Robot-assisted surgery
Transforming surgery through robotics
Mark Slack, Chief Medical Officer and Co-founder of CMR Surgical, speaks to CSJ about the impact of robotics and digital technologies on surgical approaches, access to training, patient outcomes, and clinical research.
Ten years ago, CMR embarked on an ambitious mission to increase access to minimally invasive surgery for patients around the world, using the latest in surgical robotics. The rapid growth of the UK-based company and the speed in which it has delivered on this ambition caught many by surprise. The company now has operations in more than 20 markets, has surpassed 17,000 surgical procedures, and recently secured £133 million in fundraising to support continued innovation and commercial growth. “There has been nothing like this in the
MedTech sector,” commented Mark Slack, Chief Medical Officer and Co-founder of CMR. “We’ve come to the market, after the leader has dominated for 20 years – it’s never happened before. Robot-assisted surgery is predicted to be the biggest MedTech growth area in history, with predicted annual growth of 15%.1
extraordinary,” Mark exclaimed. When the business was first founded in 2014, Mark questioned why so many people were still
not getting minimal access surgery, despite its many advantages over open surgery. “Minimal access surgery reduces infections
and reduces complications, yet only around 50%2 of people receive minimally invasive surgery, depending on the specialty. The reason the majority are still getting open surgery is that it is difficult to perform good keyhole surgery,” Mark commented. “I’m not stating that robotics is better than minimal access (although I’m starting to see evidence), but robotics will enable more surgeons to perform keyhole surgery and therefore more patients will be able to access its advantages.” He pointed out that with open surgery the
It’s
size of the incision increases the risk of a wound infection: “Wound infections alone cost the European economy around 19 billion Euros per year.3
By increasing access to minimal invasive
surgery, this could be cut to around 1-2 billion,” he commented. “The other aspect of robotics that could
make a big difference is that it will allow more people to be operated on as outpatients. Some procedures can be performed as day cases, and patients can go home the same evening. By adding wearables to the mix, an added layer of safety could be achieved with alarms alerting clinicians in the event of any issues.”
Ergonomics Mark highlighted that there has been “an explosion in robotic surgery” with around 20 robots on the market today. However, he pointed out that what distinguishes Versius is the fact that it ‘biomimicks’ the human arm and holds the instruments in much the same way as a surgeon. The system is fully wristed and can rotate and flex. This dexterity, combined with enhanced 3D HD vision, gives surgeons a high level of accuracy when performing complicated procedural steps or operating in hard-to-reach areas. The technology also tackles the important issue of surgeon fatigue. Nearly 20% of surgeons in the UK think they may need to retire early due to the physical impact of conducting laparoscopic surgery. However, Versius has an ergonomic console which allows surgeons to sit or stand in a comfortable position during surgery, which has the potential to reduce stress and fatigue. “There are lots of surgeons now retiring in their 50s because of musculoskeletal problems and arm problems. The peak age for a surgeon is 60. It takes many years to become really skilled – to have the judgement and ability – so if we can retain these highly skilled surgeons, this will have a significant impact on the Health Service. Robots will help keep surgeons operating for longer,” Mark commented.
Training Mark believes that robotics could also shorten the learning curve significantly: “To teach you to tie a knot on a normal keyhole set would take around 60 hours to learn. On a robot, I can teach you in less than an hour. “This is an important point, as one of the key
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