Prior Fiscal: $3.72 Billion
Percentage Change: +20.4%
No. of Employees: 7,326
Global Headquarters: Sunnyvale, Calif.
Gary S. Guthart, Ph.D., CEO
Marshall L. Mohr, Exec. VP and CFO
Myriam J. Curet, M.D., FACS, Exec. VP and Chief Medical Officer
Bob DeSantis, Exec. VP and General Manager, Instruments, Accessories, and Endoscopes
Brian Miller, Exec. VP and General Manager, Systems and Vision
Colin Morales, Sr. VP and General Manager, Secondary Market Equipment and Service
Chris Carlson, Ph.D., VP and General Manager, Endoluminal
Intuitive Surgical has essentially had the robotic surgical systems market to itself for years. Today there are several others in the arena, but none of the rivals have gone head-to-head against its flagship da Vinci robotic surgical system.
That is, until last September, when Medtronic hosted an analysts day focused on robotic surgical systems with a special emphasis on a new soft-tissue robot to compete directly with da Vinci.
Recently retired CEO Omar Ishrak stated in the company’s Q1 fiscal 2020 conference call that “in virtually every area that we have a procedural presence, we will look at robotics because that’s how it’s going to be.”
Medtronic is a formidable threat. The company has close relationships with major hospital systems around the world, which frequently extend to personal contact with their surgeons. Medtronic isn’t new to robotic surgical systems—the company acquired robotic-assisted spinal and brain surgery technology firm Mazor Robotics in 2018.
Dethroning Intuitive won’t be easy. As of Dec. 31, 2019, the company had an installed base of 5,582 systems. Intuitive continued its meteoric rise last year, as sales rocketed 20.4 percent to $4.48 billion. Product revenue rose a sharp 22 percent to reach $3.8 billion, with instruments and accessories proceeds climbing 23 percent to $2.4 billion. This growth was mainly a result of 18 percent procedure growth and swelling advanced instrument sales. Strong increase in hernia repair, cholecystectomy, colorectal, bariatric, and thoracic procedures fueled U.S. sales. Procedures jumped 21 percent outside the U.S., mainly driven by growth in urologic, general surgery, and gynecology operations. The main growth hotspots globally were Japan, Germany, Korea, and China.
ANALYST INSIGHTS: As a market leader in robotics, Intuitive will continue to have many competitors attacking it (large and small) from multiple angles. The question remains: does Intuitive simply play defense or does it get aggressive on offense? It certainly has the capital and ability to make inorganic waves if it so chooses.
—Dave Sheppard, Co-Founder and Managing Director, MedWorld Advisors
Systems revenue shot up 19 percent to $1.3 billion, thanks to higher system shipments, higher 2019 ASPs, higher operating lease revenue, and higher lease buyouts. A total of 1,119 da Vinci systems were shipped in 2019, compared with 926 systems the previous year. Service revenue grew 14 percent to $724 million due to the larger installed base of da Vinci systems.
Intuitive earned FDA clearance last February for the Ion endoluminal system, a flexible robotic catheter for minimally invasive biopsy in the peripheral lung. The 3.5 mm diameter flexible articulating robotic catheter moves 180 degrees in all directions, passing through tight bends to collect peripheral lung tissue. A 2 mm working channel accommodates biopsy forceps or cytology brushes if necessary, and integrates into existing lung nodule biopsy workflows and imaging like fluoroscopy, radial-endobronchial ultrasound, and cone-beam CT. Shipments of Ion began in the second quarter of last year.
The da Vinci SP (single port) surgical system obtained an FDA nod for two lateral oropharyngectomy procedures last March—radical tonsillectomy and tongue base resection. Transoral otolaryngology procedures and urology procedures (cleared in 2018) are now in the da Vinci single port system’s skillset.
The da Vinci Handheld Camera, a lightweight 2D camera head, gained FDA clearance last June. It can connect to third-party laparoscopes, allowing image display on the da Vinci X/Xi vision cart to address aspects of procedures requiring laparoscope use. This eliminates redundant equipment in the OR.
In July, Intuitive acquired the robotic endoscope business of its over 20-year strategic supplier Schölly Fiberoptic, a German developer of visualization systems for minimally invasive diagnostics and surgical applications. The buy will integrate Schölly’s robotic endoscope manufacturing line and two Schölly sites (along with about 200 employees) into Intuitive operations.
“Application-specific and advanced image quality is our passion and the key for successful and safe minimally invasive surgery,” said Prof. Dr. Holger Reinecke, then-CEO of Schölly. “We have a long, successful relationship with Intuitive, and we share the common mission to advance healthcare by providing state-of-the-art technologies and innovative product features. This transaction will allow Schölly to focus more strategically on our global visualization business and ensure sustainable growth.”
The Sureform 45 mm Curved-Tip stapler and SureForm 45 mm Gray reload won an FDA nod in July as well. The SureForm 45 mm Curved-Tip single-use, fully wristed stapling instrument has a curved tip for resection, transection, and/or anastomoses creation. The single-use SureForm 45 mm Gray Reload cartridge contains multiple staggered rows of implantable staples and a stainless steel knife. Both are of particular utility in thoracic procedures.
November saw FDA clearance for two technologies to improve procedures requiring sealing: SynchroSeal and the E-100 generator. E-100 is a robotic generator to power the flagship Vessel Sealer Extend energy sealing instrument and the new, enhanced SynchroSeal instrument. SynchroSeal enables rapid one-step sealing and transection using bipolar energy from a raised electrode. This transects tissue then quickly cools it. SynchroSeal also features wristed articulation and a refined curved jaw.
The firm opened a new U.K. and Ireland headquarters and training suite at Oxford Science Park’s Schrödinger Building in September. The facility will offer a selection of education and training programs and help showcase its product pipeline.
Q1 2020 Revenue: $1.1 Billion
Q1 2019 Revenue: $974 Million
Percentage Change: +12.9%
“In response to COVID-19, Intuitive’s priorities are the health and safety of those we serve, including care teams, their patients, our employees, our communities, and our suppliers,” Intuitive CEO Gary Guthart told the press. “While we cannot predict the depth or duration of the disruption caused by the pandemic, we remain committed to our mission and the long-term need to improve patient outcomes.”
Intuitive and the Intuitive Foundation have built or sourced over 100,000 pieces of PPE. The Intuitive Foundation also launched a DIY face mask initiative. To support the manufacturing of critical PPE, Intuitive employees assembled face shields at the company’s Sunnyvale, Calif. and Connecticut campuses. They have assembled DIY facemasks using materials and instruction from the Intuitive Foundation.