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Product Review: Johnson & Johnson Ottava (Robot Assisted Surgery System)

Johnson and Johnson Ottava Robot Assisted Surgery System

Healthcare | May, 2021

The healthcare industry has been evolving leaps and bounds to keep up with the growing needs of the population. And technology has always been at the forefront of medical innovations, enhancing patient outcomes and medical care. Currently, surgical robots are a hot topic in the Medtech industry due to their unlimited potential in revolutionizing the healthcare ecosystem. Robot-assisted surgeries are faster, require less staff, reduces recovery time, and decreases the risk of infections. Over the last two decades, robotic-assisted surgeries have been growing substantially, mitigating human errors, and producing excellent results. Johnson & Johnson recently unveiled its surgical robotic platform, Ottava designed to provide unrivalled flexibility and control for surgical interventions. With six arms and a zero-footprint design, the J&J’s digital ecosystem enables treating challenging anatomy in a minimally invasive manner, enhance patient access, and improve workflow. The term, “Ottava” in Italian means to play music an octave higher, and as the name reflects, J&J robotic system intends to take robotics to a new level. 

 

The new surgical system improves surgical outcomes for a variety of diseases by offering robotic control and coordination across a full breadth of procedures more than any other available system in the market. Inculcating the newest technology and integrating data capabilities, Ottava has been developed to provide an ability to the clinicians to improve and deliver as good outcomes as possible according to his/her level of technical understanding and knowledge. One of the key features of the technology introduced in Ottava is that the device has the potential to extend into more intervention or endoluminal techniques, which would result in a significant broadening of the use of surgical robotics. The new surgical system is currently in the exciting stage of development where it is gradually coming to life, but J&J is planning to enroll it for clinical trials in 2022 and the launch is unlikely before 2024.

 

In 2000, da Vinci became the first FDA-approved robotic surgical system for general laparoscopic surgery and since then Intuitive Surgical has continued to its dominance the market for robot-assisted surgeries. Currently, Intuitive Surgical constitutes 92.3% of the robotic surgical market for many general surgery procedures such as hernia repair, hysterectomies, cholecystectomies, colectomies, myomectomies, and prostatectomies. Rest includes the use of Stryker’s MAKO system for orthopedic procedures and Medtronic’s Mazor system for neurological procedures. Introducing Ottava into the rapidly expanding surgical robot market, J&J plans to take over Intuitive Surgical and expand its market share. Currently, John & Johnson holds a market share of 1.7% in the global surgical robot market, acquiring Auris Health and its Monarch system for bronchoscopy procedures in 2019.

 

The MedTech giant has been developing its digital platform by combining technologies, which came out of the company’s collaboration with Verily, Alphabet life sciences as well as Auris Health and its FDA-cleared Monarch platform. The Monarch platform is an advanced bronchoscopy that can be used to perform lung biopsies. So, the surgical system can help the surgeons to access nodules in patient’s lungs to diagnose and target treatments. The Ottava system leverages Ethicon instrumentation with advanced visualization and machine learning that would help to make surgeons smarter and reduce variation in surgical outcomes while improving the overall patient experience. 

 

Like Intuitive Surgical da Vinci, Ottava would be able to perform both the abdominal and chest surgeries along with performing those types of procedures for which robots are not typically used. The new J&J surgical system operations would extend to vascular-based interventions such as endoscopy, orthopedics, and catheter-based procedures. The device features an unconventional set of six arms for more degrees of freedom to make even the complicated work easy, and thus help to make a difference. However, experts are sceptical about the six arms as a greater number of arms means more risk of clashes or entanglements. The da Vinci robot is undeniably large whereas Medtronic’s Hugo is composed of various modular components, each smaller than da Vinci's one, and takes up lesser space even when combined. On the other hand, Ottava’s design differs from da Vinci’s boom-mounted nature and Hugo’s modular format and is designed to free up space to enable better patient access and facilitate the mobility of the entire platform from one operating room to another. 

 

With Ottava, doctors can examine the disease as well as treat it on the same day, which saves a lot of time for the patient as well as medical practitioners. Taking assistance from Ottava, the surgeon can enhance the precision of the operation, which could lead to fewer side effects. Also, the device can perform many types of operation, which could help hospitals avoid buying multiple robots, designed for a different purpose, thus saves them a lot of overhead costs. 

