By Piergiulio Lauriano, Partner, Alira Health
The future of Robotic Assisted Surgery (RAS) looks bright as it continues to gain greater adoption in the operating room and diffuse across a wider range of minimally invasive procedures. This ongoing revolution will impact all OR suppliers from single patient use products to small and large capital equipment, not just RAS vendors. A recent study involving 73 hospitals in Michigan showed that from 2012 to 2018 the use of robotic surgery for common surgical procedures increased from 1.8% to 15.1%. The WW market is estimated to grow at an aggressive 13% between 2021 and 2030 reaching almost $21B with some western markets riding a high double digit growth rate.
In terms of RAS procedures, laparoscopy remains the largest market followed by orthopedics which results in better clinical evidence, and other niche specialties (ophthalmic, vascular, etc.). While endoluminal and microsurgery are still maturing, many expect they will become increasingly well adopted in the coming years.
Even though RAS acceptance continues to increase, concerns over its clinical benefits remain for many procedures: predominantly better patient outcomes during surgery; faster recovery time; and reduced complications and cost- effectiveness, with some studies showing that an episode of care may cost up to 25% more in RAS than in alternative techniques. Undoubtedly, hospitals that possess RAS platforms continue to increase their use; however, suppliers must continue to invest in proving clinical benefits and cost-effectiveness if they hope to accelerate adoption beyond Tier 1 hospital systems that are already considered a red ocean today.
Fortunately, beyond the incumbents there are 150+ and counting RAS companies between the commercial and clinical stage that are striving to prove the business case for the rest of us and will drive the expansion of the robotic market.
Business models are also evolving and while in the past the predominant recipe was an outright sale of the capital equipment, today suppliers have started to explore waived capital acquisition with disposable commitment models, pay-per-use, and subscriptions making the investment more affordable. Perhaps the answer to this challenge requires new entrants to understand what it takes to stay ahead of the curve. In the last 10 years, through several waves of mechatronic technology improvement, RAS value proposition for the surgeon revolved around precision and dexterity, requiring a quite extensive period of adaptation and training which does not fit all. Besides, the surgical outcome is still largely dependent on the human factors and may vary substantially from surgeon to surgeon. In the next 10 years, technologies such as AR and AI, coupled with more and more available data, will make RAS accessible to any surgeon reducing surgical outcome variability with minimal training required. Moreover, further improvement in mechatronics will enable a single RAS platform to perform a diverse and broad set of procedures.
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About the Author
Piergiulio has over 15 years of functional and domain experience advising healthcare and life sciences organizations on strategy, innovation, and business development, leveraging deep healthcare, finance, and technology background. His clients range from early-stage start-ups to Fortune 500 firms at the intersection of medical care and medical technology focusing on corporate strategy, portfolio innovation and prioritization, business planning, organic/inorganic growth, and diligence. Prior to Alira Health, Piergiulio was the Director of Strategy and Innovation at Unifarm and earned his MBA from IE Business School and Yale.