Intuitive Surgical: General Surgery Penetration

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It's interesting you mentioned the ceiling isn't as high for laparoscopic surgery as it can be for robotic surgery. If I were to think about it in terms of metrics, how do you measure that ceiling? Is it in clinical outcomes? How do you think about what makes robotic surgery better than laparoscopic surgery, if we were to quantify it?

Number one, you have increased precision from the platform, increased stability, and better visualization. It helps surgeons become better surgeons and makes the learning curve for performing complex, minimally invasive procedures easier for a larger number of surgeons. That's significant.

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The reason I'm asking is that one common concern with robotic surgery is that the typical procedure takes longer than pure laparoscopic surgery. Over an entire year, the number of cases you can do is lower, which potentially affects your pay. How do you think about the length of the procedures compared to laparoscopic? What's your experience?

But for the majority of complex cases, if it extends the OR time just a few minutes to set things up, it saves time during the procedure by making certain tasks easier. A lot of questions about time come down to where people are on their learning curve. Robotics is being embraced more widely today than in the past, but the data comes from years ago. If you look at database data from 2010 to 2015 or 2015 to 2020, it's like a history report. It's a different era with people at different points in their learning curve. Early in the learning curve, less skilled and less efficient surgeons skew the data, which doesn't reflect what's possible.

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