Steve Bell
Chief Commercial Officer at CMR Surgical
We know that for many surgeons manual laparoscopy can be highly complex to perform. It is really challenging in advanced procedures where there is a steep learning curve to become confident in this approach. While surgical robotics can often make laparoscopy easier to learn and perform (by bringing open surgery style manoeuvres into the laparoscopic approach), it would be wrong to say surgical robotics comes without its own set of unique challenges.
There are clearly some key barriers preventing robotics being more widespread today. But I would challenge that many of these barriers can be overcome by having a new style of versatile system which allows surgeons to operate in their preferred way; according to patient need and surgeon choice.
I believe our versatile robotic system, Versius, can help shift the dial to enable more minimal access surgery (MAS) to be performed, potentially benefiting millions of patients across the globe that were destined for open surgery.
Here’s why…
1. Versatility to work in all operating rooms
Monolithic and huge modular robots can dominate the operating room and even feel like they get in the way. As you move to different countries, peripheral hospitals, private hospitals, outpatient departments and even ambulatory surgical centres; often these massive robots just don’t fit at all. This can then limit access to MAS, as the surgical robot can only be used in large ORs with sufficient space and the ability to make structural modifications to the estate to cater for it.
With a small footprint and a modular design, Versius can fit into virtually any operating room — giving surgeons and hospitals the versatility to make use of the surgical robot in all operating rooms, whatever the size. This means that more patients can be offered a Robotic Assisted Surgery approach, such as in the growing number of day case procedures which often happen in smaller ORs.
2. Versatility of a modular system
When a hospital invests in a surgical robot, it’s essential for them to be able to “sweat the asset” i.e., keep it busy all day. While monolithic robots can be too big for some ORs, once it is in there, the size often means that it cannot be easily moved. If a hospital can’t move its robot from say a gynaecology OR in the morning to a colorectal OR in the afternoon, it is unlikely that the robot is going to be working at its maximum capacity all day. This low utilisation may be a barrier to MAS uptake, and it can also be a major issue for hospitals financially.
Versius has a small, lightweight, and modular design that can be moved easily between departments or hospital sites, and then set up in only a matter of minutes — so that surgeons and hospitals have the versatility to use Versius wherever and whenever it is needed. Then, when it’s not being used it can then be easily stored, not taking up valuable OR space.
3. Versatility in surgical approach
The architecture of non-modular robots often dictates where a surgeon must put their ports, which is often different from the port positions they would have used for a laparoscopic case. Not only do surgeons working with monolithic robots need to learn a new system, but they must also learn a whole new surgical approach. So, wouldn’t you want a system that has the versatility to allow the ports to go where a surgeon wants them, where is best for the patient, and where the surgeon already knows how to do that procedure with that port placement?
Because Versius has a modular design, it means that surgeons can place their ports where they want them. This, importantly, gives surgeons the versatility to perform fully-robotic procedures — from routine to complex — with a familiar port placement. But it also means that they can plan a surgical approach where part of the procedure is performed robotically, while using other laparoscopic instruments for specific sections of the operation. This means that patients benefit from the entire procedure being performed with a minimal access approach.
4. Versatility to integrate into existing workflows
The setup and workflow of an operating room are essential to having an efficient and collaborative surgical team. Whilst new technology being introduced to the OR can revolutionise the way we deliver quality healthcare, it can be frustrating if you have to change your existing setup to cater for it. You shouldn’t have to adapt everything to your surgical robotic system, it should adapt to you.
It was important to us that Versius could integrate seamlessly into existing workflows and be compatible with conventional surgical devices — so that surgeons have the versatility to operate robotically, without needing to change their current practice.
So what does this mean? All in all, we believe that surgical robots are an enabling tool to help surgeons take the step from open surgery towards a wider uptake of MAS. But that surgical robot needs to work around the surgeon, surgical team, and the OR — and not the other way around. The versatility that Versius offers can help with this. The clue is in the name after all.