未來的手術(shù)室-機器人輔助手術(shù)的崛起

作者MARCOBüHREN副合伙人MATTHIASBüNTE高級合伙人RANDYBRüCKNER咨詢顧問SALILCHURI副合伙人THILOKALTENBACH高級合伙人PETERMAGUNIA高級合伙人

手術(shù)的崛起六月2023一個到2030年規(guī)模將翻三番的行業(yè)RASRAS300[1203017%CGR)215ntuitieSurgicalMedtronitrye,Johnson&Johnso）AsensusZimmerBiometRASRAS。RASRASRASRBRASmarketmodel;May2023一個令人興奮的行業(yè)正在迅速發(fā)展RAS。RAS[45]。3DRAS。一個不斷增長的市場提供全球機遇77ntuitieSurgical202262[7],收入的80%RAS機器人系統(tǒng)板塊RAS系統(tǒng)的價格50300[8],2022與診儀器和配件板塊2022服務(wù)板塊2022RASSAAS2022203014%按板塊拆分[百萬美元；%]

按地區(qū)劃分[百萬美元；%]

按應(yīng)用科室拆分[百萬美元；%]31%13%31%13%

21.5

+13.7%

21.5

+13.7%

21.516%13%12%5%16%13%12%+15.1%

20%20%4.432%51%56%4.450%4.448%

+15.1%

17%4%

+15.0%2018

2022

2030

2018

2022

2030

2018

2022

2030儀器以及配件 服機器人系統(tǒng)

北美 亞太 歐

其他地區(qū)

其他

骨科

婦科

普通外科資料來源：羅蘭貝格2182022RAS1%2020Covid19RAS2022203017%（復(fù)合年增長率21560%ntuitieSurgical[1,11]203020228日本和韓國看起來正在推動亞洲區(qū)域的增長[12,13]。及RAS[14]RAS（心外科：心臟腫瘤切除、二尖瓣修復(fù)、冠狀動脈旁路嫁接[15,16];(DBSRAS滲透率也相助。RASDR)RAS要額外使用的耗材費用。普通外科手術(shù)是RAS年占據(jù)市場份額的[1011]202237RASMatryeRos（ZimmerBiomet）CoiSmith&NepheEelsiusGPGlobusMeical輔助在骨科領(lǐng)域的使用一直在強勁增長。RAS部分手術(shù)RAS應(yīng)用概覽德國DRG報銷額度[歐元]德國DRG報銷額度[歐元]

惡性綜合征

食道手術(shù)[Thor.]12.000

胰腺/胰十二指腸切除術(shù)[Visc.]

結(jié)直腸手術(shù)[Visc.]10.000

0低

子宮內(nèi)膜異位癥[Gyn.]支氣管鏡檢查[Thor.]

膝關(guān)節(jié)置換術(shù)腹部疝氣腹股溝疝]

前列腺切除術(shù)[Uro.]高RAS適配性[Gen.]=內(nèi)臟手術(shù)新的玩家正在挑戰(zhàn)市場領(lǐng)導(dǎo)者ntuitieSurgicalRAS80%[18]手術(shù)。e市場競爭環(huán)境Johnson&

Siemens

Zimmer

BrainLab

（施樂輝）

（博醫(yī)來）(美敦力)

