A medical robot is a semi-automatic intermediate instrument which assists in performing some medical procedure. These include surgical robots, rehabilitation robots, bio-robots, pharmacy automation, disinfection robots and others. The field of medical robots is being dominated by the surgical robots. The market for surgical robots is growing with an explosive CAGR growth of greater than 20 % and is poised to reach a staggering USD 21,225.0 million by 2023.
The drivers of the medical robots market are segmented into technological and clinical. The clinical drivers are the demand for minimally invasive surgeries which has advantages such as lower degree of the trauma, faster recovery period, reduced risk of infection and thus reduced stay in the hospital. The other clinical driver of the market is the better ergonomic position reducing the physical strain on the physician’s hands. Increasing precision is another advantage of surgical robots with the robotic arm programmed to filter out any tremors in the physician’s hands. The surgical robots also filter out naturally occurring hand tremors by the robot’s computer software.
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The technological drivers include better hand-eye coordination and manoeuvrability due to rapid advances of robotics control systems. Another aspect where technology has improved is non-invasive imaging such as cardiac PET scan, cardiac CT scan and cardiac MRI. The miniaturization of the invasive surgical cameras coupled with the robots themselves is also an important market driver for surgical robots. A careful analysis of the trends of surgical robots reveal a very assuring picture. For instance, with the help of Da Vinci system surgical robots, a total of 563,000 procedures are performed in U.S. in 2016, of which 44% was in gynaecology, 33% was in general surgery, and 19% was in urology. The procedure performed outside U.S. accounts for 190,000. Another aspect where surgical robots have gained an upper edge is real time imaging using Positron emission tomography (PET), computed tomography (CT) and magnetic resonance imaging (MRI) etc. These allow the surgeon to operate with the surgical robot with a direct image of the condition.
The restraints of the medical robots are the abhorrent costs involved in performing a robotic surgery. Critics have also claimed that higher profit motive from companies and hospitals has driven the market, with patient needs and welfare being pushed under the carpet. Cost is the largest restraints of robotic surgery, which may increase by USD 1500 to USD 3000 as compared to traditional surgery. For example, for a robotic laparoscopic surgery, cost of a single robot may be about $2 million with disposable attachments may cost anywhere from $3,000 to $6,000 more than traditional laparoscopic surgery.
The surgical robots also have a steep learning curve, the situation which has been worsened by the lack of training surgeons receive. Medical colleges do not provide for the training due to low availability and volume of both surgical robots and robotic surgeries. The low availability of surgical robots coupled with low volume of robotic surgeries make mass training difficult. Other restraint is the lack of compatible instruments and equipment is also due to lack of standardisation. As robotic surgery is in its infant stage different systems use different standards of equipment and instruments thus increasing the cost of maintaining different accessories.
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Challenges and Opportunities
Product development is the most attractive strategy for the development of the market. Technological advancements will provide the highest returns on investment. Most of present surgical robots have large size and footprint with numerous mechanical joints which increases friction. Thus miniaturization of the system has achieved huge importance which will have the added advantage of reduced expenditure on infrastructure. Robotic surgeries also require different instruments and equipment compatible with the robots. The situation is made more complex due to the need to develop compatible software’s and newer computer algorithms. Using these will also involve greater use of micro sensors so as to make the robot sense the equipment which increases the challenge.
Remote surgeries involves operating on a patient who is at a different location than the surgeon. Remote surgery has the potential advantages of reduced costs, reducing the transit time for surgeons who are scarce. Remote surgery has huge utility in battlefields where the surgeon cannot go due to safety concerns. The development of advanced computer controlled system has increased the propensity of remote surgery where the surgeon operates from a remote location.
Thus attitude towards technology is an important determinant of the future of surgical robots. Attitude toward using technology and extrinsic motivation for users coupled with perceived utility of robotic surgery and its safety as well as efficacy and effectiveness remain strong deterrents for the surgical robots market. The costs and benefit analysis of surgical robots need to be analysed before their mass adoption by mainstream surgery. Thus behavioural attitudes and technological lag will affect the rapid adoption of robotic surgery. This lag will be more severe in the developing region market.
Competitive landscape and trends
The medical robot market is a highly consolidated market with Intuitive Surgical leading the market with its DaVinci surgical robots. The high growth and strategic nature of the market has resulted in numerous takeovers and collaborations. New players are also entering the field with Zimmer-Biomet & Medtech leading the list. Another entrant is Stryker who bought up Mako Surgical in 2013 so as to take advantage of skills and technology of Mako Rio robots. Another collaboration example is of Johnson & Johnson and Google. In December 2015, Google’s Alphabet and Johnson & Johnson announced the formation of Verb Surgical. Verb Surgical which takes advantage of the medical instrumentation technology developed by Johnson & Johnson, and the data and machine learning expertise of Google. Thus collaborations between companies has the advantage of reducing the development costs and risks.
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The U.S. is in a better position as the technological uptake is faster in the U.S. as compared to other regions which cannot be said of other regions of the world. U.S. also has a high expenditure on healthcare and also higher per capita income. Europe is another market to look at due to similar conditions. Germany is expected to lead the medical robotic market due to its large medical device industry. Thus medical robots require a research ecology with support of
The Asia pacific market particularly China and India is expected to drive the future growth. However Japan leads the Asia Pacific market due to high per capita income and developed infrastructure. Middle East is another market to target due to its high wealth and growing healthcare expenditure. The development of large hospitals such as King Fahd hospital in Riyadh is a stimulus to the market. The African market is however expected to generate low growth due to poor socio-economic conditions.
However we should also remember that each innovation has its challenges and surgical robots may be today, what microsurgery was some decades before. Thus development of surgical robots have huge potentialities to a point of becoming a mainstay of surgical speciality, opening up new vistas
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