 

Other Players in Robot-assisted Surgery

 

Intuitive Surgical da Vinci 

The da Vinci surgical system allows surgeons to perform various general laparoscopic surgery with clinically supported precision and accuracy. The da Vinci surgical system consists of a patient cart with four robotic arms, an ergonomically designed surgeon’s console, a high-tech vision system, and patented EndoWrist instruments. The advanced robotic platform has been employed for tens and thousands of procedures and its safety and efficacy are well-documented in clinical publications. Expanding surgeon’s capabilities, da Vinci aid surgeons in surgical procedures for a variety of procedures providing excellent dexterity and control during surgery and the ability to execute 1-2 cm incisions versus longer incisions. Providing surgeons with superior vision, greater precision, enhanced dexterity, and ergonomic comfort, the da Vinci Surgical System makes it possible for surgeons to perform delicate dissection or reconstruction. Roughly, 75% of all prostate cancer operations in the US are performed using da Vinci devices due to their efficacy and reliable tool. 

 

Stryker Mako

FDA-approved in 2015, Stryker’s Mako is a robotic-assisted surgical platform employed for orthopaedic operations including partial knee, total hip, and total knee operations. The technology allows surgeons to create a three-dimensional virtual model of the unique anatomy of the joint to be operated upon. The unique detailing and personalized view help to prepare the bone for the implant and the robotic arm guides surgeons to perform a more accurate and better-aligned knee replacement. The MAKO robotic arm assisted surgery offers several advantages over conventional manual techniques such as real-time sensory feedbacks, proper penetration of the bone, precise placement of the implant, minimal blood loss and scarring, preserve healthy bone and soft tissue from damage, quick recovery, short hospital stay, and less post-operative pain.

 

Siemens Healthineers Corindus Vascular Robotics

The surgical robot system designed for coronary, peripheral vascular, and neurovascular procedures, Corindus Vascular Robotics consists of robotic-assisted control of coronary guide catheters, guidewires, and rapid exchange catheter with a sub-millimeter measurement that enables proper stent positioning. Corindus CorPath System is the first FDA-approved medical device for coronary angioplasty procedures in the USA. The system allows physicians to perform procedures, advancing stents and guidewires with utmost accuracy using digital controls, all while seating in a cockpit protected from radiation exposure. Enabling proximity and ergonomic visualization, the device helps physicians overcome the struggle to see angiography. Besides, the robotic intervention eliminates trial and error and assures precise ‘point and shoot’ predictability. 

 

Conclusion 

There are different surgical robots designed for different purposes, but J&J Ottava promises to perform a variety of surgical interventions, which is a huge advantage for hospitals. Also, according to industry experts, six arms seem a bit more and can hinder the productivity of operation if not managed well. Until now, no clinical research has been made on the newly built device therefore, its efficacy cannot be determined yet. However, it is evident that the surgical robotic system market has a huge potential, and the top players are much involved in refining their products to the best of quality to serve the growing needs of patients as well as doctors. 

According to TechSci research report on “Global Surgical Robots Market By Component (Systems, Instruments and Accessories, Services), By Mechanism of Control (Computer Control, Direct Telemanipulator), By Application (Orthopedic Surgery, Endometriosis, General Surgery, Neurosurgery, Thoracic Surgery, Colorectal Surgery, Gynecology, Heart Surgery, Urologic Surgery and Others), By End User (Hospitals & Clinics and Ambulatory Surgical Centers), By Region, Competition, Forecast & Opportunities, 2025”, the global surgical robots market is anticipated to grow at a CAGR of 15% and reach USD13 billion by 2025. The growth can be attributed to the increasing incidences of degenerative and chronic diseases and technological innovation and advancements coupled with new product launches. Besides, rising geriatric population and highly complex surgical procedures are fuelling the demand for global surgical robots market.

According to another TechSci research report on “Global Robotics Market By Component (Hardware and Software), By Type (Articulated, Cartesian, SCARA, Cylindrical and Others), By End User (Healthcare, Media & Entertainment, Aerospace & Defence, Logistics, Automotive and Others), By Region, Competition, Forecast & Opportunities, 2016-2026”, the global robotics market valued at USD49.94 billion in 2020 and is expected to forecast at a CAGR of 4.91% by 2026. The growth can be attributed to the rising necessity for remote communications and introduction of advanced robotic system by top players in the market. 


 

Source : TechSci Research

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