Intuitive Expects To See New Companies Enter Robotic Surgery Market: Dr. Myriam J. Curet

Robots are making their way into operating rooms around the world, acting as extensions of the surgeon. And minimally invasive surgery has become the go to procedure as it involves lesser risk and better results. A growing community of passionate and committed Indian surgeons are adopting the solutions in indication areas including gynaecology, urology, general surgery, and surgical oncology, among others. Today, India has more than 800 robotic-assisted trained surgeons.  Intuitive Surgical, a mainstay in the robotic-assisted surgery field has more than 94 da Vinci robotic-assisted surgical systems installed across major private and government hospitals.

How do you think the scenario of Robotic surgeries has evolved over the last couple of years in India? Also with new emerging players in the market with respect to surgical robots how does Intuitive plan to maintain its lead? 

India has been experiencing the rise of health technology, and that includes a remarkable increase in the adoption of robotic-assisted surgery, which mirrors the trend we’ve also seen globally. 

Intuitive has a history of working in India to bring robotic-assisted surgery to surgeons and their patients in India. In 2018, Intuitive made the commitment to sell directly in India, and established our Intuitive India headquarters in Bengaluru. 

Our mission in India aligns with our work around the world and is rooted in our belief that minimally invasive care is life-enhancing care. We have more than 25 years of experience in the thoughtful and careful development of technology to advance minimally invasive care. Collaboration with surgeons and their care teams remains key to evolving technology, and in India, we have collaborated with various surgeon societies and associations to help us support and enhance the ecosystem necessary for successful robotics programs. 

Intuitive expects to see new companies enter the robotic surgery market, considering the increase of surgeons and hospitals building robotic programs. However, we have always faced competition with other surgical modalities, treatments, and companies since our inception. We remain focused on improving patient outcomes, improving the patient and care team experience, and reducing the total cost to treat and we’ll keep that focus as additional competition enters the market. 

How do you think Robotic Surgeries can become more affordable in India? 

We are seeing a shift from cost-based services to value-based care models, and in our experience, hospital executives are thinking about the overall financial impact of all surgical options. We continually invest in supporting hospitals to help them optimise their investments in our technology by deeply understanding their needs and offering them technology that best meets their clinical requirements and budgets.  

To help them in that evaluation, Intuitive provides analytics that can help show how they can improve OR turn-around time and efficiency to maximise system utilisation while keeping patient safety at the forefront.  

Apart from that, another way to boost the affordability of robotic-assisted surgery is to build awareness around the inclusion of the latest surgical procedures such as RAS into all insurance solutions.  This will help new technologies reach their full potential in India, helping boost the effectiveness of its healthcare system. 

Do you think continuous training is enhancing RAS adoption in India?  

We find that Indian surgeons are eager to learn the latest technologies that medical science offers, and that willingness has greatly increased RAS adoption in India. What is important to the India market is not only introducing the technology, but also helping our customers establish robotics programs through Intuitive’s comprehensive ecosystem subsuming the training, services, and other support critical for successful programs. 

Training is a critical piece of the ecosystem and is based on the belief that surgical training is a journey not a destination and that surgeons and their care teams are at different levels during their career. Intuitive has used 25+ years of innovation and experience to refine the customer learning journey to provide a structured and measured training pathway for surgeons, physicians, and care teams.  

There are more than 60,000 surgeons trained on da Vinci robotic systems, and Intuitive’s training pathway provides a systematic learning journey that helps customers build technical proficiency. The learning journey consists of five training pathways supported by a diverse set of courses and engagements that are enabled by technology. These pathways are designed for surgeons and physicians, residents and fellows, OR care team members, patient side assists, and robotic program coordinators. 

We believe that our commitment to continued training for all members of the care team has been a catalyst for the RAS adoption in India.  

Is there a need for including RAS in the medical curriculum? What’s Intuitive for medical students?  

It is very important to introduce advanced surgical technology to surgical residents, as it will bring the latest global technology and surgical expertise to the patients in India.  

To build awareness about RAS among young surgeons, Intuitive India has collaborated with reputable medical institutions such as AIIMS Delhi to develop a program called ‘Intuitive Robotic Onboarding Program and Education’ (I-ROPE), which allows the surgical residents to get acquainted with RAS. This is a key step towards nurturing early adopters of advanced surgical technologies.  

In addition to programmes like I-ROPE, introducing robotic-assisted surgical technology into the medical curriculum for students could help support the next generation of India’s robotic surgeons, for those who choose that pathway. 

What do you think is the role of AI and data science in robotic-assisted surgery? How are you using AI and data analytics in your technologies? 

Intuitive is harnessing the power of Artificial intelligence (AI), Machine Learning (ML), and big data to help achieve our core goals of improving patient outcomes and enhancing surgeon and care team experiences. 

Today, data science is increasingly being used in surgical disciplines to help support the quality and value of care. As a result, surgical interventions are rooted not only in individual surgeon experiences, but also in objective decision-making based on data from diverse sources as part of the move toward personalised medicine. 

Using data science, robotic-assisted systems can provide surgeons with actionable data that may support their continued improvement and efficiency.  

Our products are designed to augment a surgeon's clinical decision-making and become better at using our technology. A great example of how Intuitive uses AI is our robotic stapler. With 1,000+ measurements per second, it makes automatic adjustments to the firing process to improve the quality and consistency of each stapling. With this, the surgeon can fire the stapler from the console while performing the RAS procedure.  

What are the future plans of Intuitive in India? Are there any new projects in the pipeline? 

To support the growing interest in robotic-assisted surgery in India, Intuitive continues to develop new products and solutions to help surgeons along in their learning journey. Early this year, we launched India's first remote surgical case observation technology, ‘Intuitive Telepresence’. This technology enables surgeons to learn from expert surgeons without the need for travel or time away from their busy practice. It uses proprietary technology that enables real-time exchange of audio and video between the remote observer and the operating surgeon. Through this, observers can be virtually present in the operating room where a procedure with our robotic system is being performed. 

We also introduced My Intuitive App, which serves as a single point of access for surgeons to their data. My Intuitive App captures surgeons' ergonomic preferences, timelines for cases, and instruments used. This data generated during the robotic-assisted surgical procedures performed using Intuitive’s robotic systems gets captured and is analysed to deliver actionable insights that surgeons can use to improve their skills and benchmark their performances against aggregated, anonymised data. 

As we look beyond 2022, we will continue to support our surgeon and hospital customers to better understand their needs and how we can continue to help meet these through enhancing our ecosystem and developing new programs and solutions.