(強生公司

（雷尼紹）(西門子醫(yī)療（史賽克）捷邁邦美） （ ） （

Excelsius

Circ普通外科泌尿科婦科骨科心外科神經(jīng)外科其他

GPS

涵蓋 不涵蓋資料來源：羅蘭貝格HugoMonarchSenhanentuitie過18130[19]和3[1RASRASIntuitieIntuitieAsensus。OttvantuitieDaVnci——[20]展示了這些高度創(chuàng)新系統(tǒng)所需要面對的各類技術(shù)挑戰(zhàn)。CorPathGRXSentanteSentantetryerMaoZimmerBiometRosaThinkTSoutionOneSmith&NephewCori。GlobusMedicalEelsiusGPSMedtronicMaoZimmerBiometRosaOneBrainlabCirqntuitieMedtronitryerZimmerBiome0%ntuitieHugo3DTitanMedicalVicariousSurgicalntuitieIon[21,2Corndus62[23]RAS與此同時，RAS領(lǐng)域的進步正在將重點從產(chǎn)品轉(zhuǎn)移到手術(shù)和更廣泛的解決方案上。因包括規(guī)劃、(A)。RAS是實現(xiàn)完全智能互聯(lián)手術(shù)室的關(guān)鍵一步。RAS在手術(shù)不同階段介入角色術(shù)前 術(shù)中 術(shù)后術(shù)前模擬——通常由機器學(xué)習(xí)數(shù)據(jù)庫支持——為外科醫(yī)生和他們的團隊提供理想的前期準(zhǔn)備

感知實時指導(dǎo)，提供決策支持，改善手術(shù)過程中的協(xié)作和信息共享

隨著時間推移通過分析優(yōu)化手術(shù)表現(xiàn)，確?；颊呖祻?fù)期間的隨訪并建立全球標(biāo)準(zhǔn)化資料來源：羅蘭貝格但所有公司仍有一些障礙需要清除RASRASRAS滲透程度比預(yù)期要慢RASRAS732012年的1.8%上升到218年1%[25],——ntuitieSurgicaltryerMaoMazorRASO)RAS100,000RAS[26]100的神經(jīng)外科部門在2021和202240[17]RASRAS[27][2829RAS更耗費時間和資源的結(jié)論。RAS.53%[27RASRAS202180[31]25[32]。安裝RAS200[33,2018RAS3,5003,0007,00020[35]。安裝RAS的高成本顯得不符合邏輯。[28]保險RAS銷政策。RASTHILOKALTENBACH高級合伙人德國

RAS市場的機遇吸引了越來越多的玩家參”機器人手術(shù)公司下一步應(yīng)該做什么RAS5公司的戰(zhàn)略重心贏得市場準(zhǔn)入機會贏得市場準(zhǔn)入機會注重以客戶為中心 針對醫(yī)療體系制定令人信服的價值主張注重以客戶為中心針對醫(yī)療體系制定令人信服的價值主張產(chǎn)生令人信服的臨床和真實世界數(shù)據(jù)產(chǎn)生令人信服的臨床和真實世界數(shù)據(jù)和具備領(lǐng)導(dǎo)地位的醫(yī)院和學(xué)術(shù)中心合作5大機遇資料來源：羅蘭貝格RASRASRASRASRAS1010O)RASRASRAS醫(yī)RASRASRASRAS在羅蘭貝格，我們幫助公司解決戰(zhàn)略問題，以便他們能夠承擔(dān)或維持其行業(yè)的領(lǐng)先地RASRAS參考文獻：

