New Robotic Surgical Systems in Urology: An Update

Theodore Cisu; Fabio Crocerossa; Umberto Carbonara; Francesco Porpiglia; Riccardo Autorino

Disclosures

Curr Opin Urol. 2021;31(1):37-42. 

In This Article

Upcoming Systems

Verb Surgical

The creation of Verb Surgical in March 2015 started as a joint venture between Ethicon, the medical device company of Johnson & Johnson, and Verily, a life sciences research organization within the Google/Alphabet conglomerate (https://www.verbsurgical.com/about/). Ethicon is known for its surgical instruments, and Google's Verily has expertise in machine learning and visualization. In February 2019, Ethicon acquired Auris Health, a developer of robotic diagnostics and surgical devices initially used for lung cancer. At $3.4 billion, this was the largest private medical technology mergers and acquisitions deal in history (https://www.jnj.com/johnson-johnson-announces-agreement-to-acquire-auris-health-inc).

There are no publicly available details on the Verb robotic surgery platform other than its stated technology pillars, which include robotics, advanced instrumentation, enhanced visualization, connectivity, and data analytics & machine learning. What is known is that a working prototype was shown to Google and Johnson & Johnson executives in December 2019, and there are 300 employees working on its development as of 2019. Verb Surgical describes its next-generation digital surgery system as 'Surgery 4.0' where open surgery is surgery 1.0, laparoscopic surgery is surgery 2.0, and robotic surgery is surgery 3.0 (https://www.verbsurgical.com/media/).

Hugo

As the world's largest medical device company, Medtronic has been working on a robotic surgical system since it acquired German-based robotic system MiroSurge as part of the acquisition of Covidien in 2014 (https://newsroom.medtronic.com/news-releases/news-release-details/medtronic-acquire-covidien-429-billion-cash-and-stock-0/). Medtronic unveiled its robotic surgical system, Hugo, in September 2019 and highlighted its modular design and cost-effectiveness as key features (https://www.medtronic.com/us-en/transforming-healthcare/meaningful-innovation/science-behind-healthcare/robotic-assisted-surgery.html). Each of the robotic arms and system components, such as surgeon console are on wheels, and the system is designed to be upgradeable so that new systems need not be purchased in years to come. The surgeon sits in an open console with 3D-HD glasses.

Medtronic is not unfamiliar to the robotic-assisted surgery space, as it acquired Mazor Robotics in December 2018 and launched the Mazor X Stealth robotic-assisted surgical platform for use in spine surgery soon thereafter (https://newsroom.medtronic.com/news-releases/news-release-details/medtronic-announces-us-commercial-launch-mazor-x-stealthtm/). Medtronic purchased Digital Surgery (London, UK), a British surgical artificial intelligence company in February 2020. Digital Surgery created a platform for health professionals designed to be an interactive surgical simulator to provide 'a realistic and detailed guide to every step of a procedure' in preparation for surgery (https://digitalsurgery.com/2020/02/14/digitalsurgery-medtronic/). In June 2020, Titan Medical developed an agreement with Medtronic to provide access to intellectual property and license to the single-port SPORT Surgical System, with the stated goal that each company will continue to develop their own robot (https://titanmedicalinc.com/titan-medical-announces-development-and-license-agreements-with-medtronic-and-senior-secured-loan/). With original plans to start gathering clinical data outside of the United States in 2020, Medtronic has pushed back their preclinical deadlines by at least a year because of the COVID-19 pandemic.

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