already a leader in many of the input technologies that enable robotics surgeries. Watch this video for more details!