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Artificial Intelligence is making inroads into every segment of the economy including medicine and surgery. Intuitive Surgical Inc. (NASDAQ:ISRG), the market leader in robotic surgery, commands $3.3 billion in annual sales, and the numbers are going to increase manifold in the near future. Companies like Alphabet Inc. (NASDAQ:GOOG) by GOOGL and Johnson & Johnson (NYSE:JNJ) making a foray into the industry by acquiring firms with emerging innovations that can reshape the robotic surgery applications and reach.
The industry is witnessing many mergers and acquisitions such as that of Auris by Johnson and Johnson and the $1.6 billion acquisition of Mazor by Medtronic plc (NYSE:MDT) to name a few, that prove the growth potential that this sector has to offer.
The “Global Surgical Robotics Market: Focus on Products, Applications, End Users, Countries, Patents, Market Share and Competitive Landscape – Analysis and Forecast (2017-2025)” report by ResearchAndMarkets.com offers some interesting insights into the market. Most importantly, the report estimates that global surgical robotics market will be worth $12.60 billion by 2025, with the instruments and accessories segment clocking growth at the CAGR of 11.4% during 2017-2025.
At present, robotic surgery is limited to procedures involving minimally invasive technology, but with rapid advancements in technology the scope and reach of these will see an exponential increase by way of adaptation for a variety of procedures. There are a lot of niche areas that still haven’t been covered yet, and the field is wide open for new entrants who can differentiate themselves from the competition.
A report published by Mazor that states that robot-assisted surgery has shown a five-fold reduction in complications as well as a seven-fold decrease in revision surgeries can act as a strong advocate for the use of this technology.
Here’s a look at some companies that are developing breakthrough technologies that can further propel the growth in the industry.
Accuray (NASDAQ: ARAY)
Market Cap: $440.28M; Current Share Price: 5.01 USD
The company develops novel radiotherapy systems that are personalized to suit each patient and delivered with precision resulting in minimal side effects and cost-efficiency. Its Synchrony or motion synchronization makes it the only such solution available for true motion tracking for moving targets such as breasts and lungs and ensures precise dosing and minimal peripheral tissue damage. Its product offerings include CyberKnife, Radixact, TomoTherapy and Onrad.
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CyberKnife Precision Robotic Treatment is a first-in-class robotic radiation therapy system that offers multiple advantages such as real-time tracking, motion synchronization, precision and reduced toxicity. It offers Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT). It comprises of a linear accelerator mounted on a robotic arm that can greatly improve the precision and delivery of radiation beams while its integrated X-Ray imager facilitates real-time tracking.
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In addition, it can target various indications including intracranial, lung liver and prostate and can enhance patient experience and improve cost –effectiveness. As part of its continuous R&D efforts, the company has introduced CyberKnife Volvo Optimizer that can be used in conjunction with Volo and MLC to target a disease site in 15 to 30 minutes which translates to reduced treatment planning time by 50% and delivery time by a whopping 90%. The iDMS™ Data Management System acts as a link between all Accuray treatment planning and delivery systems thereby ensuring an integrated database of all relevant patient information.
Its proprietary TomoHelical™ Treatment Delivery that works with its Radixact® and TomoTherapy® systems, is an image guided, intensity modulated radiation therapy (IG-IMRT) that uses a unique ultra-fast multi-leaf collimator (MLC) to treat breast cancers.
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The clinical data for CyberKnife for Prostate treatment shows excellent cancer control with minimal side effects as well as improved survival rates when compared with conventional radiation options. RadiXact system enables high precision handling of complex cases with motion synchronization ability.
The company has manufacturing facilities in Madison, Wisconsin, Sunnyvale, California and China. Its operations are spread over seven facilities around the world which support over 850 installed systems in 50+ countries.
Image Source: https://www.accuray.com/
As per the company’s projections its revenue are expected to be $415 million to $425 million for Q1, 2019. The company has successfully managed to lower its debt exposure to $150 million from $ 215 million over a two-year period.
Monarch Platform is at the forefront of Auris Health, Inc’s strategy to revolutionize the endoscopy market. An amalgamation of the very best in robotics, sensing, micro-instrumentation, endoscopic design and data mining, Monarch has been designed to conduct bronchoscope procedures that can reduce cost and improve outcomes.
Its innovative design allows for extended reach, diagnosis and control, while its interface uses an instinctive controller for efficient navigation. The platform can be streamlined and extended further for therapeutic and diagnostic procedures. It aims to go a step beyond the existing minimally invasive techniques by integrating the best that science and technology has to offer.
The company’s current focus is on lung cancer with emphasis on faster diagnosis and precision therapy and overcoming the limitations of existing therapeutic and surgical options.
The company also featured in the CNBC Disruptor 50 List for 2018 for its commendable work in the bronchoscopic procedures space. Frederic Moll, M.D, the founder of the company is also called the forefather of robotic surgery and has served as a founder of Hansen Medical (HNSN) Restoration Robotics (HAIR), Intuitive Surgical (ISRG) and Origin Medsystems.
Auris first entered into collaboration with NeuWave Medical, a subsidiary of Ethicon, Inc. and part of the Johnson & Johnson Medical Devices Companies in May 2018. The agreement was for the co-development of integrated systems for robotic control, navigation and application of microwave ablation delivered via bronchoscopes. The company also managed to raise a record round of funding of $220 million in November 2018. Auris has raised an estimated $800 million in debt and equity financing since 2011, and is valued at $2.2 billion according to Pitchbook.
The partnership with Johnson & Johnson culminated into an acquisition of Auris Health for approximately $3.4 billion in cash, plus additional milestone payments of up to $2.35 billion, the formalities of which are expected to be completed by Q2, 2019.
ViewRay (NASDAQ: VRAY)
Market Cap: $770.63M; Current Share Price: 8.05 USD
A pioneer in the radiation therapy and imaging field, the company holds the exclusive global license for its combination of MRI and radiation therapy technologies. Its MRI-Guided Real-time On-table Adaptive Radiotherapy (ROAR™) overcomes the limitations of conventional IGRT such as poor tissue contrast, need of surrogates to identify anatomy, and lack of real-time guidance during beam-on by combining the precision radiation delivery with ground-breaking MR image guidance and on-table adaptive therapy.
ViewRay’s MRIdian is developed using a patented split-magnet MR design that presents an unhindered radiation beam path and optimal source-axis-distance (SAD). This in turn results in sharp SRS and SRBT-tailored penumbra, a simplified beam dosimetry and a high dose rate beam delivery.
Its SmartVISION technology offers high-definition MR imaging while doing away with skin toxicities and distorted doses.
Its SmartADAPT technology can help generate MR scans in seconds and give accurate details of the tumor and the peripheral critical organs while the patient is on the table undergoing treatment, finally its SmartTARGET can envisage any changes in the tumor or the peripheral organs position and automatically regulate beam delivery. The technology has been used to deliver over 3,000 treatments and 3500 on-table adapted fractions world-wide.
It is currently holding clinical trials for locally advanced unresectable pancreatic cancer. The company recently celebrated five years of its MRI-guided radiation treatments.
As per its unaudited financial results for full year ended December 31, 2018, cash and cash equivalents were approximately $167 million. Its full year revenue stood at an estimated $81 million up from $34.0 million in 2017. The Company’s backlog stood at an estimated $212 million.
Disclosure: I/we have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours.