Robotic surgery market shakes up with Medtronic’s Hugo

Guy’s and St Thomas’ hospital was the first UK NHS trust to adopt Medtronic’s new Hugo Robotic-assisted Surgery (RAS) system. 

Having the largest robotic surgery programme in the country and adding Hugo to the trust’s arsenal gave it seven robots that operate across six specialties. The hospital’s other RAS systems include CMR Surgical’s Versius robot, and four of Intuitive Surgical’s da Vinci robots. 

One of the first patients to benefit from the device at Guy’s and St Thomas’ was 70-year-old professor of palliative care, Rob George from Honor Oak Park in southeast London, after being diagnosed with prostate cancer and requiring a prostatectomy. 

“We carry out the most robotic operations in the NHS with more than 1,500 cases a year,” said Ben Challacombe, clinical lead for robotic surgery at Guy’s and St Thomas’. “Expanding our robotics programme with Hugo allows us to offer the benefits of this technology, including fewer complications and smaller scars, to even more patients.” 

The use of Hugo involves the surgeon sitting at an open console, which displays a high-definition 3D view and allows them to precisely control the robotic arms and instruments. Surgical training on the device is delivered by Proximie. Via the platform, surgeons can view live surgeries without the need to be physically present. They can also access recordings of previous surgeries, providing opportunities to develop the necessary expertise to use the system.

The surgical robotics market was worth $8.6 billion in 2022, and by 2030, it is forecast to have grown at a compound annual growth rate of 8% to $15.8 billion

In October 2022, Medtronic received a general surgery indication in Europe and Canada and the Ministry of Health, Labour and Welfare approval for use in gynecologic and urologic procedures in Japan, tapping into a lucrative market that has been dominated exclusively by Intuitive Surgical for almost two decades. 

The company is expecting a growing number of laparoscopic hernia repairs to be performed via robotic surgery. Hernia surgery is the fourth most common operation in the world and a fast-growing market. 

“Our biggest goal is expanding access to care, and robotic systems have the ability to enable more people to receive general surgery overall,” Dr. Carla Peron, chief medical officer of Medtronic’s Surgical Robotics, tells Medical Device Network.  

“We know that healthcare systems are in a tough position and the cost of health can be high. But slowly, payors are getting more comfortable with robotic surgery as we publish more evidence of the benefits of the procedure, such as reducing the length of stay.” 

Globally, 4% of surgeries are performed with the assistance of a robot, and in Western Europe, 2% of procedures are done robotically, while the majority, 65%, are open surgeries, with others performed via traditional minimally invasive surgery. 

RAS is touted as having several benefits over laparoscopic surgery in hernia repair, as the robot can provide three-dimensional images of the inside of the abdomen and surgeons can use stitches to sew tissue and mesh inside the abdomen. The patient is also left with tiny scars, compared to one large incision scar. 

In comparison to the da Vinci robot, Medtronic’s Hugo utilizes a modular, multi-quadrant platform that combines wristed instruments, 3D visualization, and a cloud-based surgical video capture option. 

Market leader Intuitive will no doubt be keeping an eye on Medtronic’s expansion as it continues to recover from the pandemic, which saw postponement of non-urgent procedures and supply chain difficulties that slowed production of the company’s systems. 

“The market leader of general surgery robotic surgical systems is still Intuitive Surgical and will remain so for the foreseeable future. However, I think Medtronic is in a strong position to start changing that by capitalizing on its established global sales channels, improved product designs, e.g., portability of the Hugo RAS over the da Vinci system, and a growing list of marketed countries and indications of use,” says GlobalData Senior Medical Device Analyst Brian Hicks.  

“With a growing list of indications for use, there will be greater interest among hospitals to purchase these systems and this will accelerate the growth of the robotic surgical systems market.”

In the UK the government pledged a £21 million fund to roll out artificial intelligence across the National Health Service (NHS) – giving NHS staff the latest AI technology to diagnose and treat patients more efficiently. 

On average 600,000 chest X-rays are performed each month in England, and with the distribution of diagnostic AI tools, NHS Trusts clinicians will have the ability to diagnose cancer patients earlier on. 

Eager about the fund and its potential to improve cancer imaging Dr Katharine Halliday, President of the Royal College of Radiologists said: “There is huge promise in AI, which could save clinicians time by maximising our efficiency, supporting our decision-making, and helping identify and prioritise the most urgent cases. Together with a highly trained and expert radiologist workforce, AI will undoubtedly play a significant part in the future of diagnostics.” 

By incorporating AI into the diagnostic workflow, radiologists can obtain additional insights and validation, reducing the occurrence of false positives and false negatives. This collaboration between human expertise and AI assistance enhances diagnostic confidence and helps ensure that patients receive the most appropriate care. 

There have also been other investments in AI tools. “The UK government has recently invested £16 million; nine companies were given funding through the AI in Healthcare Awards. The winners included AI systems that help detect cancer, diagnose rare diseases, identify women at high risk of premature birth, and support the treatment of neurological conditions like dementia,” said Alexandra Murdoch, medical analyst at GlobalData. 

In the EU the European Commission has rolled out its Europe’s Beating Cancer Plan: Launch of the European Cancer Imaging Initiative. Creating a digital infrastructure connecting resources and databases of cancer imaging data across the EU. The project is starting with 21 clinical sites from 12 countries and includes two projects, the EUCAIM project and the AI Testing and Experimentation Facility for Health. 

In North America, the US and Canadian governments are investing in AI initiatives too. “I think any initiative that aims to help healthcare professionals ease their workload while also improving cancer screening is a good one.” Sharing her thoughts on Europe’s Beating Cancer Plan Murdoch added, “I do think that they may run into a few issues along the way because there are not yet a lot of initiatives like this, so they are kind of paving the way so to speak. But I think we will see a lot more of these types of programs in the future.”

In drug development, every storage location and every transport hub is a supply chain risk, Walsh added. As demand for new treatments outpaces transport and manufacturing capacity, the stakes of supply chain management are quickly rising, he said.