In the medical industry, adoption of new cutting-edge technology is slow compared to other industries, such as the automotive industry. Computer-assisted and robotic-assisted surgery (CAS and RAS, respectively) have been around for decades, yet a small percentage of procedures performed take advantage of the innovative solutions available on the market today. In coming years, the number of procedures using robotics and surgical navigation is predicted to increase at a double-digit rate year over year to reach over 6 million procedures by 2028. This rise in CAS and RAS can be attributed to the predicted increase in the utilization of navigation systems and robotic devices as more companies launch new or next-generation systems for assisted surgery.
Figure 1: Number of procedures using navigation systems and robotics in the United States from 2018-2028. Access iData's U.S. robotics and surgical navigation market report to view more granular data.
Reasons For Slow CAS And RAS Adoption
Some argue that using CAS and RAS is not worth the time and monetary investment, as using this technology often increases procedure planning time and reduces the number of procedures a facility can complete in a certain time frame. However, more studies have come out in recent years that highlight the clinical benefits of using CAS or RAS compared to unassisted surgeries. For example, it has been found that using navigation for total hip arthroplasty (THA) procedures significantly reduces hip dislocations and the need for future revision surgeries compared to unguided surgeries. Other studies have shown that using RAS can drastically reduce recovery times, allowing patients to spend less time in the hospital post-operation. As more studies like this are published, adoption of CAS and RAS is expected to increase.
An exception to these doubts is neurosurgery procedures; it is considered to be the standard of care that neurosurgeries use a navigation system. Because of this, the neurosurgery navigation system market has the highest adoption rate and poses a challenge to companies attempting to penetrate the market by offering state-of-the-art robotic systems. In addition to the slow adoption of new technology, robotic solutions tend to be much more costly than navigation devices, some of which have an average selling price (ASP) upwards of $1 million for one robot while navigation systems tend to be a fraction of that cost. However, some companies, such as Brainlab, have developed affordable robotic solutions with pricing that is competitive with navigation systems on the market.
Figure 2: Comparison of average selling price (ASP) for navigation systems and robots for procedure types that have both applications. Access iData's U.S. robotics and surgical navigation market report to view more granular data.
Recent Advancements To CAS And RAS
Since 2018, the FDA has made several approvals in the U.S. robotics and surgical navigation market, including clearances for devices as well as updated software modules. The companies that were granted 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 are staying up to date with market trends as they have all developed robots for procedures with the highest compound annual growth rate over the forecast period, according to the iData Research report. Brainlab, Medtronic, and Zimmer Biomet have come up with 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 robotic-assisted surgery market is the largest, with approximately 85% of all robotic procedures performed in 2021 being minimally invasive. The robotic-assisted MIS segment has been dominated by Intuitive Surgical; however, more companies have entered the market, looking to compete with Intuitive’s da Vinci system. Auris Health and Medtronic have both released robotic solutions for MIS alongside several other competitors looking to chip away at Intuitive Surgical’s share of the market. These product releases are anticipated to help drive robotic procedure volume as these companies are well established in the medical device industry.
Of all navigated orthopedic procedures, THA has the lowest adoption compared to total or partial knee arthroplasties. However, computer-assisted THA 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 last decade or so, which in turn led to an increase in THA procedures performed from a direct anterior approach. Although most navigated orthopedic procedures done in 2021 were knee procedures, those procedures are expected to exhibit a slower growth rate over the forecast period.
Current CAS And RAS Adoption
Another major factor that impacts the adoption rate of CAS and RAS is the procedure type. For minimally invasive robotics, urological procedures have the highest robotic penetration while cardiac procedures have the lowest adoption rate. While there is a small margin of error for all surgeries, there is more caution taken for procedures that involve vital organs such as the heart, hence the low adoption rate. For spinal surgery, the adoption of CAS was nearly sevenfold higher than that of RAS in 2021. Interestingly, the opposite is seen for orthopedic surgery, where RAS adoption was over two times higher than CAS in 2021. The difference in trends seen for orthopedic and spinal surgeries is likely due to the several new robotic orthopedic systems released recently, such as DePuy Synthes’ VELYS Robotic-Assisted Solution.
Figure 3: Adoption rates for robotic-assisted and computer assisted surgery in the U.S. in 2021. Contact iData Research for more granular data.
Conclusion
There is no doubt that as technology advances across the globe, more surgeries will be performed that make use of the updated technological advancements. With the release of long-term impact studies, new product launches, and training programs, more patients and surgeons will feel comfortable opting for a computer-assisted or robotic-assisted approach over an unguided approach for their surgery. An increase in procedure volume is coupled with an increase in disposable surgical costs, driving the overall robotics and surgical navigation market in the United States.