1) There are several newer robotic surgery systems that have entered the market to compete with the da Vinci system, including the Hugo RAS system, Versius, and others. 2) These new systems differ from da Vinci in their surgeon console, patient-side setup, vision systems, instruments, and intended applications. 3) Factors like system cost, per-procedure cost, instrument costs, and maintenance costs also vary between systems.

1. Newer
Robotics
Dr.K.Priyatham
MCh Urology, Fellowship in Uro-
Oncology(RGCI)
Prashanth Hospital, Vijayawada

2. No conflicts of interest

5. Multiport
Robot Company
Da Vinci Intuitive Surgical, USA
Senhance Sofar, Italy; acquired by
transenterix USA
Hugo-RAS Medtronic USA
Avatera Avater Medical, Germany
Revo-I Meerecompany,
Seongnam, Korea
Hinotori Kawasaki, Japan
Versius CMR surgical, UK
Dexter Distalmotion, Lausanne,
CH, Switzerland
Verb Surgical Johnson & Johnson, USA
MedBot’s Toumai Medport, Shanghai,China
KD-SR-01 Suzhou Kangduo Robot
Jiangsu, China
Mantra SSI innovations, India
Single port
Robot Company
SP 1098-platform Intuitive Surgical, USA
Surgibot Transenterix USA
IREP Columbia University, USA
ENOS Titan medical, Canada
SPRINT ARAKNES, Italy,
Switzerland, Germany

6. Console
Closed Semi-closed Open

7. Manipulation
Loop like Pistol like Laparoscopy

8. Robotic Arms
Single Beam Individual

9. Davinci - SP

10. First-Ever ‘Made In India’ surgical robotic
system installed at Rajiv Gandhi Institute in
July 2022

11. Versius Surgical robot was first sold in India in 2019

13. Hugo™ RAS System

14. TECHNOLOGY DIFFERENTIATORS
• Open Face Surgeon Console
• Head tracking
• Large 32” 3D HD monitor
• 23” 2D touch monitor for patient data and control buttons
• Ergonomic
• Hand controls and foot pedals visible
• Inferior ergonomics with hunched over surgeon position
• Smaller 3D view for the surgeon
• Very small images of patient information
• No Secondary monitor
• Hand Controls and foot pedals not visible while surgeon
operating
• Open Face surgeon Console
• Eye tracking feature
• All buttons in the hand controls
• No foot pedals
• No secondary monitor
• Slim design carts with mounted arms
• Flexible cart and arm positioning
• Flexibility for the number of arms (3-5)
• Needs more OT space
• All arms mounted on a single beam of patient side cart
• Potential collision of robotic arms
• Fixed 4 arm system
• 7 DOF Modular Arm that is directly connected to the
instrument
• The entire arm has to move with the instruments for
surgical tasks
• No Tool Interface
• Needs more OT space
• Large 32” 3D 1080p HD monitor provides 3D vision to
entire patient side team and trainees
• In built OMNI 3D HDTM system for 3D/2D recording
system. Tele-mentoring/Tele-training Capability.
• 4-way articulating 1080p 3D HD endoscope
• 24” 2D monitor only for the patient side team and trainees
• No depth perceived by the table side team during
instrument exchanges and introduction of supplies
• 0 and 30 degree endoscopes requiring exchanges to
achieve desired view
• 1920x1080p hd endoscope
• There is no Vision Cart
• The vision system is in the Surgeon Console
• Only 2D monitor for the table side team
Surgeon
Console
Patient Side
Arm Carts
Vision Cart

15. • Over thirty 9 mm MUDRATM Endo-Surgical
Instruments for multi-specialty procedures
• Longer Instruments
• Wide range of 8 mm Instruments for multi-
specialty procedures except Coronary Bypass
Surgery
• Longer Instruments
• Only 6 types of 5 mm size Instruments
• Gripping force not equal to 8-9 mm instruments
• Shorter Instruments
• Advanced Instruments – NADI (Automated
Anastomotic Connector) for coronary bypass
Surgery, Multi-fire Clip Appliers and Cardiac
Endo-Stabilizer
• Advanced Instruments – Vessel Sealer,
Harmonic, Staplers
• Not Available
• Urology, Gynaecology, General Surgery,
Cardiac (including coronary bypass surgery),
Thoracic and Head & Neck.
• Urology, Gynaecology, General Surgery,
Cardiac (except coronary bypass surgery),
Thoracic and Head & Neck.
• Urology, Gynaecology & General Surgery
Instruments
Advanced
Instrumentatio
n
Intended to use
for Specialty
INSTRUMENTS, APPLICATIONS AND COST
• Low System Cost ~ $0.55M to $0.82M
• Low per instruments cost per case ~ Rs 35,000
• Low maintenance cost ~ after three year of free
warranty, $59 K 4th year, $63 K 5th year with cap
at $65 K for the remaining 5 years
• High System Cost ~ $1.2 M to $2.5M
• Higher instrument cost per case – Rs 90,000
• High Comprehensive Maintenance cost ~ $80K to
$190K
• High System Cost ~ $2 M
• High per Procedure Cost ~ * $3 M+ with
Procedure bundling
Cost

16. Future – Tele Robotic Surgery

17. Future Robotics
Nanobots & Microbots Xenobots

18. Conclusion
• The robotic surgery field is expected to advance by leaps and bounds
over the next decade.
• More progress is expected in the next 10 years than we've seen in the
entire history of surgical robotics, and that is primarily because of
software enhancements.
• Several Robotic systems expected to hit the market within next 5-10
years

19. • High technical standards of four da Vinci generations have set a high
bar for upcoming robotic systems
New platforms will need to be critically assessed, and their performance
necessarily compared with the current ‘gold standard’
• Implementation will depend on actual clinical applicability and costs
How these developments will facilitate the surgeons and whether their use
will translate into better outcomes for our patients remains to be determined

20. Thank You