New Era of Smart Surgery, Innovation, and Market Growth

Topic/Category: Digital Surgery

While surgical markets are beginning to rebound from the negative impact of COVID-19, recent advances in digital technologies—including artificial intelligence (AI), machine learning, and augmented/virtual reality (AR/VR)—are propelling market growth to levels not seen in years, advancing revenues more than fourfold since 2014.

Digital Surgery: The Fourth Generation of Surgery

Digital surgery is an evolution of the robotic surgery market pioneered by Intuitive Surgical, which launched the groundbreaking da Vinci system in 1999 in Europe and in 2000 in the US to help surgeons perform more precise minimally invasive surgery using high-definition 3D vision and wristed instrumentation driven by robotic and computer assistance. 

Some consider digital surgery to be the “fourth generation of surgery” or “Surgery 4.0”; see figure below. 

With its ability to empower the surgical team with data science and analytics, new insights, and 5G connectivity, the modern operating room (OR)—transformed by “smarter” 4.0 digital technologies—can now reach greater levels of efficiency. 

Digital surgery technologies provide a host of benefits, such as:  

• advanced surgical navigation and visualization (e.g., using 3D and VR)
• more precise minimally invasive (MI) surgery
• reduction in surgeon variability and cognitive load 
• reduction in surgical errors
• improved communication and decision-making
• real-life 3D surgical simulations for interactive surgical team training 
  
  

Building a Digital Surgery Ecosystem

Recent technological advancements in minimally invasive surgery include the adoption of digital surgery ecosystems by several leading medical device companies dominating the robotic surgery space with well-known robotic-assisted surgery (RAS) platforms—such as Intuitive Surgical (da Vinci platform), J&J/Auris Health (MONARCH), and Medtronic (HUGO Robotic-Assisted Surgery, MAZOR X Stealth Edition). Next-generation robotic surgical systems have also entered the market via pivotal acquisitions of innovative startups, such as Verb Surgical and Orthotaxy (by J&J). According to LSI Medtech Pro data, J&J is expected to finally launch the new, multi-specialty Ottava system by 2024 (See Medtech Pro Deals Database), and the new VELYS RAS system received FDA 510(k) clearance in 2021 for use with J&J’s ATTUNE Total Knee System and the VELYS Digital Surgery Platform, a revolutionary new digital surgery ecosystem. 

Next-generation digital surgery ecosystems utilize AI, AR, and VR to transform surgeries into safer, smarter, less invasive, and more personalized interventions to improve healthcare delivery across the entire continuum-of-care while allowing surgeons to learn and improve through machine-learning and AI. These advanced systems are driving growth in the global digital surgical technologies market, and encompass the following six core technologies:  

• preoperative planning
• presurgical anatomical recognition
• intraoperative visualization
• surgical navigation
• workflow management 
• surgical performance analytics 

Opportunities for Growth

According to the recently published Medtech Pro Global Digital Surgery Technologies Market Report, the volume of robotic-assisted procedures continues to increase globally, and digital surgery offers an opportunity to expand into new and traditional areas of MI surgery, including oncology, orthopedics, and neurosurgery. Expansion into these areas will more than double the volume of robotic procedures (including soft-tissue abdominal and orthopedic surgeries), from an estimated 1.7 million in 2020 to approximately 3.9 million in 2025, based on the Medtech Pro Global Surgical Procedure Volumes (SPV) Tracker. This healthy rebound in surgical procedure volumes is also driving robust growth in digital surgery technology revenues.

Double-digit Market Expansion 

The global market for digital surgery technologies is substantial - estimated at approximately $5 billion in 2020. Driven by four key segments, the market is poised to grow at an 18% compound annual growth rate (CAGR), topping $12.5 billion by 2025. The four key segments (with estimated revenues in 2020), as defined by LSI Medtech Pro data, include:

• surgical robotics platforms 
• intelligent surgical robotics instrumentation 
• digital surgery planning solutions 
• surgical navigation & advanced visualization 

The largest segment, intelligent surgical robotics instrumentation, is compatible with robotic system platforms and accounted for slightly over half of total product sales in 2020.

