Lonnie M. Smith - Intuitive Surgical
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The document discusses the history and development of robotic surgery using the da Vinci surgical system. It describes how the system was developed to enable surgeons to perform complex surgery through small incisions with greater precision than is possible manually. It outlines key innovations in the system over time, including 3D HD vision and more advanced instruments. It also discusses clinical benefits shown in various procedures like prostatectomy and how adoption has occurred procedure by procedure.
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Lonnie M. Smith - Intuitive Surgical
- 1. Training Class Intuitive Surgical & ab medica 10 th Anniversary of Robotic Surgery in Italy
- 2. Disruptive Innovation “ Breakthrough” Technologies are Born Ugly
- 5. Hansen Way
- 8. Patient Side Arms and Set-up
- 9. Gary & Tom doing a Demo
- 10. 1 st “System Shipped
- 12. Peeling a Grape
- 13. New Technology Adoption Curve Innovators Early Adopters Early Majority Late Majority Laggards
- 14. Adoption is Driven by a Significant Shift in the Value to the Customer That Value Equation for Surgery is Efficacy Patient Value = Invasiveness
- 15. Adoption is Driven by a Significant Shift in the Value to the Customer That Value Equation for Surgery is 2 Efficacy Patient Value = Invasiveness
- 16. Procedure Value Matrix Invasiveness Efficacy High Low High Most Attractive High
- 17. Procedure Value Matrix Prostate Cancer Invasiveness Efficacy High Low High Most Attractive Open Radical Prostatectomy Hormonal Treatment Radioactive Seeds Watchful Waiting Radiation
- 19. Grading of Operation from the Patients Perspective Dr. Menon - Henry Ford Hospital (524) 87% (373) 62% 600 SCORE 100% 89% No transfusion Blood loss 3 7 Score* Pain 98% 85% No comps Safety 66% 33% Sexual Intcourse Potency (6 mths) 96% 60% No pads Continence (6 mths) 94% 76% Neg Margins Cancer removal Menon VIP HFHS RRP Test
- 20. Procedure Value Matrix Invasiveness Efficacy High Low High Open Radical Prostatectomy dVP Radioactive Seeds
- 22. daVinci Prostatectomy U.S. Adoption Curve Regression Analysis Quarterly Data 2002-Q4, 2007 dVP / Total Prostatectomies Y = .2611-5.4011 2 R = 0.9833
- 23. U.S. Prostatectomy Adoption Curve Quarterly Procedures 100,000 Annually
- 24. Robotic Surgery adoption will occur procedure by procedure Robotic Surgery Adoption Curve dVPostatectomy
- 27. dVH Adoption Curve Quarterly Procedures 250,000 Annually
- 28. Robotic Surgery adoption will occur procedure by procedure Robotic Surgery Adoption Curve dVPostatectomy dVHysterectomy
- 32. Robotic Surgery adoption will occur procedure by procedure
- 33. WW Procedures
- 34. da Vinci ® Surgical System U.S. Installed Base 1999 – 2009 Alaska Hawaii 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009-through Q3
- 35. da Vinci ® European Installed Base 1999 – 2009 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009-through Q3
- 36. da Vinci ® Asian Installed Base 1999 – 2009 2002 2003 2004 2005 2006 2007 2008 2009-through Q3
- 37. Net Sales Trend - ($MM) 67% CAGR
- 38. Dual Console - Fully Integrated OR
- 40. da Vinci Connect
- 44. Single Port & Natural Body Orifice Surgery
- 48. The Journey “ Taking surgery beyond the limits of the human hand. ™ ”
- 49. Training Class Intuitive Surgical & ab medica 10 th Anniversary of Robotic Surgery in Italy
Editor's Notes
- 1947 William Shockley (Stanford) successfully tested a point-contact transistor setting off the semiconductor revolution. 1953 Jay Forrester(MIT) installed a magnetic core memory on a computer. 1955 TRADIC was the 1 st fully transistorized computer Followed in 1956 by Magnetic Disk Memory 1 st Integrated Circuits in 1958 Microprocessors emerged in the late 60’s and early 70’s Leading to “Super Computers”, Mini-Computers, Personal Computers, routers, and servers.
- Suggested script: The next generation da Vinci System was the da Vinci S system, introduced in 2006. The ‘S’ offered the surgeon HD vision for the first time in robotic surgery. Furthermore, many of the information sources such as patient vitals that a surgeon was accustomed to seeing in open or laparoscopic surgery on a monitor were integrated into the surgeon console viewer through the advent of our TilePro feature. In addition, by increasing the instrument reach and arm movement, the da Vinci ‘S’ offered the surgeon the ability to have multi-quadrant access. Previously on the Standard System, the device would have to be undocked, moved, and then re-docked. Finally, the da Vinci S system significantly streamlined the OR set-up and turnover process by offering a simplified set-up, less pieces to coordinate. Now, we have introduced the da Vinci Si system. With the Standard and ‘S’ systems, the surgeon worked in an independent fashion, even on complex cases where two surgeons would normally collaborate in open or even laparoscopic surgery. Now, with the dual console capability of da Vinci Si, two surgeons can work collaboratively in a robotic MIS fashion! (More on this in just a moment). The ‘Si’ also has significantly enhanced vision, refined master controllers, a simplified and enhanced energy control footswitch panel, additional ergonomic setting, and several enhancements to increase the surgeons control of the operative field and the OR. Enhanced HD Vision (1080i) Refined Masters Enhanced Energy Control Superior Ergonomics Increased Surgeon Control Scalable architecture
- Robotics are at the beginning of the adoption curve and after about 10 years we are about the same place as the internet.
- If you place the two value drives on a matrix, it looks like this. With the patients comfort zone in this area. The most attract zone is in the upper left hand corner.
- Alternative conventional treatments for prostate cancer might look something like this. Open Radical being the most effective, but also the most invasive with significant potential side effects. Seeds being perceived as less invasive, but arguably less effective - the cancer is not removed. Hormonal treatment less invasive and less effective than the others And watchful waiting clearly the least invasive.
- daVinci Prostatectomy has in general effected both value drives: Increasing efficacy with better margins, better continence, and reduced sexual dysfunction. And at the same time reducing the invasiveness of the procedure, allowing the patient to return to normal life actives more quickly. And as a result gaining widespread patient acceptance.
- Over the last five years the installed base of da Vinci Surgical Systems has grown significantly.
- Over the last five years the installed base of da Vinci Surgical Systems has grown significantly.
- Over the last five years the installed base of da Vinci Surgical Systems has grown significantly.