Joe Mullings l Digital Surgery, Imaging, and Navigation

Digital surgery
Digital Imaging
Digital navigation.

The centralization of power…I mean data.
Computers make it easier to centralize power in a single hub.

Historically, the ability to manufacture and distribute analog medical devices around the world was the way to have an outsized advantage over the smaller manufacturers of competitive analog devices and own a market.

There were certainly smaller analog medical device companies that could compete in markets selling into centers of care in areas that the large strategics did not see a large enough market cap to buy out or elbow out such device companies.

But what happens if one of the historical giants does not execute properly to get into the digital surgery race in the initial wave?

Gathering data makes it easier to develop AI. Having AI with enough of a head start makes even a fast follower, let alone a miserable laggard, the second-place winner of steak knives or third-place, being fired. (Ode to Glengarry Glen Ross).

In a data driven healthtech world, can you catch up by throwing manufacturing and distribution muscle at a problem where you currently do not have domain expertise nor a robotic data acquisition model in the field?

Forget about the current cost of R&D. What is the future cost of time in a market?

– Intuitive (predominantly digital) has 13,600 employees with a market cap of $180 B
– Medtronic (predominantly analog) has 90,000 employees with a market cap of $115 B
– Johnson & Johnson (predominantly analog) has 130,000 employees overall, 60,000 in medtech and a marketcap of $386 B.

Following the math?

Intuitive have more than 12 million procedures worldwide.

Every surgical choice made and recorded providing insights for training, every image examined and annotated, training of algorithms for AI-based advisement, refinement of haptics and feedback, surgeon and care team likes and dislikes, a virtual hub in every OR reporting back to the team for ongoing development and unleashing the capabilities under the hood of the ever evolving system as the “robot” makes its way through the FDA.

As the large strategics continue to trip over the same problems in their pursuit of a robotic solution in surgery, they have also started to cut their budgets in those areas as well. R&D teams, marketing and sales teams, are all being required to do even more catch up, with less resources.

Not having an independent, stand-alone digital surgery division to build soft tissue, endovascular, or endoluminal systems, nor a best in category visualization platform in market which has the most robust data sets in the healthcare world, as we extrapolate in other analog to digital models of industry, I wonder what this landscape is going to look like in a few years.

Distalmotion, SS Innovations, CMR Surgical, Asensus Surgical the clock is running on this vintage.

And by the way, you have to acquire the digital development mindset and team. Not the product.