News and Insights

Robot-Assisted Surgical Systems Provide a Growing and Profitable Niche for Investors in Health Care 

History shows that surgical techniques will only continue to advance. Credit Suisse Asset Management sees a range of investment opportunities to ride the wave of success together with medical device startups, existing robotics-assisted surgical companies and the architects of artificial intelligence. 

It is difficult to imagine how researchers could possibly push the barriers of medicine beyond the realms of organ transplants, fetal surgery and 3-D printed tissue. However, robot-assisted surgical systems are that next step toward the future.

Dr. Russell Taylor is a John C. Malone Professor at Johns Hopkins University, one of the most prominent research institutions in the US. He is recognized internationally as the father of medical robotics and one of only a handful of global influencers to win the Honda Prize for his contribution to a new generation of technology (other notable winners include Benoit Mandelbrot and Carl Sagan).

Dr. Taylor is confident that the next generation of computer-integrated surgical systems will become commonplace in the next five to ten years. “It won't be like turning on a light,” he notes. “It is an evolution, but things are happening very rapidly.”

A multiyear collaborative initiative among researchers at Johns Hopkins University, Carnegie Mellon University and Vanderbilt University is driving change that will take intelligent surgeon-robot partnerships from the lab and into the operating room. The research is funded by the US National Science Foundation’s National Robotics Initiative, the purpose of which is to promote symbiotic relationships between robots and their human partners.

A Development Towards Robot-Assisted Surgery

The development of surgical procedures throughout history has had its ebbs and flows, but each phase of growth has been transformational. For instance, in the mid-nineteenth century, the introduction of anesthesia and open surgery made practices such as leeching and whiskey-shot amputations a thing of the past.

Less shocking but equally transformational was the shift toward minimally invasive surgery in the 1980s. These procedures, such as laparoscopies and endoscopies, eliminate the need for large incisions, reduce the threat of infection, speed recovery, cost less and have a higher rate of success.

Robotic surgery milestones

However, inherent limitations continue to prevent the blanket use of minimally invasive procedures. These limitations include the absence of sensation or touch, a constricted field of vision and limited surgical dexterity.

Throughout the last decade, robots have become the tool of choice for many surgeons when conducting minimally invasive operations. Remote surgery has given surgeons the ability to view real-time images via a control panel. By virtually manipulating these images, a surgeon directs the movements of the robot; in turn, the robot moves the tools in tandem with the surgeon, albeit in a reduced and more precise manner. This first generation of robotics-assisted surgeries has delivered significant benefits. But a sense of touch is not one of them.

However, Dr. Taylor believes that change is on the horizon: “Robotic systems can help surgeons overcome many of the sensory-motor limitations commonly found in present-day surgery.”

Recent advances have given robots the ability to sense and interpret forces exerted by tools onto tissue during minimally invasive procedures. This is a critical development, since force feedback is integral to palpating an organ and confirming the existence and location of a tumor.

Robot-assisted palpation techniques will help speed discovery and confirm the location of organ abnormalities. Although these methods are currently programmed explicitly, it is possible that robots will eventually have the capacity to learn palpation techniques through experience.

Researchers at Carnegie Mellon University who are participating in the advancement of computer-integrated surgical systems are focusing their efforts on the dexterity provided by a flexible system of robotics. The Flex® Robotic System, often referred to using the more illustrative moniker “snake robot,” is a highly articulate and dexterous robot system that received European CE marking clearance in 2014 and was approved by the US Food and Drug Administration in 2015.

The foundation of success, Dr. Taylor emphasizes, is the three-way partnership between the surgeon, the technology (or robot) and the information that is generated prior to and during the surgery. The system is incomplete without this information, since the robot and the surgeon will both rely on that steady stream of data to make decisions that will optimize the outcome of the surgery.

Investing In Robot-Assisted Surgery

According to The Lancet Commission on Global Surgery,1 more than 10% of the EU’s population undergoes some type of surgical procedure each year; in terms of the US population, the US Center for Disease Control estimates that number as closer to 15%.2 Together, that represents nearly 125 million surgical procedures each year. As technology advances, the natural progression will no doubt be a continued shift from inpatient, open surgical procedures to minimally invasive surgery.

Thanks to open-source research being carried out in the US, the UK, Korea, Hungary and a number of other countries, advances in computer-integrated surgical systems are sure to continue at a rapid pace, creating a win-win situation for all stakeholders.

Patients will benefit from less risk, improved outcomes and quicker recovery times. For hospitals, this will translate into a more efficient use of resources and corresponding cost reductions.

History shows that surgical techniques will only continue to advance. Investment opportunities exist to ride the wave of success together with medical device startups, existing robotics-assisted surgical companies and the architects of artificial intelligence.