Highest-Growth Segments

Two new technology segments that complement surgical robotics systems—digital surgery planning solutions and surgical navigation & advancement visualization—are expected to expand at the highest CAGRs of 51.2% and 80%, respectively, through 2025. Market drivers include a number of factors, including greater accessibility and technology adoption, affordability, and compatibility with robotic surgery platforms in the OR.

Influx of New Startups 

In the digital surgery planning solutions segment, growth will result from increased recognition of the true value of surgical planning and educational solutions by major institutions and providers—due to a reduction in surgeon variability, improvement in outcomes, and reduction in costs. This market will also flourish due to an influx of competitors, such as Activ Surgical, Caresyntax, and dozens more (see Medtech Pro Startup Tracker). In addition, startups are competing with systems developed from major medical device companies, such as J&J’s new VELYS Digital Surgery Platform for orthopedic surgery (helping to simplify knee replacement and hip/shoulder surgery), which connects surgeons and healthcare professionals throughout the entire continuum-of-care—from pre-operative, surgical planning, surgical implementation to post-operative monitoring.

According to the Medtech Pro Global Digital Surgery Technologies Market Report, growth of the surgical navigation & advancement visualization segment will expand at the highest CAGR of 80%. This is also a reflection of the ability of AI/AR/VR technologies to improve surgical performance and outcomes, particularly in complex surgical specialties, such as electrophysiology, neurosurgery, oncology, and orthopedics. Dozens of companies have also entered this space, offering advanced 3D, VR, and medical training simulators, including companies such as Surgical Theatre, Surgical Science Sweden AB, EchoPixel, Proximie, and Osso VR, leading the way (see Medtech Pro Startup Tracker). 

Examples of other innovative digital surgical technologies include those offered by Vicarious Surgical and Mimic Technologies/Surgical Science Sweden AB (see Medtech Pro Startup Tracker). Vicarious is developing a VR-based abdominal robotic MI surgery technology—the Vicarious Surgical Robot—that allows 360^∘ visualization, a flexible robotic arm that moves freely in all directions, and insertion of the flexible robot via a single port that only requires an ultra-small 1.5cm surgical incision smaller than a dime. The Vicarious system is not yet FDA cleared. 

Mimic Technologies offers AR/VR simulation platforms for surgeon training using the da Vinci RAS. The company partners with Intuitive and claims its virtual simulation training is used by nearly every surgeon who uses the da Vinci platform. The proprietary Mimic hardware and software systems reduce the learning curve and use extensive data and analytics to help surgeons evaluate their performance using MScore benchmarks.

The benefits of these advanced technologies may attract further acquisitions by major surgical robotics players, such as Intuitive Surgical, Medtronic and J&J, as they fiercely compete in the evolving digital surgery technologies market.

Several emerging digital surgical technologies companies presented at the LSI USA ’22 Emerging Medtech Summit that was hosted from March 15 – 18, 2022.

Positive Impact on Healthcare Delivery 

Overall, digital surgery is empowering the surgical team with smarter data driven by artificial intelligence, advanced instrumentation, visualization, and connectivity. This is resulting in fewer surgical errors and complications, which is improving patient outcomes for an ever-expanding realm of minimally invasive surgeries. As we witness smart technology transform hospital ORs while it becomes more efficient, accessible, and affordable, both hospitals and patients will benefit from improved healthcare delivery. As a result, LSI Medtech Pro analysts expect the highly competitive, multi-billion dollar Global Digital Surgery Technologies Market to continue to thrive, reaching new heights by 2025. For more information, including a comprehensive market and competitive analysis, see LSI’s recently published medtech report, Global Digital Surgery Technologies Market Report.