2016 Global Surgical Robotics for Neurosurgical Interventions
Company of the Year Award
2016
BEST PRACTICES RESEARCH
Contents
Background and Company Performance ........................................................................ 3
Industry Challenges .............................................................................................. 3
Visionary Innovation & Performance and Customer Impact of Medtech SA ................... 3
Conclusion........................................................................................................... 4
Significance of Company of the Year ............................................................................. 5
Understanding Company of the Year ............................................................................. 8
Key Benchmarking Criteria .................................................................................... 8
The Intersection between 360-Degree Research and Best Practices Awards ....................... 9
Research Methodology .......................................................................................... 9
Best Practices Recognition: 10 Steps to Researching, Identifying, and Recognizing Best Practices ................................................................................................................. 10
About Frost & Sullivan .............................................................................................. 11
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Background and Company Performance
Industry Challenges
The United States (US) surgical robotics market is experiencing rapid growth, primarily due
to the extensive system benefits to both surgeons and patients. Additionally, patient
interest in robot-assisted surgeries has risen due to increased amounts of clinical research
and market participant advertising that emphasizes these benefits. Surgical robot-assisted
systems allow surgeons to plan upcoming surgeries in more detail, promoting increased
accuracy and workflow. The systems also provide higher safety rates by reducing surgeon
fatigue and hand tremors and, in many cases, reduce surgical time. This decreases hospital
costs of operating room (OR) use and allows surgeons to increase revenue by being able to
conduct more surgeries. Since surgical assistant robot systems allow for minimally-invasive
procedures, patients experience less bleeding, pain, and risks of infection, thereby
decreasing recovery time. Furthermore, surgical assistant robot systems used for brain
surgery eliminate the need for a stereotactic frame, further reducing patient pain and
anxiety from having to undergo a pre-surgery procedure in which a support frame is
screwed into their cranium.
While the surgical assisted robot systems market is experiencing rapid growth, the market
still faces many challenges—primarily in regards to entrance—creating a compact, top-
heavy market structure. Developing robot systems with accuracy, precision, and an easy-to-
use platform takes years of research and development (R&D), and requires large upfront
capital. According to Frost & Sullivan research, these long and expensive R&D times can
lead to completed systems being marketed at, sometimes, over one million dollars.
In addition to purchasing the systems, hospitals are required to pay for annual
maintenance, and lose valuable OR space from bulky robotic systems. Hospitals must also
train hospital staff to use the robot system for optimal return on their investment. Finally,
due to the developing nature of the market, insurance reimbursement codes have not been
restructured to account for expensive maintenance, training, and system set-up, leading to
hospitals being only partially reimbursed for procedures utilizing this technology. While Frost
& Sullivan estimates that the reimbursement structure will be updated to take these
features into account within the next 8 to 10 years, at present, many hospitals are hesitant
to invest the capital required to buy and maintain these systems.
Visionary Innovation & Performance and Customer Impact of Medtech SA
In order to combat these challenges while still providing highly accurate and easy-to-use
systems, Medtech SA has created the ROSA™ robotic device for use in MIS neurosurgery
applications. This device provides all the added benefits of robotic-assisted surgery with a
lower than average system cost. Medtech SA’s experience creating surgical assistant robotic
devices has led the company to become one of the robotics industry’s leaders in
neurological applications, and the company’s recent development of the breakthrough
ROSA™ Spine system. This is the second year that Frost & Sullivan has recognized Medtech
SA for its ongoing commitment to groundbreaking innovation.
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History of Experience Leading to Best-in-Class Design
Headquartered in Montpellier, France, Medtech SA has maintained a commitment to robotic
development throughout its history. The company started creating second generation
robotics suited for daily OR use in 2002 with its development of the BRIGIT™ system for
robotic-assisted knee replacement. The machine’s advanced design led a large orthopedic
technology company, Zimmer, to purchase the entire patent portfolio. With this influx of
capital, Medtech SA set its sights higher: the creation of a robot-assistant for neurosurgical
procedures, more specifically, spine surgery. Medtech SA recognized the reduced amount of
complications in using a robot for brain surgery as compared to spine surgery—primarily the
inability to completely stabilize a patient’s spine during surgery due to the patient’s
breathing patterns—and decided to first develop a robot for brain surgery applications. It
then used it as a benchmark for later expansion of this technology towards spine surgery
applications. Medtech SA developed the ROSA™ Brain system, providing a way for surgeons
to plan and perform minimally-invasive brain surgery. After being launched for clinical trials
in Europe in 2008, the ROSA™ Brain received a CE Mark of approval in 2009 and FDA
approval in 2010. The demand for the system has grown rapidly, and it is now utilized in
over 50 centers worldwide.
Staying Focused on Development Goals
In 2011, Medtech SA fulfilled its original goal of providing a solution for robotic-assisted
spine surgery by expanding the ROSA™ system’s platform. This new platform allows real-
time monitoring of patient movements and compensates for these movements without the
necessity to stabilize the robot using the surrounding vertebrae. The ROSA™ Spine received
its CE mark in 2014, and Amiens-Picardy University Hospital was the first hospital worldwide
to use the robot for spine procedures after receiving the CE mark in December of that year.
