Robotic surgery systems offer precise, accurate, and easily replicated results that can greatly assist surgeons and improve patient outcomes. The term “robotic surgery” is often viewed as an autonomous robot completing the procedure without human interaction, however it is important to note this is not the case in most systems. Robotics-assisted surgical systems are guided by professional, certified surgeons to facilitate the procedure being conducted. These systems are proliferating rapidly as of recent, and the Food and Drug Administration (FDA) is clearing more each year. In this article, DocWire News has compiled the top five robotic surgery systems currently being used by physicians.
In 2000, Intuitive’s da Vinci Surgical System was the first robotic surgery device to gain FDA clearance for use in general laparoscopic surgeries. The da Vinci Surgical System allows surgeons to perform various minimally invasive procedures with clinically supported precision and accuracy. The system applies to a wide array of operations, including minimally invasive cardiac, colorectal, gynecology, head and neck, thoracic, urology, and general surgeries. The surgeon operates via the Surgeon Console that controls the Patient Cart’s robotic devices, including various surgical instruments and a camera.
Over 1,700 da Vinci Systems are currently installed in hospitals internationally, and more than 775,000 patients have received procedures from this robotic surgical system. With roughly 75 percent of all prostate cancer operations in the U.S. being performed using da Vinci devices, this robotic platform has established itself as an effective and reliable tool.
Ion, another robotic surgical system by Intuitive, received 510(k) clearance from the FDA in February 2019. The device is a robotic endoluminal system, designed to let surgeons perform minimally invasive biopsies deep in the lung. The robotic catheter is used by the physician to navigate through the small and intricate airways of the lung to reach areas of interest. Biopsy tools, such as forceps and needles, fit inside of the catheter and use it as a guide to reach the targeted lung tissue. Ion utilizes fiber optic shape-sensing technology to allow robotic control of the catheter’s position during the navigation process. The catheter locks in upon reaching the desired area, providing unprecedented stability needed for biopsy precision. Ion’s catheter moves 180° in all directions to allow fine-tuning in biopsy precision.
The Mako System is a robotics-assisted surgical device that currently offers partial knee, total hip and total knee operations. The pre-operative planning process allows for accurate implant positioning, using data from a CT scan to generate a 3D model of the patient’s bone structure. This yields a plan unique to the individual patient that the physician can review before operation. Modifications may need to be made regarding the optimal implant placement, with data being collected during the operation and applied to the CT scan model. The initial creator of the technology, Mako Surgical Corporation, was acquired by Stryker in 2013 for $1.65 billion.
The NAVIO Surgical System also uses robotic-assisted technology to assist with total knee replacement procedures. Rather than using preoperative CT-scans, bone mapping is achieved during the operation to yield a 3D representation of the bone structure. This software model is used by the surgeon to virtually position the implant and balance tissues prior to cutting bone. The surgeon then uses a robotics-assisted hand tool to guide the procedure based on the bone mapping. The NAVIO Surgical System received 510(k) clearance from the FDA in April 2018.
Smith & Nephew recently collaborated with Osso VR, a surgical training company, to create a module for the NAVIO Surgical System. This module is designed to be used by practicing surgeons and residents who are learning the robotics-assisted procedure and involves clinically supported virtual reality (VR) simulations of the procedure.
Dr. Cyril (Jay) Kruse, Medical Director of Orthopedic Surgery at Unity and Mercy Hospitals, evaluated both the Mako and NAVIO systems and prefers NAVIO for both its precision and the fact that patients do not need to undergo CT scans. He notes that the CT scan is not only a time-consuming and costly procedure, but it exposes patients to harmful radiation as well.
Auris Health’s bronchoscopic device, the Monarch System, received 510(k) clearance from the FDA in March 2018. The robotics-assisted system incorporates a video game-like controller into the procedure, with the surgeon using it to navigate a flexible robotic endoscope throughout the branches of the lungs. Offering continuous bronchoscope vision, computed guidance and precise control of instruments, this system offers an innovative new technology to perform lung endoscopic procedures. It also aggregates the traditional endoscopic viewpoints with computer guided navigation based on 3D models unique to the patient.
In 2013, Johnson & Johnson’s Ethicon subsidiary acquired Auris Health for $3.4 billion. The deal included an additional $2.35 billion in contingent payments, bringing this total to a staggering $5.75 billion.