Intuitive Surgical Inc: Taking the Broader View - ISRG in a Great Spot.

Research evidence excerpt

Intuitive Surgical Inc: Taking the Broader View - ISRG in a Great Spot.

FigureSource:UBS3: ResearchSummaryestimatesview of automation areas by challenge and timingSummary

Ironically, the nearest-term and highest probability automation is the scaffolding around

the operative work, like camera control, docking, retraction, all rather than the operative

steps themselves. These are repetitive in nature, low-judgement and tolerant of error (a

mis-framed camera is hardly an emergency), and they are a decent slice of time and

personnel.

Autonomous tissue retraction and exposure has been demonstrated by multiple groups

(e.g. Nagy et al.), while autonomous camera control via gaze and kinematics is

developing (Wagner et al.). Even for docking there have been substantial developments

with AI-driven docking vehicles (e.g. Tian et al.), while a few other robotics businesses

are trying to remove the issue entirely through form factor (consider what Virtual

Incision is gunning for as an example).

Beyond the setup, we're also seeing nascent automation attempts across the more

direct parts of surgery. While much of this is ex-vivo today, we think it's only a matter of

time longer term. For example, within resection we've seen ex vivo tumor resection work

done at John Hopkins with electrocautery tooling. Equally there have been attempts to

automate suturing with porcine work being done through end-to-end intestinal

anastomosis, benchmarked against manual surgery, laparoscopy, and RAS.

The main areas we would be more cautious on overall is what we'd consider the highly

subjective parts of dissection requiring a lot of human judgement. These would be deep

interventional around sensitive vascular or nervous structures that may require a rapid