By Devon Philpott and Kamran Zamanian, iData Research
In the medical industry, the adoption of new advanced technologies is slow compared to other industries, such as the automotive industry.1 Computer-assisted surgery and robot-assisted surgery (CAS and RAS, respectively) have been around for decades, but a small percentage of the procedures performed take advantage of the innovative solutions available on the market today. In the coming years, the number of procedures using robotics and surgical navigation is expected to grow at a double-digit rate year-over-year to reach over 6 million procedures by 2028.2 This increase in CAS and RAS can be attributed to the expected increase in the use of navigation systems and robotic devices as more companies release new or next-generation systems for assisted surgery.
Reasons for Slow Adoption of CAS and RAS
Some argue that using CAS and RAS is not worth the investment of time and money because using this technology often increases procedure planning time and reduces the number of procedures a facility can perform. within a certain period of time.3 However, more and more studies have been published in recent years that highlight the clinical advantages of using CAS or RAS over unassisted surgeries. For example, the use of navigation for total hip arthroplasty (THA) procedures has been found to significantly reduce hip dislocations and the need for future revision surgeries compared to unguided surgeries.4.5 Other studies have shown that using RAS can significantly reduce recovery times, allowing patients to spend less time in the hospital after surgery.6.7 As more studies like this are published, the adoption of CAS and RAS is expected to increase.
An exception to these doubts concerns neurosurgical procedures; it is considered the standard of care that neurosurgeries use a navigation system. For this reason, the market for neurosurgical navigation systems has the highest adoption rate and poses a challenge for companies trying to enter the market by offering advanced robotic systems. In addition to the slow adoption of new technologies, robotic solutions tend to be much more expensive than navigational devices, some of which have an average selling price (ASP) of over $1 million for a robot, while navigation systems tend to be a fraction of that price. Cost.2 However, some companies, such as Brainlab, have developed affordable robotic solutions with competitive prices compared to navigation systems on the market.
Recent Advances in CAS and RAS
Since 2018, the FDA has granted several approvals in the US robotics and surgical navigation market, including clearances for devices as well as updated software modules. Companies that have obtained clearance for their navigation and robotics products include, but are not limited to, Auris Health, Brainlab, DePuy Synthes, Intuitive Surgical, Medtronic, Smith & Nephew, and Zimmer Biomet. These companies keep abreast of the market trends as they all developed procedure robots with the highest compound annual growth rate during the forecast period, according to the report by iData Research.2 Brainlab, Medtronic and Zimmer Biomet have developed robotic solutions for neurosurgery, while DePuy Synthes, Smith & Nephew and Zimmer Biomet have developed new robots to perform orthopedic procedures.
The minimally invasive surgery (MIS) segment of the robot-assisted surgery market is the largest, with approximately 85% of all robotic procedures performed in 2021 being minimally invasive.2 The robot-assisted MIS segment was dominated by Intuitive Surgical; however, more and more companies entered the market, seeking to compete with Intuitive’s da Vinci system. Both Auris Health and Medtronic have launched robotic solutions for MIS alongside several other competitors seeking to squeeze Intuitive Surgical’s market share. These product launches are expected to help increase the volume of robotic procedures as these companies are well established in the medical device industry.
Of all the navigated orthopedic procedures, THA has the lowest adoption compared to total or partial knee replacements.2 However, computer-assisted PTH procedures are expected to increase at the fastest rate due to the development of fluoroscopy-based navigation systems. These systems have gained immense popularity over the past decade, leading to an increase in THA procedures performed from a direct anterior approach.8 Although most of the navigated orthopedic procedures performed in 2021 were knee procedures, these procedures are expected to show a slower growth rate over the forecast period.2
Current adoption of CAS and RAS
Another major factor that influences the rate of adoption of CAS and RAS is the type of procedure. For minimally invasive robotics, urological procedures have the highest robotic penetration while cardiac procedures have the lowest adoption rate.2 Although there is a small margin of error for all surgeries, there is more caution for procedures that involve vital organs such as the heart, hence the low adoption rate. For spine surgery, adoption of CAS was nearly seven times higher than that of RAS in 2021.2 Interestingly, the reverse is seen for orthopedic surgery, where adoption of RAS was more than twice as high as CAS in 2021.2 The difference in trends observed for orthopedic and spinal surgeries is likely due to the many new robotic orthopedic systems launched recently, such as the VELYS robot-assisted solution from DePuy Synthes.
There is no doubt that as technology advances in the world, more surgeries will be performed using updated technological advancements. With the publication of long-term impact studies, new product launches and training programs, more patients and surgeons will feel comfortable opting for a computer-assisted or robot-assisted approach instead. than an unguided approach to their surgery. An increase in the volume of procedures is associated with an increase in disposable surgical costs, which is driving the overall robotics and surgical navigation market in the United States.
- Shaw B, Chisholm O. Crawling through the backdoor: Disruption in medicine and health. Before Pharmacol. 2020;11:818. doi:10.3389/fphar.2020.00818
- iData Research Inc. US Surgical Robotics and Navigation Market – 2022. Published June 17, 2022. Accessed June 17, 2022. [URL].
- Bakalar N. Are robotic surgeries really better? The New York Times. https://www.nytimes.com/2021/08/16/well/live/robotic-surgery-benefits.html. Published August 16, 2021. Accessed May 13, 2022.
- Agarwal S, Eckhard L, Walter WL, et al. Use of computer navigation in total hip arthroplasty is associated with a reduced rate of revision for dislocation: a study of 6,912 navigated THA procedures from the Australian Orthopedic Association’s National Joint Replacement Registry . Journal of Bone and Joint Surgery. 2021;103(20):1900-1905. doi:10.2106/JBJS.20.00950
- Sharma AK, Cizmic Z, Carroll KM, et al. Computer navigation for revision total hip arthroplasty reduces dislocation rates. JOIO. Published online February 24, 2022. doi:10.1007/s43465-022-00606-7
- Use of the da Vinci robot for minimally invasive surgery. Accessed May 13, 2022. https://www.adventisthealth.org/blog/2022/february/using-the-da-vinci-robot-for-minimally-invasive-/
- Ali M, Kamson A, Yoo C, Singh I, Ferguson C, Dahl R. Early superior clinical outcomes in robot-assisted TKA versus conventional TKA in the same patient: a comparative analysis. Knee surgery J. Published online February 18, 2022. doi:10.1055/s-0042-1743232
- Werner JA, Schwarz J, Werner LA. The evolution of anterior total hip arthroplasty: the past, the present and the future. NYU Hospital Bulletin for Joint Diseases. 2021;79(1):51-58. Accessed May 13, 2022. https://go.gale.com/ps/i.do?p=HRCA&sw=w&issn=19369719&v=2.1&it=r&id=GALE%7CA654815391&sid=googleScholar&linkaccess=abs
About the authors:
Devon Philpott is a Research Analyst at iData Research. She develops and composes syndicated research projects relevant to the medical device industry, publishing the US Robotic and Surgical Navigation series of reports.
Kamran Zamanian, Ph.D., is CEO and founding partner of iData Research. He has spent over 25 years working in the market research industry with a dedication to studying medical devices used in the health of patients around the world.
About iData Research
For 17 years, iData Research has been a strong advocate for data-driven decision-making within the global medical device, dental, and pharmaceutical industries. By providing customized research and consulting solutions, iData enables its customers to trust the data source and make important strategic decisions with confidence.