It’s too early to see the whole picture regarding the alleged downfall of “Intuitive Surgical” I.S., but some signs cannot be ignored regarding what I.S. will face in the immediate future. In the first quarter report of 2022, I.S. didn’t meet the equipment placement or sales goals in hospitals, raising investors’ concerns.

What is left in the market for I.S? Who is coming to take its share?

What is happening from a medical standpoint? First of all, it is fair to say it’s tough to picture the world of surgical robotics without I.S. for 20 years. The only option in the robotic surgical world was this company; all the robotic surgeons have been involved in the training of its surgical systems. It was utterly groundbreaking; I remember myself using the Da Vinci surgical system for the first time and thinking that the future of surgery was already here. The robot usage is ergonomic and easy. It takes a few sessions to get used to it, but once users have a certain pace, this surgical robot makes life easier, even speaking about really complex procedures. Like almost all new techniques in medicine, there was some reluctance to it. Some people in the surgical world didn’t find the benefit of using it and questioned the actual utility of the new system; even to date, the prices in some places besides the U.S. can’t outweigh the benefit of using it.

“Nobody has monopoly on good ideas.― Kevin O’Leary

One of the most significant problems regarding the business model of I.S is the abusive way of treating the surgeon. Imagine you are a pilot on an airline, so for you to be trained on the different models of planes, including in your airline, you have to take hours of practice on a simulator; well, all of that doesn’t have any cost for the pilots, it makes sense right? You want to encourage the Airlines to use your product, so the easiest way is to train as many pilots as possible, so the airlines find it suitable to buy your airplanes and not waste much more time preparing the pilots to use them. Well, this isn’t the same for the surgeons. As a surgeon, you have to pay for the extra training on the robot. The cost goes up to 5000 USD, plus expenses to travel to a certified training location. Most of them are found in the U.S. Once you finish the training, you will have to make your first cases under the supervision of a Proctor, which also has an extra cost for the surgeon in training. So as you can imagine, most surgeons never finish the whole process of becoming certified as Robotic surgeons.

This type of model undoubtedly worked for I.S. long time, revenue speaking, but for almost 20 years, there was no competition. At the moment, at least three options for surgical technologies have emerged to compete directly with I.S. Hugo surgical system by Medtronic, Senhance surgical system by Asensus, and still in development Titan Single port robot system are a few interesting upcoming technologies set to compete with I.S.

It’s been at least six years since the last announcement of truly new exciting technology by I.S. with the single port robot, and its application is still limited to just a few procedures. So right now, the focus should go to other investment opportunities inside the world of robotic surgery. Is this event just the first announcement of the downfall of “Intuitive Surgical”?