Intuitive Surgical, Inc. is an American corporation that develops, manufactures, and markets robotic products designed to improve clinical outcomes of patients through minimally invasive surgery, most notably with the da Vinci Surgical System. The company is part of the NASDAQ-100 and S&P 500. As of December 31, 2019, Intuitive Surgical had an installed base of 5,582 da Vinci Surgical Systems, including 3,531 in the U.S., 977 in Europe, 780 in Asia, and 294 in the rest of the world.
History
The research that eventually led to the development of the da Vinci Surgical System was performed in the late 1980s at a non-profit research instituteSRI International. In 1990, SRI received funding from the National Institutes of Health. SRI developed a prototype robotic surgical system that caught the interest of the Defense Advanced Research Projects Agency, which was interested in the system for its potential to allow surgeons to operate remotely on soldiers wounded on the battlefield. In 1994, Dr. Frederic Moll became interested in the SRI System, as the device was known at the time. At the time, Moll was employed by Guidant. He tried to interest Guidant in backing it, to no avail. In 1995, Moll was introduced to John Freund, who had recently left Acuson Corporation. Freund negotiated an option to acquire SRI's intellectual property, and incorporated a new company that he named Intuitive Surgical Devices, Inc. At that point Freund, Moll, and Robert Younge wrote the business plan for the company and raised its initial venture capital. Early investors included the Mayfield Fund, Sierra Ventures, and Morgan Stanley. The company refined the SRI System into a prototype known originally as "Lenny", which was ready for testing in 1997. As the company's prototypes became more advanced, they were named using da Vinci themes. One was named "Leonardo", and another was "Mona". The final version of the prototype was nicknamed the da Vinci Surgical System, and the name stuck when the system was eventually commercialized. After further testing, Intuitive Surgical began marketing this system in Europe in 1999, while awaiting FDA approval in the United States. The company raised $46 million in an initial public offering in 2000. That same year, the FDA approved use of the da Vinci Surgical System for general laparoscopic surgery, which can be used to address gallbladder disease and gastroesophageal disease. In 2001, the FDA approved use of the system for prostate surgery. The FDA has subsequently approved the system for thoracoscopic surgery, cardiac procedures performed with adjunctive incisions, and gynecologic procedures. Shortly before going public, Intuitive Surgical was sued for patent infringement by Computer Motion, Inc, its chief rival. Computer Motion had actually gotten into the robotic surgery field earlier than Intuitive Surgical, with its own system, the ZEUS Robotic Surgical System. Although the ZEUS system was approved in Europe, the U.S. Food and Drug Administration had not yet approved it for any procedure at the time that the FDA first approved the da Vinci system. The uncertainty created by the litigation between the companies was a drag on each company's growth. In 2003, Intuitive Surgical and Computer Motion agreed to merge, thus ending the litigation between them. The ZEUS system was ultimately phased out in favor of the da Vinci system. Computer Motion was lead by Chairman Robert Duggan from 1990 until 2003, when the two companies merged. Before the buyout of Computer Motion, the stock of Intuitive was selling at around $14 per share, adjusted for stock splits. After the merger, the stock price rose significantly, primarily because of the growth in systems sold and the number of surgical procedures performed.
Finances
For the fiscal year 2017, Intuitive Surgical reported earnings of US$660 million, with an annual revenue of US$3.129 billion, an increase of 15.7% over the previous fiscal cycle. Intuitive Surgical's shares traded at over $307 per share, and its market capitalization was valued at over US$58 billion in November 2018.
The da Vinci Surgical System is a robotic surgical system. The system is controlled by a surgeon from a console. It is commonly used for prostatectomies and increasingly for cardiac valve repair and gynecologic surgical procedures. A da Vinci Surgical System costs approximately $1.5 million. The new da Vinci SI released in April 2009 cost about $1.75 million. In addition, there are maintenance contracts plus expenditures for instruments used during surgery. Surgical procedures performed with the robot take longer than traditional ones. Critics have pointed out that hospitals have a hard time recovering the cost and that most clinical data does not support the claim of improved patient outcomes.
Efficacy
While the use of robotic surgery has become an item in the advertisement of medical services, there is a lack of studies that indicated long-term results are superior to results following laparoscopic surgery.
