At the LSI Emerging Medtech Summit, one clear trend became apparent: soft-tissue robotic surgical technologies are transforming how we deliver surgical care. The principal question currently facing the medical technology industry is no longer whether this revolution will take place, but rather how we should design future surgical robotic systems to embrace the tides of transformation.
An ongoing debate continues to dominate discussions within the industry: should surgical robotics develop as integrated, common-source “open” systems that support interoperability among multiple vendors, or as isolated, proprietary “closed” systems developed by individual manufacturers?
The “Closed” and “Open” design classifications
Increasingly, industry executives perceive the closed- and open-system classifications more as a continuum than as mutually exclusive categories.
While open system designs prioritize flexibility and allow for the modular integration of third-party technologies (including imaging devices, hand instruments, data analytics, and the use of guidance/navigation), closed system designs emphasize the need for consistency and seek to implement all components through a single source of the manufacturing vendor, thereby allowing for seamless system operation and maintenance.
Shift Toward Performance-Driven Surgical Platforms
In real-world scenarios, many of the contemporary surgical robotic platforms exhibit both flexible and rigid design characteristics. On the horizon, the industry will continue to move from “label” discussions to evaluations of which surgical robotic systems deliver the best surgical performance and efficiency.
Innovation Is Accelerating System Change. Currently, rapid innovations are emerging across soft tissue robotics, including Artificial Intelligence-enabled decision support systems, real-time imaging, digital navigation, and connected surgical data systems. These advancements are creating challenges for vertically integrated development due to their rapid pace.
There is no single entity that can effectively develop and support best-in-class solutions that encompass all connected components of the surgical ecosystem; specialized innovators are increasingly involved in creating and offering modular technologies that can interact with the broader surgical platform.
Consequently, the change to this new model of surgical innovation is extending into how and where capital funds are invested. Rather than concentrating funding on a single comprehensive solution, more capital is being allocated to targeted technology solutions that address specific high-value opportunities within the surgical workflow.
Continued movement from hospital settings to outpatient locations, such as ambulatory surgical centers, is another significant force shaping the design of surgical platforms.
Much of the technology required by these outpatient environments must meet the following criteria:
1. Compact and adaptable systems
2. Lower capital and operational expenditure.
3. Has a shorter setup time with a faster turnover.
4. Seamless integration into high-throughput workflows.
Since care delivery has been moving outside traditional hospital environments, high-complexity and/or rigid solutions are expected to have difficulty scaling effectively. In summary, both flexibility and ease of use should now be on par with clinical capability.
Innovation Multiplying Ecosystem
One of the most significant conclusions made was that open ecosystems can create a compounding effect on innovation.
When platforms offer third-party developers an opportunity to build tools and technology, there will be:
- More specialized alternatives have been developed
- Lower adoption barriers because of new technology
- Investment activity across the entire ecosystem will increase.
- Improved clinical outcomes from a more straightforward iteration process.
However, the open ecosystem must also be well coordinated for interoperability, safety, and consistent functioning across all integrated parts.
An Emerging Hybrid Future
While there are differing theories regarding whether openness or integration will prevail, most agree that the future of surgical robotics will not be one or the other. Instead, surgical robotics will likely move toward a hybrid development model in which core systems will remain tightly governed on a stable platform, while non-core elements remain open to innovation and development outside the core system.
This hybrid approach will allow platforms to maintain their reliability while still benefiting from rapid advancements that occur externally.
Moving Beyond Platforms
The maturation of this conversation means the industry is starting to move beyond discussions solely about architectural designs. The much larger picture needs to be addressed. For example:
- How can surgical technology be optimized to provide better surgical outcomes throughout multiple care settings?
- How can efficiency and access to care be improved without adding further complications?
- How can digital/collaborative tools provide seamless connections across the entire continuum of surgical care?
If we think about surgical care in this way, we can see robotics as one evolving piece of a larger digital surgical ecosystem.
Conversations at the LSI Emerging Medtech Summit highlight how rapidly this area of technology is changing. Robotics for soft tissue procedures is advancing quickly, but success will be driven by more than simply advancements in hardware.
Regardless of whether the systems are open, closed, or hybri,, the overall success will be determined by one factor: how well they improve the accuracy of surgical procedures, provide efficient and accurate care delivery, and achieve better patient outcomes in an increasingly decentralized healthcare model.
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