ofmajorsurgery:AglobalproblemthatisnotgoingDobsonIntJSurg.2020Sep.[Link]OriginsofRoboticSurgery:SkepticismtoStandardofCare.GeorgeEI,BrandTC,LaPortaA,MarescauxJ,SatavaRM.JSLS.2018Oct-Dec.[Link]RoboticSurgery:ANarrativeBramheS,PathakSS.Cureus.2022Sep15.[Link]ReducingLengthofStayUsingaRobotic-assistedApproachforRetromuscularHerniaRepair:AComparativeAnalysistheAmericasHerniaSocietyQualityCollaborative.CarbonellAM,JA,PrabhuAS,etal.AnnSurg.2018[Link]EffectofRobot-AssistedRadicalCystectomyWithIntracorporealUrinaryDiversionvsOpenRadicalCystectomyon90-DayMorbidityandMortalityAmongPatientsWithBladderCancer.CattoKhetrapalRicciardietal.JAMA.2022.[Link]Reviewofemergingsurgicalrobotictechnology.PetersBS,ArmijoPR,KrauseC,ChoudhurySA,OleynikovD.SurgEndosc.2018[Link]MorganHealthcareConference2023,Intuitivesurgicaloperations.AccessedMay2023.[Link]Marketpotentialsofroboticsystemsinmedicalscience:analysisoftheAvateraroboticsystem.Liatsikos,E.,A.,Kyriazis,I.etal.WorldJournalofUrology.2021Aug.[Link]AliteraturesurveyoftherobotictechnologiesduringtheCOVID-19pandemic.L.JournalofManufacturingSystems.2021.[Link]Statusofroboticassistedsurgery(RAS)andtheeffectsofCoronavirus(COVID-19)onRASintheDepartmentofDefense(DoD).RizzoKR,GrassoS,B,MyersA,OfstunE,A.JRobotSurg.2023[Link]StatisticalanalysisofdaVinciprocedurevolumesof2021intheChineseMainland.RuihuaXue,RongLiu.IntelligentSurgery.2022Sep.[Link]IntuitiveSurgical:AnnualReport2022.AccessedMay2023.[Link]IntuitiveSurgical:AnnualReport2021.AccessedMay2023.[Link]Roboticsurgery.ClevelandClinic.AccessedMay2023.[Link]ThestateofroboticcardiacsurgeryinEurope.PettinariM,NavarraE,NoirhommeGutermannH.AnnCardiothoracSurg.2017Jan.[Link]RoboticCardiacSurgeryinEurope:Status2020.CernyS,OosterlinckOnanBetal.FrontiersinCardiovascularMedicine.2022.[Link]Roboticsinneurosurgery:Currentprevalenceandfuturedirections.SinghR,K,QureshiMB,RangelIC,BrownNJ,ShahrestaniS,GottfriedON,PatelBydonM.SurgNeurolInt.2022Aug.[Link]12IntuitiveSurgical:HighQualityMarketLeaderWithAmpleRunwayGrowth.SeekingAlpha.2023Jan.AccessedMay2023.[Link]12Laparoscopicsurgery.ClevelandClinic.AccessedMay2023.[Link]Johnson&Johnsondisclosestwo-yeardelayforOttavarobot.WhooleyS.2021Oct.AccessedMay2023.[Link]Johnson&Johnsoncutsnearly350surgicalroboticsjobs.NewmarkerCMassDevice.2023AccessedMay2023.[Link]RobotstartupVicariousislatestmedtechcompanytocutjobs.KellyS.MedtechDive.2023AccessedinMay2023.[Link]SiemensHealthineersQ2profitfalls,quitsheartsurgeryrobotsbusiness.HübnerA,DabrowskiB.2023[Link]ArtificialIntelligence-AssistedSurgery:PotentialandChallenges.BodenstedtS,WagnerM,Müller-StichWeitzJ,SpeidelS.ViscMed.2020.[Link]intheAdoptionofRoboticSurgeryforCommonSurgicalProcedures.SheetzKH,ClaflinJ,DimickJB.JAMA.2020.[Link]Roboticandrobotic-assistedskullbaseneurosurgery:systematicreviewofcurrentapplicationsandfuturedirections.PangalCoteRuzevickJ,B,KugenerG,WrobelB,FerenceEH,SwansonM,HungAJ,DonohoDA,GiannottaS,ZadaG.NeurosurgFocus.2022Jan.[Link]AdverseEventsinRoboticSurgery:ARetrospectiveStudyof14ofFDAData.AlemzadehH,RamanJ,LevesonN,KalbarczykZ,IyerRK.PLoSOne.2016[Link]Diffusionandadoptionofthesurgicalrobotinurology.ShahAA,BandariJ,PelzmanDaviesBJ,JacobsBL.AndrolUrol.2021.[Link]Reductioninpostoperativecomplicationsbyroboticsurgery:acase-controlstudyofroboticversusconventionallaparoscopicsurgeryforgastriccancer.KinoshitaSatoR,AkimotoE,OkayamaHabuSurgEndosc.2022[Link]Surgicalroboticsystems:Whatwehavenow?Aurologicalperspective.Almujalhem,A,Rha,KH.BJUICompass.2020.[Link]ShouldRoboticSurgeryBecomeaGeneralSurgeryResidencyRequirement?ANationalSurveyofProgramDirectorsinSurgery.RodriguezKapadiaS,Moazze