Faster, Better, Cheaper: The Future of Medical Robotic Technology

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Faster, Better, Cheaper The Future of Medical
Robotic Technology
Carnegie Mellon

• Howie Choset

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Minimally Invasive Surgery Benefits

• Reduced post-operative discomfort
• Reduced Costs
• Improved access to quality medical care

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Robotic Cardiac MIS

vs.

Reduce discomfort no crack chest Reduce cost
shorter hospital stay Disseminate care more can
be done
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What has been doneMinimally Invasive Medical
Robotics
Tissue Engineering Weiss, et. al.
HeartlanderCam Riviere, and Marco Zenati
DaVinci, Intuitive Surgical
Cyberknife
Steerable Needles, Dupont, et al Rviere
Alterovitz, et al Salcudean, et al., Okamura
Virtual Incision (U of Neb, Farritor)
Sonic flashlight, Stetton
Given Imaging
Dario, Webster, et al
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Vision for Medical Robotics

• Blur the boundary between specialist and surgeon
• Shorter length procedures
• Enable New Procedures
• Natural orifice
• single port access
• Robotic tools, not robotic surgeon

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The United States is Unique
Robotics Engineering
Medicine
Enterprises
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Why Government Leadership?
Capital equipment GE/Intuitive Surgical
Operating room tools BSci, Guidant, Stryker
Vs.

• Small companies and academia
• playing in the middle
• developing technology and innovative clinical
  approaches
• can create a new industry
• Haphazard way of engineers and doctors meeting
• NIH is currently not the right match

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Appendix
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Carnegie Mellon Spin0ff

• Founded in 2005
• Licensed IP from Carnegie Mellon and the Univ.
  Pittsburgh
• Inventors were 2006 recipient of 2.2 Million NIH
  grant for epicardial robotics

• Raised to date 11.6 Million (includes 2.6M
  convertible) in Series A financing
• Since 2004, there have been 6 generations of
  prototypes tested in animals and cadavers
• Clinical prototype complete and undergoing
  testing and verification

• Completed more than a dozen animal trials --
  closed-chest access, pericardial navigation,
  direct visualization, transmural lesion ablation
  -- results published, no adverse hemodynamic or
  electrocardiographic impact from CardioARM
• Completed two human cadaver trials closed-chest
  access, pericardial navigation, direct
  visualization, box lesion ablation pattern

• Thirty five (35) patents and pending applications
  on snake robotics
• 2 issued US patent s
• 33 other patents pending 21 independent
• Received Freedom to Operate opinion from
  Pepper Hamilton Law PC
• Company received a formal opinion on their
  regulatory status as 510(k)

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Costs difficult to assess

• Hospital characteristics (size, community or
  specialist setting, administration, etc.)
• Surgeons ability and experience
• Types of supplies used
• Different procedures costs vary
• Hospitalization/OR time costs vary
• Role and use of residents/fellows
• Learning curve issues (make it more expensive at
  first)
• Players
• Patient and employer
• Insurance company
• Tool makers

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DaVinci Systems
2008 335 units sold Total 1,111 units installed
875 million, 46
Income in 2008 increased by 59 to 387MM
Source Intuitive Surgical 10-K SEC report
(ANNUAL REPORT 2008)