The pre-CE mark world premiere was completed by Montpellier University Hospital. Medtech
SA is currently in the process of training and assisting in the ROSA™ spine’s implementation
in three other centers in Europe. The platform’s design and trial results have been
submitted to the FDA, and Medtech SA is hoping to receive approval within the end of the
year.
Commitment to Unique Features to Address Unmet Needs
With its previous experience in developing surgical robotics for orthopedic applications,
Medtech SA was able to understand and overcome all the challenges of developing and
using these robots for surgery during upfront development of the ROSA™ platform.
Neurosurgery requires surgeons to complete complex tasks; performing neurosurgery under
minimally-invasive conditions reduces the visual field, further increasing the difficulty of the
technique. The ROSA™ system overcomes this difficulty with its advanced planning and
positioning software. Pre-operative scans are integrated into the system which creates
three-dimensional images from the scans. Surgeons use these images to identify their
targets, plan their approach, and anticipate any possible complications before surgery
begins. The surgeon loads his plan into the ROSA™ system, allowing the system to follow
and assist him throughout the procedure according to that plan.
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If the surgeon needs to change his plan in mid-operation, the system can easily adapt and
automatically react to the changes, ensuring optimized workflow of the new process.
Repeatability and reproducibility are easily obtained with the ROSA™ robot. Since Medtech
SA has previous experience of developing the BRIGIT™ system, its engineers were able to
create the ROSA™ system with less upfront R&D time, allowing the company to offer the
system for $400,000 to $750,000 (depending on added capabilities), well below the average
industry cost.
Added Benefits of the ROSA™ Spine
Minimally-invasive spine surgery shares the same difficulties as brain surgery, such as
reduced visual field, but includes added complications like the inability to fully immobilize
the patient. Accurate intraoperative planning is obtained with ROSA™ Spine. During
surgery, patients need to breathe, and when the surgeon operates he exerts pressure on
the patient causing the spine to move. To overcome this movement, surgeons operating
without robot-assistant systems have to compensate for the body’s movement, decreasing
surgical accuracy. Previously developed robots for spine surgery assistance were designed
to be bone-mounted but, due to its weight and stability, the ROSA™ Spine robotic arm
offers firm, accurate instrument guidance. Moreover, it has a dynamic guidance system that
tracks and responds to patient movement in real time, providing compensation for the
body’s movements without the additional risk of clamping onto the spine. Since the design
of the ROSA™ robot is the same as for brain and spine surgery, Medtech SA has expanded
its software and array of instruments to offer a platform that can be used for both types of
surgery, providing optimal value to centers using the robot-assistant for these two
applications.
Commitment to Service and Training Leading to Optimized Robot Use
Medtech SA provides high-quality service and maintenance support to its customers,
ensuring their satisfaction. Right from the initial purchase and installation, Medtech SA
sends a clinical support technician (CST) to the health center’s site. The CST is responsible
for the initial system set-up and configurations to ensure its smooth implementation into the
spatial constraints of ORs. Additionally, CSTs are responsible for training hospital staff to
ensure optimized system use.
CSTs are located both at Medtech SA’s worldwide facilities as well as distributor sites,
allowing Medtech SA to maintain fast service turnaround times to provide customers
maximum returns on their investment. CSTs ensure that the systems are optimally used by
being present in the operating rooms during surgical procedures. CSTs can see the
technology in action, collect feedback on the current technology’s capabilities and also
provide ideas for future system improvements. To reduce large maintenance costs, Medtech
SA performs preventive maintenance checks on its systems, reducing system downtime and
costs associated with large system issues by quickly identifying potential problems.
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Design Success Evidenced in Rapid Revenue Growth
Medtech SA’s success is evidenced by the company’s rapid product line expansion and
revenue growth. As of June 2015, Medtech SA reported a total of 48 ROSA™ robots in use
worldwide, including 21 in North America and the first ROSA™ Spine system in Europe.
Furthermore, the company achieved an overall 130% revenue growth between 2014 and
2015, growing from $3.4 million to $7.9 million. Medtech SA plans to maintain its steady
growth rate, and continuously acquires new, talented team members to offer advanced
development, service, and support. The company continues expanding its R&D department
by employing experts across fields, allowing advancements on the ROSA™ system as the
industry identifies new needs. Medtech SA’s R&D team also maintains close relationships
with key industry opinion leaders and academic partners to remain on the cutting-edge of
innovation and development. Due to the high demand for advanced surgical-assistant
robotic devices, Medtech SA estimates that its growth will primarily continue in the US.
Conclusion
Surgical-assistant robots have contributed to increasing the number of minimally-invasive
neurosurgical interventions, reducing operating and recovery time, patient pain, and the risk
of infection. Medtech SA’s advanced ROSA™ Brain system is a pioneer in the industry,
allowing surgeons to plan their surgery more efficiently, pre-operatively, leading to greater
savings due to reduced operating times. The company has expanded its ROSA™ Brain
technology to create the ROSA™ Spine system for spine applications. The robot’s advanced
tracking system overcomes the complications of patient movement and increases procedure
accuracy. With its worldwide distribution of advanced systems, the company experienced a
130% revenue growth in the past year.
