Vicarious Surgical is going public in a special purpose acquisition company (SPAC) deal, and is now set to trade on the New York Stock Exchange as RBOT after merging with D8 Holdings. The listing comes a year and a half after the US Food and Drug Administration (FDA) granted breakthrough device designation to Vicarious’s surgical robot, the first such device to be recognised in this way.

The company was founded in 2014 and is aiming to combine innovations in both robotics and virtual reality (VR) to develop a new tool for minimally invasive surgery. Its system boasts nine degrees of freedom per arm with 360° visualisation, all possible through a 1.5cm incision. The robotic arms are designed to replicate human motion, making the system as intuitive to use as possible for surgeons.

D8 Holdings’ acquisition of the company will add over $425m to Vicarious’s balance sheet upon the deal’s close. Pipe investors include BD, Khosla Ventures, Innovation Endeavours, E15 VC and Bill Gates.

Vicarious Surgical co-founder and CEO Adam Sachs said: “Our robot can see, reach, and work anywhere inside the abdomen, which effectively shrinks the surgeon and puts her/him inside the human body. Our system fits through a standard door making it portable from operating room to operating room, and does not require a large footprint or facility construction build-out.

“With cost of goods that are significantly lower than competing products, we believe our robotic solution will offer a cost-effective path to improving patient outcomes and increasing the efficiency of surgical procedures for hospitals and ambulatory surgical centres.”

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But Vicarious faces stiff competition in the robotic surgery market, both from industry heavyweights like Intuitive Surgical and from relative newcomers to the market.

J&J enters the market with Ottava

J&J has been making noise about entering the robotic surgery market for a while now, finally unveiling the Ottava surgical assistant robot in November. In Italian, Ottava means to play music an octave higher.

“[An octave higher] is what we mean to enable in medical intervention,” said J&J robotics chief development officer Dr Frederic Moll at the product’s launch. “We view Ottava as the surgeon’s instrument for orchestrating a new level and elevating the surgical experience.”

The system has six arms and is designed to provide increased control and flexibility during surgery. J&J has said the robotic arms will be integrated into the operating table, rather than using a separate module.

The company has decided against a 501(k) clearance for the system. Instead, it is aiming to start first-in-human studies in 2022, following verification and validation processes this year.

Asensus Surgical is bringing augmented intelligence to robotic surgery

Formerly known as TransEnterix, Asensus Surgical recently received CE approval for its Intelligent Surgical Unit (ISU), which adds artificial intelligence (AI) capabilities to its Senhance robotic surgery system.

The unit enables machine vision capabilities on the Senhance surgical system, providing Senhance digital laparoscopic programmes in Europe with augmented intelligence capabilities in surgical settings. The AI system is designed to recognise certain objects and locations in the surgical field, and use this data to improve surgical teams’ collaboration by sharing the surgeon’s console view with the entire operating room in real time.

ISU also features 3D point-to-point measurement anatomical structure identification to enhance the digital laparoscopic experience.

Hackensack Meridian Health Pascack Valley Medical Center chair of surgery Dr Amit Trivedi, the first surgeon to use ISU, said: “I’ve been able to benefit from the new capabilities of the Senhance System in over 40 surgeries, to seamlessly move the camera to specific points in the surgical field and track with my instruments as I perform delicate tasks. This new technology is interpreting and analysing information from the surgery, and the additional possibilities of this platform are very exciting.”

Intuitive Surgical is bouncing back after a tough time with Covid-19

A round-up of the robotic surgery market would not be complete without mention of Intuitive Surgical, the world’s dominant robotic surgery company. Intuitive found itself in the same boat as many medical device equipment companies during 2020 as the Covid-19 pandemic hit, with non-emergency surgeries cancelled in many countries and leaving the company’s overall revenue down 2.7% by the end of the year.

But the company still sought to end 2020 on a high. It launched a $100m venture capital fund to support independent initiatives in minimally invasive care. Its stocks also rose 38% over the course of the year, making it one of 2020’s best performing medtech stocks.

First-quarter financial results posted on 20 April have shown a revenue growth of 18% year-on-year to $1.29bn, beating forecasts from industry analysts. The company ended Q1 with $7.2bn in cash, something Intuitive CEO Gary Cuthbert said “reflects customers choosing Intuitive as Covid eases”.

Corindus makes waves in the telerobotic surgery space

Siemens Healthineers spent $1.1bn acquiring Corindus Vascular Robotics in 2019, and the latter company has gone from strength to strength since. Corindus’s CorPath GRX system is FDA-cleared to perform coronary and peripheral vascular procedures, enabling robotic-assisted control of coronary guide catheters, guidewires and rapid exchange catheters. The robot also enables sub-millimetre measurement and 1mm movement for highly accurate stent positioning. It is the first FDA-cleared medical device to bring robotics to percutaneous coronary and vascular procedures.

Corindus has gone beyond standalone robotics development to become a pioneer in the telesurgery space. The first remote surgeries on the platform were carried out in 2018, when five patients underwent percutaneous coronary intervention (PCI) at the Apex Heart Institute in Ahmedabad, India. Their surgeon was stationed 20 miles away, guiding the robot from a remote workstation.

In December 2020, Corindus received 501(k) clearance for a new set of automated robotic movements in its technIQ series for the CorPath GRX, designed to provide predictable and consistent movements for advanced device manipulation during complex coronary peripheral procedures.

Monteris Medical is pioneering minimally invasive brain surgery

When we picture brain surgery, it’s often a rather grisly, dramatic scene – but with Monteris Medical’s NeuroBlate robot-assisted brain surgery system, this could all change. The NeuroBlate system uses an MRI-guided robotically-controlled laser to ablated unwanted brain tissue, such as tumours or lesions.

The platform has been used primarily to treat epilepsy, gliomas, brain metastases and radiation necrosis, with a growing body of evidence backing up its use. MRI-guided laser ablation has proven itself superior to craniotomy across a number of measures, including decreased morbidity from a minimally invasive procedure, faster recovery time, shorter hospital and intensive care stay, and an ability to access lesions not amenable to surgery.

In a May 2020 statement, Northwestern Feinberg School of Medicine chief of epilepsy and clinical neurophysiology Dr Stephan Schuele said: “Patients appreciate the minimally-invasive nature of NeuroBlate. They usually return home with a minimal hospital stay. It’s become an important tool in our kit for helping people with epilepsy and can make a real difference in people’s lives.”