According to Markets and Markets, a market consulting and research agency, the global medical robot market is expected to exceed US$22.1 billion in 2027 (data for reference only). The medical robotics industry has a bright future, and has a high degree of gathering of technical resources, industrial resources and financial resources. In this industry, more highly competitive products will emerge.
Medical robots can be roughly divided into four categories: surgical robots, rehabilitation robots, auxiliary robots, and service robots.
This article will mainly focus on the seven overseas surgical robot companies that have been approved in recent years from the field of surgical robots.
- Medrobotics
“Fortune” magazine once expressed its opinion on the prospect of the future robotics industry, and the laparoscopic surgery capabilities of robots will be stronger than humans. Colorectal cancer is currently the third most common cancer in both sexes. Morbidity and mortality have been declining since 1980 due to improvements in screening and prevention. In 2021, the American Cancer Society estimates that approximately 104,270 new cases will be diagnosed. Therefore, colorectal cancer screening is very necessary.
Medrobotics is a company that provides colorectal cancer surgery solutions. It uses a flexible robotic arm robot to perform rectal scene inspection and surgery. Some clinical studies have shown that laparoscopy is feasible for colon surgery, but it is very difficult for rectal surgery because of the narrow pelvic space, and laparoscopy is not non-inferior to open rectal surgery. Rectal surgery requires the next generation of flexible robots through the natural orifice. Medrobotics is one of them. The company has gone from cardiovascular, oral, and gastrointestinal surgery all the way to digestive tract surgery, directly competing with Da Vinci’s SinglePort, and the company has developed very hard.
Founded in 2005 and headquartered in Massachusetts, USA, Medrobotics exclusively licenses the Flex®️ robot system, which passed FDA approval in July 2015. Its Flex® robot system obtained the European CE certification in 2014.
- EndoMaster
Gastrointestinal mucosal surgery will gradually be performed by gastrointestinal robots. For example, mucosal resection or mucosal dissection is an important way to treat gastrointestinal tumors. Ordinary endoscopic techniques do not have enough freedom at the end of the device and lack stability during the intraoperative suturing phase due to insufficient field of view. Mucosal dissection under ordinary endoscopy will also have some complications, such as muscle perforation.
The EndoMaster EASE system can effectively remove gastrointestinal tumors through endoscopy without the need for surgical incisions. In September 2020, the team performed the first endoscopic submucosal dissection of the colon using a flexible endoscopic robotic system. The EndoMaster start-up team came to Nanyang Technological University, Singapore. The CEO of the company, Seow Ping, worked for Johnson & Johnson from 1999 to 2010 and served as the general manager of Johnson & Johnson in Singapore.
- Cybernife®️
In the process of radiotherapy, there are many factors that adversely affect the accuracy, the most common example is the effect of breathing. The accuracy algorithm of the treatment equipment directly determines the quality of the clinical curative effect. How to match it to minimize the clinical treatment error and improve the clinical efficiency is the primary problem that radiological equipment manufacturers need to solve.
As an intelligent radiosurgery robot, CyberKnife®️ can track the inevitable displacement of the target area and can adjust the position of the radiation synchronously for treatment, ensuring the accuracy of the treatment. The robot’s detection of displacement changes and high-precision machine displacement control can automatically correct the target area without interrupting treatment or user intervention.
CyberKnife®️ equipment takes up a lot of hospital space, and the tumor volume of the indication is limited, which is one of the problems to be solved in terms of the efficiency of the equipment. For example, the long duration of radiotherapy resulted in “less than 1 cm burn in 4 hours”, or it may be the reason for the limitation of clinical application.
CyberKnife®️ was approved by the FDA in 1999 for intracranial treatment, and has been expanded to extracranial since 2001. So far, more than 400,000 patients worldwide have been treated with CyberKnife®️. CyberKnife®️, its parent company, Accuray, also has product lines such as the TomoH series of helical tomotherapy systems and the Radixact series of helical tomotherapy systems.
- ZAP Surgery System
It can be said that ZAP-X® and CyberKnife®️ are “students from the same school”, both of which were developed by John R. Adler, a professor of brain surgery and radiation oncology at Stanford University. Zap Surgical is mainly used for non-invasive treatment of brain, head and neck tumors. In 2017, ZAP-X received FDA 510k filing. In April 2018, ZAP-X entered the green channel for innovative medical devices of China Food and Drug Administration. In early January 2020, before the national first-level prevention of new coronary pneumonia was closed, 2 patients received Zap-X robot treatment at the First Medical Center of the PLA General Hospital in Beijing.
