Roger Smith, PhD, is the chief technology officer for the Florida Hospital Nicholson Center in Celebration, a high-tech training and education institute focusing on disseminating leading-edge surgical knowledge and techniques for the global community.
He was previously the CTO for U.S. Army simulation, training and instrumentation and a research scientist at Texas A&M University in College Station. He is also a graduate faculty member at the University of Central Florida in Orlando and president of Simulation First, where he provides keynote event presentations and scientific lectures.
Dr. Smith has authored several books, including A CTO Thinks About Innovation, Simulation & Game Technology for Medical Education and Military Simulation and Serious Games.
Question: How have robotic systems helped/hindered spine surgery?
Dr. Roger Smith: There have been four commercially released spinal robotics systems and a few academic prototypes that did not come all the way to market. Three of the original system companies have been sufficiently successful to attract larger buyers. Mazor Robotics launched from Israel and has been acquired by Medtronic as they attempt to construct an internal robotic product line. Medtech originated in France and has recently been acquired by Zimmer Biomet. KB Medical from Switzerland was acquired by Globus Medical, bringing two competing spinal robotic systems into the same parent company. These acquisitions suggest that there is definitely market demand from physicians and hospitals for robotic assistance in spinal procedures. They also indicate that the big medical device companies believe that robotics, the technologies that they embody, and the improvements that they enable will be of growing importance in the near future. It may also suggest that it is now more difficult to launch a start-up and build it into a multi-billion-dollar company in the same way that Intuitive Surgical has done over the last 20 years.
Q: What does the next five years look like in terms of robotic spine surgery?
RS: We at the Nicholson Center have identified and are tracking more than 60 medical devices that are marketed as surgical robots or robotic-assistance devices. The computer, electronic, mechanical and software technologies that are necessary to improve on manual human performance in dozens of surgical procedures have arrived. These are empowering established companies and start-ups to create new robotic devices; prove their equivalence or superiority to traditional methods; and present them to clinicians, patients, and hospitals with compelling stories of improved outcomes.
The da Vinci robot by Intuitive Surgical has been successful in the same way that the iPhone transformed Apple and the PageRank algorithm launched Google to world leadership. That kind of success is motivating dozens of companies to search for the next blockbuster device in every surgical specialty. Mazor, Globus, KB, and Medtech are not the last robotic systems that will be created to assist with spinal surgeries. These devices currently address only a few of the important steps in a procedure. There are many more opportunities for robots to help human surgeons to apply their skills toward better patient outcomes in the future.
The next five years will see the existing robotic devices being used in a growing number of procedures and the emergence of at least as many new competitors who believe they can do a better job. Robotic assistance, coupled with intelligent software, is an inevitable global trend in all industries, including spinal surgery.