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CMR Surgical: Advancing Flexibility and Precision in Robotic Surgery

The Driver:

CMR Surgical recently raised $165M. The funding round was led by Softbank and Tencent and included all of its existing investors including Ally Bridge Group, Cambridge Innovation Capital, Escala Capital, LGT, RPMI Railpen, and Watrium. The funding brings CMR Surgical’s total funds raised to $1.1B per Crunchbase and the company’s value remains the same as it was at the time of its Series D in 2021 when it was $3b according to Sifted. The company stated it plans to use the funds to drive continued product innovation, including new technological developments, and to support the further commercialization of the system in key existing, and new, geographies.

Key Takeaways:

  • From January 2012 through June 2018, the use of robotic-assisted surgery for all general surgery procedures increased from 1.8% to 15.1%, equaling an 8.4-fold change (JAMA)

  • Cost savings from robotic surgery generally appear to be a function of operating time and reduction in complications with one study showing approximately a 3030-minuteeduction in time and a 10% reduction in complications to achieve savings (BMJ Surgery, Interventions, and Health Technologies).

  • The market for soft-tissue robotic-assisted minimal access surgery is projected to exceed $7B per year (CMR Surgical)

  • The typical costs for a robotic-assisted surgical machine range anywhere from $1.5M to $2.0M USD (Cureus)

The Story:

CMR was founded in 2014 with the goal of giving as many people in as many places in the world access to minimal-access surgery (MAS). As Mark Slack, Chief Medical Officer noted in 2022, “our goal is to make robotic-assisted surgery more accessible globally, offering a solution with flexible and novel financing models that can work for both public and private contracts and for low-and middle-income countries. The company sells robotic-assisted minimal access surgery systems to hospitals for hernia repair, colectomies (partial or full removal of a colon), hysterectomies, sacrocolpopexies (repair weakness or damage in pelvic organs often using surgical mesh) and lobectomies (removal of a lobe of a lung).

As noted by Fierce Health back in 2017, CMR is combining the design and economics of its devices to broaden the use of robotic-assisted surgery in hospitals. “CMR wants the device …to be economically viable for more hospitals. As it stands, hospitals make big upfront investments to acquire robots. This limits uptake…CMR has designed Versius to cost less than other systems. And it is pairing this cost-conscious design with a business model that could make the economics more favorable still for hospitals.” As a result, Versius is being used in routine clinical practice to deliver high-quality surgical care to patients around the world.

The Differentiators

As noted by the company, what distinguishes CMR Surgical’s Versius robotic surgical assistant is its patented “V-wrist technology, which allows [its] small, fully wristed instruments to have seven degrees of freedom which can be rotated 360 degrees in both directions by the arm. This technology, which bio mimics the human arm, has helped [CMR surgical] make the units so much smaller than other systems.” CMR Surgical argues that this gives surgeons increased precision, accuracy and proficiency allowing them to reach hard-to-reach areas when necessary.

This in turn facilitates the small “footprint and modular design” of CMR’s Versius robotic surgical assistant, where each robotic “arm” is independent of the other, allowing a surgeon to place a singular arm or “port” where necessary to best suit the needs of the patient for a given procedure. This is in contrast to market leader, Intuitive Surgical’s DaVinci Robot where all arms emanate from a single pod above the patient, giving rise to a so-called Octopus configuration of robot arms. CMR Surgical units also allow surgeons to either sit or stand at the surgical console, or even change positions during operations, thereby causing less physical strain on the body during lengthy procedures. This can be particularly important given current workforce shortages and issues around clinician satisfaction.

The Big Picture:

As noted by the Mayo Clinic, “the primary benefit of robotic surgery for patients is faster recovery” primarily due to smaller incisions and less blood loss during procedures. This “allows patients to return to daily activities sooner...and have fewer surgical complications.” In addition, robotically assisted surgery can reduce opioid use and help reduce the overall cost of and length of hospitalizations. For example, as noted by a 2021 study in BMJ Surgery, Interventions and Health Technologies, cost savings from robotic surgery generally appear to be a function of operating time and reduction in complications with one study showing approximately a 30-minute reduction in time and a 10% reduction in complications to achieve savings

However, it should be noted that this topic has been the subject of considerable debate (please see “Robotic Surgery: A Comprehensive Review of the Literature and Current Trends”, Cureus, July 2023 for a review of current trends, applications and issues). We do believe that over time as lower-cost robotically assisted surgery like CMR Surgical’s Versius come to market, costs will decrease, helping to reduce length of stay and system costs which will be crucial for hospitals that are under continuous margin pressure. In addition, as adoption and technologies such as robotics and artificial reality (AR) and virtual reality (VR) increase, the training and proficiency of surgeons should increase as well. For example, according to a recent article in Semiconductor Engineering, having a recording of the procedure will enable “future analysis to improve the process and for educational purposes. [As such] there is great hope that as time goes by robotic-assisted surgery will increase accuracy, efficiency, and safety, all while potentially reducing healthcare costs.”


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