The ZAP-X® Gyroscopic Radiosurgery Platform is believed to be the first and only SRS delivery system without shielded exterior walls, eliminating the need for suppliers to build costly shielded radiotherapy bunkers. Utilizing modern linear accelerators to generate radiation, ZAP-X® is the first and only dedicated radiosurgery system that does not require cobalt-60 radioactive sources. Huge costs for licensing, fixing and regular replacement of radioisotopes are no longer necessary.
In January 2020, Zap Surgical Systems announced the completion of a round of equity funding for a total of $81 million. The round was led by Primavera Capital Group with participation from GT Healthcare Capital Partners, Chow Tai Fook Enterprises, Shanghai Bay Capital and Hogy Medical, with existing investors Foxconn Technology Group and Varian Medical Systems also joined them.
- Cambridge Medical Robotics (CMR)
Robotic-assisted heart surgery, such as percutaneous mitral valve repair, has the advantage of being minimally invasive and requiring no open chest. Because the chest wall is not involved in suturing, the pain is greatly reduced, the risk of infection and bleeding is greatly reduced, and the recovery time is shortened. At present, some top hospitals in China have the ability to carry out such minimally invasive surgery assisted by robots.
Heart valve surgery is more complicated, and the number and orientation of wounds in different surgical approaches require high precision. Surgical robots can complete precise resection and suturing through small incisions under control. The British unicorn CMR surgical split robot has relatively obvious advantages in this type of surgery. Multiple CMR robotics can meet the needs of multiple channels, and this robot does not occupy as much area as Da Vinci. The agility and lower cost of CMR surgical, which can move at any time, also make them a possible challenger to Da Vinci.
Cambridge Medical Robotics was founded in 2014 and is headquartered in Cambridge, UK. The company is committed to developing the next generation of general robotic systems for minimally invasive surgery. The company hopes that by expanding the range of robotically performed procedures, minimally invasive surgery can serve more people, and the cost of surgery is affordable and within the range of consumers. This system will change the status quo of the robotic surgery market. Its founder and CEO, Martin Frost, is a Cambridge University graduate, Chartered Management Accountant and experienced business entrepreneurial leader. He has participated in the establishment and management of 6 medical device and sensor companies, and has rich experience in entrepreneurship and financing. Several other founders of the company also have 10-20 years of entrepreneurial business or engineering experience.
In June 2021, CMR Surgical completed a financing of 425 million pounds equivalent to nearly 4 billion yuan. The financing was led by investors from Softbank and Ally Bridge Group.
- Auris Surgical Robotics
Auris is a medical device company dedicated to the development of low-invasive surgical interventional products to improve the precision of surgery and reduce surgical trauma. The co-founder and CEO of the company, Mr. Frederic Moll, is well-known because he once successfully operated another instrument company, Intuitive Surgical, which brought the Da Vinci surgical robot, which was once considered unsurpassable. The core product of Auris Health, Monarch™ endoscopic robot, can be applied to tissues and organs in the human body that are more complex and difficult to reach with general equipment.
Monarch™ has been approved by the FDA on March 23, 2018. The device can be used for diagnosis and treatment of bronchoscopic surgery. At present, the system focuses on lung cancer, and will target the treatment of various diseases in the future. The Monarch™ system is not only a robot platform, it is different from the one-handed operation interface of the traditional endoscopy system in the past. The system uses an interface similar to a game remote control, allowing doctors to more directly control the device, and integrates robots, software , data science, visual imaging and other advanced technologies enable the endoscopic field of view to have a wider reach.
- NeuroBlate
Glioma is an extremely common primary malignant brain tumor in adults, and despite intensive research over the past 50 years, patient survival remains poor. Among them, glioblastoma is the most common primary brain tumor, but the survival rate of patients after treatment is currently low. Currently, surgery is usually the initial treatment of choice. Although further tumor resection may confer a survival benefit, even in the setting of recurrence, the potential surgical risks must be weighed, especially in terms of neurologic deficits and wound-healing complications. It has become a clinical pursuit and a better treatment option.
Laser Interstitial Thermal Therapy (LITT) is a new minimally invasive technique for a variety of intracranial lesions. Epileptic foci in nuclei and white matter, etc. LITT uses magnetic resonance (MR) thermometry to deliver heat in a controlled manner through a stereotaxic laser probe to surrounding brain tissue.
The NeuroBlate system of Canada’s Monteris Medical can be used to treat brain tumors and epilepsy. It is currently the only minimally invasive system that uses MRI-guided robotic laser ablation for neurosurgery. NeuroBlate provides patients with precise ablation of brain lesions without the need for open neurosurgery and in a procedure that minimizes damage to nearby healthy tissue. The system includes hardware, software and consumables, etc.