Source: Sina Tech.
Financing in the surgical robot field has reached nearly USD 1.4 billion this year, with early-stage rounds of Series A or earlier accounting for 60 percent, including large deals such as USD 600 million for CMR Surgical and EUR 100 million for eCential Robotics.
Public data show that a third of the world’s robots are now made in China, and Shanghai alone supplies about a ninth of global robot output, making it the country’s largest robotics cluster. To consolidate that position, the Intuitive Fosun da Vinci Innovation Center officially opened in Shanghai, with total investment above 100 million yuan and operations starting in October 2021.
Pan Xiaofeng, CEO of Intuitive Fosun, told 21st Century Business Herald that robot-assisted surgery represents the direction of minimally invasive, precise surgery, and demand among medical professionals for these skills keeps growing. Since the first da Vinci surgical robot arrived in China in 2007, the cumulative total of robot-assisted procedures has passed 200,000 and installed units have exceeded 250, with growth accelerating in the past two years. China’s rich clinical practice is becoming fertile ground for clinical innovation and gradually pushing the country toward the core of the global medical innovation chain.
“As installations rise rapidly, the gap between doctors’ demand for surgical robot training and the training supply available is increasingly stark. It constrains more clinicians from mastering the technology and offering patients higher-quality minimally invasive treatment, and it limits the clinical innovation of well-trained Chinese experts in the field, and with it a stronger Chinese voice in international academia,” Pan said.
The new da Vinci Innovation Center covers urology, gynecology, cardiothoracic surgery and general surgery. It is equipped with the full range of da Vinci surgical robots and a bronchoscopy robot, plus professional linked operating tables, energy platforms and anaesthesia machines, and can run six da Vinci surgical training sessions at once.
From top hospitals to the grassroots
In December 2016, Fosun Pharma and Intuitive Surgical of the United States announced their strategic partnership in China, jointly investing USD 100 million to set up the joint venture Intuitive Fosun in Shanghai to develop, produce and sell innovative robot-assisted catheter products for early lung cancer diagnosis, a new product line beyond the da Vinci surgical system. Fosun Pharma holds 40 percent and Intuitive Surgical 60 percent.
Pan noted that before the joint venture was founded, the da Vinci robot took more than a decade to accumulate 100,000 procedures in China; since Intuitive Fosun was established, the next 100,000 took only about two and a half years.
The da Vinci robot has become the world’s most widely used surgical robot, applied to soft-tissue surgery in the chest and abdominal cavities, and high-difficulty robot-assisted surgery is an important academic arena where Chinese clinicians run high-quality studies and build international influence.
In the Chinese market, however, clinical installation of laparoscopic surgical robots is subject to national approval for large medical equipment, so numbers remain limited and da Vinci robots are still concentrated in top hospitals.
Pan believes policies to strengthen grassroots hospitals will further spread surgical robots beyond the top tier. “The state has introduced more incentives. In free trade zones, the configuration of Class B large medical equipment by privately run medical institutions is changing from approval to filing. We will pay more attention to the non-public hospital market and tailor policies to its unique needs,” he said. To bring clinical demand and industry closer and integrate research, industry, medicine and education, innovation centers have become a key industry focus, and Intuitive Fosun plans to train more than 4,000 medical professionals on the da Vinci surgical system and robot-assisted surgery over the next five years, supporting the growth of Chinese medical professionals and the upgrade and accessibility of local healthcare.
Chinese and foreign firms race for the market
As industry integration deepens, the market keeps expanding. Frost & Sullivan data show the global surgical robot market grew year by year from 2015 to 2020, with growth accelerating through 2019. In 2020 the pandemic cut surgery volumes, delaying unnecessary and elective procedures, so growth slowed yet still held near 8 percent, with the market at USD 8.32 billion and a 2015-2020 compound annual growth rate of 22.6 percent.
PwC forecasts the surgical robot market will reach USD 6.44 billion in 2021, which is why the medical robot field has never lacked entrants. According to LeadLeo Research Institute, da Vinci robots assisted 205,000 procedures worldwide in 2009 and 1.243 million in 2020, a compound annual growth rate of 17.8 percent, further evidence of steadily rising adoption.
Among multinationals, besides Intuitive, Stryker acquired the orthopedic robot maker Mako for USD 1.4 billion in 2013. Mako is now installed in more than 28 countries, with over 1,000 units and more than 350,000 operations in 14 years, holding roughly 8 percent of the global market.
Public data show the Mako smart joint robot is the only joint surgery robot approved for sale in China. It addresses the traditional difficulties of joint surgery, poor visibility, imprecise cuts and unstable alignment, greatly improving patient outcomes, and has been approved domestically for total hip and total knee replacement.
Domestic firms are not far behind. Incomplete statistics from WuXi AppTec’s content database show nearly USD 1.4 billion raised in surgical robots this year, with 60 percent in Series A or earlier, including the large CMR and eCential rounds. From January to April alone, at least five financing deals closed in China’s orthopedic robot field across trauma, joint and spine categories, while Medath Health, Xinwei Medical and Acotreet have all pushed toward the capital markets.
On the current landscape, Pan said that from a global view every major medical device company is preparing to enter the market, and domestic startups are joining to take a share, a healthy development.
“When surgical robots were invented more than 20 years ago, everyone thought it was a niche product. But as clinical results were powerfully proven and the benefits to doctors and patients became clear, the market grew and accepted it quickly, and now it is a crowded race. We think a bigger cake means better market expectations,” Pan said. Many domestic innovators are positioning in the surgical robot track and some leaders are close to product launches. “We welcome competition. More companies and products help cultivate the market and help more people recognise that robot-assisted therapy represents the future of minimally invasive surgery.”
Multinationals deepen localisation
Entering the market is one thing; doing well in it is another.
“A successful robotics programme needs more than robots. It needs a complete ecosystem, long-term technical training and strong service capability, and close cooperation with users, building a leading robot-assisted surgery system and ecosystem that helps customers improve outcomes, raise efficiency and expand access to minimally invasive treatment,” Pan said.
In practice this resembles what large imaging equipment such as CT and MRI faced when they first entered China. As domestic firms accelerated innovation and multinationals pushed localisation, imaging equipment became widespread. With innovation capacity rising and localisation deepening, China’s medical robot market can be expected to grow further.
Intuitive Fosun is following that trend, pursuing localisation, combining internationally advanced technology with China’s active clinical innovation environment to become a truly local enterprise integrating R&D, production, training, promotion and service.
Meanwhile, as the social environment, policy and capital keep supporting development, innovation incubation can further aggregate enterprises and industry, clear the blockages between technology and the economy, and turn scientific advantages into industrial advantages, making the translation of innovation into products a major trend. That is why Intuitive Fosun has set up a manufacturing and R&D base for the da Vinci surgical robot in Shanghai, its second such base worldwide after Silicon Valley.
“Innovation is endless. Today we took the first step, starting from clinical training and practice, letting more doctors master this advanced technology and support more clinical applications. Clinical practice will generate more innovation that feeds back into technology and product iteration. The innovation center, and in future a comprehensive base with more functions, can accelerate this process, deepen the localisation of the innovation chain, and raise the standing and value of the China node in the global surgical robot innovation chain,” Pan said.
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