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8 Types of Robotic Surgery Being Used Today

July 20. 2018. 7 mins read

The world changed forever in the year 2000. After Y2K ended up being quite benign, the Dot-com bubble burst, sending stocks into a tailspin that took years of recovery. The last original Peanuts comic strip was published following the death of Charles Schulz, meaning Charlie Brown will never kiss the Little Red-Haired Girl. The billionth living person in India was born, ensuring the subcontinent can support an inexhaustible supply of call centers. And in the last year of the 20th century, the U.S. Food and Drug Administration approved the first robotic surgery system. Since then, there are many types of robotic surgery devices being used by surgeons everywhere. As a result, things have taken off for companies like Intuitive Surgical, now a $60 billion dollar company as their shares have surged since the beginning of 2017:

Intuitive Surgical stock price over past 10 years
Intuitive Surgical takes flight

The da Vinci Surgical System from Intuitive Surgical (NASDAQ:ISRG) has been used in surgical procedures on more than five million patients. This made us wonder about what sorts of surgeries robots like these are taking part in. Let’s take a look at different types of surgeries being performed by FDA-approved robots today, and not just those built by Intuitive Surgical. 

Robotic Surgery for the Spine

Click for company websiteWhile there aren’t many robotic surgery stocks out there for retail investors, one that seems to be enjoying success similar to Intuitive Surgical is a “little-known” robotic surgery stock called Mazor Robotics (NASDAQ:MZOR) that now boasts a market cap of $1.65 billion with shares actually outperforming Intuitive Surgical over the past five years returning more than +350%. With devices having received FDA approval since way back in 2004, the company’s core technology today is used for spine and brain operations.

More than 30,000 procedures have been performed with Mazor Robotics technology with over 200,000 implants placed. Mazor currently collaborates with Medtronic (NYSE:MDT), a major medical device company that also happens to be a dividend champion which can be found in our dividend growth investing portfolio. We’re glad to see that Medtronic is staying on top of new technologies that will help fund those dividend increases we’re going to live off of when we decide to stop working and start waiting to die. Of course, for every Intuitive Surgical or Mazor Robotics, there’s a company like Accuray.

Update 09/25/2018: Mazor Robotics was acquired by Medtronic. We wrote about this corporate event in an article titled Medtronic Stock After the Mazor Acquisition.

Robotic Radiosurgery for Tumors

Click for company websiteFounded in 1990, Accuray (NASDAQ:ARAY) out of Silicon Valley went public in 2007 and raised $288 million. Today, it has a market cap of about $338 million having lost -86% over the last 11 years. The company’s flagship product is the CyberKnife system, which delivers precise (submillimeter) radiation treatment for people suffering from diseases like prostate cancer and something called trigeminal neuralgia, a chronic pain condition that may cause excruciating pain from even mild stimulation of the face. Back in 2001, the FDA approved the devices to be used for tumor removals anywhere on the body. Since then, the devices have been installed in more than 100 hospitals around the United States. Now, Accuray just needs to stop bleeding cash every year and turn this into a profitable venture. Investors can only wait and hope.

Robotic Surgery for Gallbladder Removals

Click for company websiteOne application for Intuitive Surgical’s da Vinci technology is removing gallbladders. The process involves making one small incision in your belly button and then yanking that puppy out with a swift tug. Actually, there’s a bit more to the process than that, but it is quite quick. The first gallbladder was removed by a surgeon in 2011 using da Vinci, a process that took just 60 minutes. Gallbladder removal is a commonly performed surgery which is also referred to as a “cholecystectomy”, and about 750,000 are performed every year in the US.

Robotic Surgery for Lung Cancer

Click for company websiteOkay, maybe this next application isn’t surgery per se, but it certainly could be with a few modifications. Founded in 2007 by the same man who started Intuitive Surgical, Auris Health had raised about $183 million when we first highlighted the company, still in stealth mode, back in 2016. Fast-forward two years later and the Silicon Valley startup has now raised a whopping $514 million. It has also unveiled its flagship robotic surgery platform – Monarch – which is a robotic endoscope that is controlled using a video game-like controller. (An endoscopy is a procedure that allows surgeons to access a patient’s body through small incisions or natural openings.) In March of this year, the device was approved by the FDA for use in diagnostic and therapeutic bronchoscopic procedures.

The Monarch Platform uses an endoscopic robot to detect lung cancer. Credit: Auris Health

The Monarch endoscope can snake through a person’s airways, all the way into the lungs, where the surgeon can get highly detailed visuals that can help detect lung cancer in its earlier stages. Only about a fifth of people who are diagnosed with lung cancer will survive for five years, but early detection gives them a better than 50 percent chance of survival, according to the American Lung Association. We like those odds.