With its innovative design and advanced planning platform, Medtech SA has earned Frost
& Sullivan’s 2016 Global Company of the Year award for surgical robotics in the
neurosurgical interventions market.
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Significance of Company of the Year
To win the Company of the Year award (i.e., to be recognized as a leader not only in your
industry, but among your non-industry peers as well) requires a company to demonstrate
excellence in growth, innovation, and leadership. This kind of excellence typically
translates into superior performance in three key areas: demand generation, brand
development, and competitive positioning. These areas serve as the foundation of a
company’s future success and prepare it to deliver on the two criteria that define the
Company of the Year Award (Visionary Innovation & Performance and Customer Impact).
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Understanding Company of the Year
As discussed above, driving demand, brand strength, and competitive differentiation all
play a critical role in delivering unique value to customers. This three-fold focus, however,
must ideally be complemented by an equally rigorous focus on visionary innovation to
enhance customer value and impact.
Key Benchmarking Criteria
For the Company of the Year Award, Frost & Sullivan analysts independently evaluated
two key factors—Visionary Innovation & Performance and Customer Impact—according to
the criteria identified below.
Visionary Innovation & Performance
Criterion 1: Addressing Unmet Needs
Criterion 2: Visionary Scenarios through Mega Trends
Criterion 3: Implementation Best Practices
Criterion 4: Blue Ocean Strategy
Criterion 5: Financial Performance
Customer Impact
Criterion 1: Price/Performance Value
Criterion 2: Customer Purchase Experience
Criterion 3: Customer Ownership Experience
Criterion 4: Customer Service Experience
Criterion 5: Brand Equity
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The Intersection between 360-Degree Research and Best Practices Awards
Research Methodology
Frost & Sullivan’s 360-degree research
methodology represents the analytical
rigor of our research process. It offers a
360-degree-view of industry challenges,
trends, and issues by integrating all 7 of
Frost & Sullivan's research methodologies.
Too often, companies make important
growth decisions based on a narrow
understanding of their environment,
leading to errors of both omission and
commission. Successful growth strategies
are founded on a thorough understanding
of market, technical, economic, financial,
customer, best practices, and demographic
analyses. The integration of these research
disciplines into the 360-degree research
methodology provides an evaluation
platform for benchmarking industry players and for identifying those performing at best-
in-class levels.
360-DEGREE RESEARCH: SEEING ORDER IN
THE CHAOS
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Best Practices Recognition: 10 Steps to Researching, Identifying, and Recognizing Best Practices
Frost & Sullivan Awards follow a 10-step process to evaluate award candidates and assess
their fit with select best practice criteria. The reputation and integrity of the Awards are
based on close adherence to this process.
STEP OBJECTIVE KEY ACTIVITIES OUTPUT
1 Monitor, target, and screen
Identify award recipient candidates from around the globe
Conduct in-depth industry research
Identify emerging sectors Scan multiple geographies
Pipeline of candidates who potentially meet all best-practice criteria
2 Perform 360-degree research
Perform comprehensive, 360-degree research on all candidates in the pipeline
Interview thought leaders and industry practitioners
Assess candidates’ fit with best-practice criteria
Rank all candidates
Matrix positioning all candidates’ performance relative to one another
3
Invite thought leadership in best practices
Perform in-depth examination of all candidates
Confirm best-practice criteria Examine eligibility of all
candidates Identify any information gaps
Detailed profiles of all ranked candidates
4
Initiate research director review
Conduct an unbiased evaluation of all candidate profiles
Brainstorm ranking options Invite multiple perspectives
on candidates’ performance Update candidate profiles
Final prioritization of all eligible candidates and companion best-practice positioning paper
5
Assemble panel of industry experts
Present findings to an expert panel of industry thought leaders
Share findings Strengthen cases for
candidate eligibility Prioritize candidates
Refined list of prioritized award candidates
6
Conduct global industry review
Build consensus on award candidates’ eligibility
Hold global team meeting to review all candidates
Pressure-test fit with criteria Confirm inclusion of all
eligible candidates
Final list of eligible award candidates, representing success stories worldwide
7 Perform quality check
Develop official award consideration materials
Perform final performance benchmarking activities
Write nominations Perform quality review
High-quality, accurate, and creative presentation of nominees’ successes
8
Reconnect with panel of industry experts
Finalize the selection of the best-practice award recipient
Review analysis with panel Build consensus Select winner
Decision on which company performs best against all best-practice criteria
9 Communicate recognition
Inform award recipient of award recognition
Present award to the CEO Inspire the organization for
continued success Celebrate the recipient’s
performance
Announcement of award and plan for how recipient can use the award to enhance the brand
10 Take strategic action
Upon licensing, company may share award news with stakeholders and customers
Coordinate media outreach Design a marketing plan Assess award’s role in future
strategic planning
Widespread awareness of recipient’s award status among investors, media personnel, and employees
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About Frost & Sullivan
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