Update 12/04/2018: Auris Health has raised $220 million in fresh funding led by Partner Fund Management to continue commercializing its robotic surgery platform. This brings the company’s total funding to $733.3 million to date. 

Robotic Surgery for Prostate Health

Click for company websiteWe wanted to title this section, “Waterboarding Your Prostate,” but apparently the SEO for that phrase isn’t so good. Still, it’s not entirely misleading, as PROCEPT BioRobotics out of Silicon Valley has developed an autonomous, heat-free waterjet system to remove enlarged prostate tissue, a condition known as benign prostatic hyperplasia. Founded in 2009, the company has taken in a large chunk of money—$200 million. About $118 million came from a mega venture round in February of this year.

The AquaBeam console, pump and articulating arm with handpiece.

The AquaBeam system uses what PROCEPT calls aquablation therapy, using water to remove the excess prostate tissue, a problem that affects about half of men over age 60. A surgeon first maps out the treatment plan using different ultrasound views of the prostate, while “sparring the anatomical landmarks responsible for continence and ejaculatory function.” We would hope so. The gold-standard treatment, TransUrethral Resection of the Prostate or TURP, does not sound like a very good alternative to us. From the Mayo Clinic:

A combined visual and surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The prostate surrounds the urethra. Using the resectoscope, your doctor trims away excess prostate tissue that’s blocking urine flow.

The AquaBeam system is reportedly the first FDA-granted robotic surgery platform for the treatment of enlarged prostates (also called Benign Prostatic Hyperplasia or BPH.)

Robotic Surgery – Ear, Nose, and Throat

Click for company websiteFounded in 2005, Massachusetts-based Medrobotics has taken in just over $181 million for their FDA-approved Flex Robotic System which was initially approved for use in ear, nose, and throat surgeries. We first came across the company in our article on 10 Robotic Surgery Companies which was published almost two years ago. Since then, they’ve received financing to expand into general surgery and have also received approval to use their device for “scar-free colorectal surgeries”.

In a fascinating side-story, the first time they successfully completed one of these surgeries, everyone went down to the pub to celebrate – as you do. The last person out of the building was the CEO, a dedicated man who has a habit of always being the last person to leave the building. Long story short, he catches some Chinese dude in there trying to steal trade secrets and holds him until the police arrive. It pays to work those long hours people.

Robotic Surgery for Orthopedics

Click for company websiteWe don’t know when THINK Surgical, Inc. was founded, or how much funding they’ve taken in. What we do know is that they develop, manufacture and market the only active robotic surgical systems for orthopaedic surgery. The systems include two components: a 3D workstation for preoperative planning, and a computer-assisted tool utilized for precise cavity and surface preparation for hip and knee replacement surgeries. The systems have been used in thousands of joint replacements worldwide since they were first put to use back in 1992.

Robotic Surgery for Hair Loss

Click for company websiteWhile we may be pushing the definition of “surgery” a bit here, what balding male wouldn’t be interested in a robot that builds a better head of hair, surgery or not? Last year we told you about an upcoming IPO for Restoration Robotics, a Silicon Valley startup that had developed the ARTAS system for transplanting hair for the follicly challenged, also known as bald dudes. The question you’ve probably been wondering since then: Did Elon Musk use the procedure?

Peter Thiel and Elon Musk looking nerdy as hell
A few good men

No idea. We do know that the Restoration Robotics (NASDAQ:HAIR) stock doesn’t look nearly as good as Elon Musk’s hair since its October 2017 IPO, with shares losing over half their value. The recent filing of a class-action lawsuit against the company probably won’t improve its near-future prospects. The lawsuit alleges that Restoration Robotics “negligently issued untrue statements of material facts to investors in connection with its IPO, including statements concerning certain product applications, and important information about the company’s salesforce.” As we always say: Buyer beware.

Conclusion

There are many other types of robotic surgery being performed, and companies like Intuitive Surgery are dabbling in everything from hysterectomies to kidney-sparing surgeries. In less than 20 years, robotic surgery has grown into a multi-billion industry. However, most of these platforms are still tools for assisting surgeons, with a human remaining in control behind the scenes. We’re waiting for the day when robotics and artificial intelligence become sophisticated enough (in other words, superior to a human surgeon) to operate on a patient autonomously. That would be mind-blowing—even for us bald dudes.

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  1. The authors completely missed one of the main orthopedic robotic systems in use today: Stryker’s Mako robot, a highly-regarded tool in use for some time now… Also missing: the Yomi dental robotic system in use for implants. And- what about CMR Surgical’s Versius system?