MED TECH
The Legacy of Robodoc
Four decades later , the first surgical robot lives on .
In the early 1980s , physicians used acrylic cement to attach hip implants to the patient ’ s body . But this material would eventually break down , and the operation had to be redone . New techniques were being developed to attach the implant to the bone without cement . Cementless implants improved longevity , but they were difficult to insert and failure rates were high .
Davis-based Integrated Surgical Systems ( which closed its doors in 2005 ) developed a robot designed to assist with hip replacement surgeries and insert these cementless implants with precision . Called Robodoc , this advanced robot was the brainchild of engineer-turnedorthopedic surgeon Dr . William Bargar and the late veterinarian Howard “ Hap ” Paul , who were both working at UC Davis then .
In 1992 , Robodoc was cleared by the FDA to begin clinical trials , the first robot ever used in surgery . ( Full clearance by the FDA was not granted until 2008 .) Forty years later , TSolution One , a direct descendant of the original Robodoc — now owned by Fremont-based Think Surgical — can be used for both hip and knee replacement surgeries . Dr . Bargar — who is now retired from the clinical practice of orthopedic surgery and continues to serve as director of medical affairs for Think Surgical — talks with Comstock ’ s about the legacy of Robodoc .
With the technology of the time , what was the biggest challenge in building a robot that could handle surgeries ? The biggest challenge was that robots in the early ‘ 80s were not able to be programmed like computers . The ones used in industry at the time required days to set up and just repeated the same task over and over . We needed to do a different job for each patient ( they come in different shapes and sizes , as you know ). And we needed to set up the robot and perform the surgery within a couple of hours .
After contacting many robot manufacturers , I nearly gave up on the idea . But then my father , who used to work for IBM , made a connection for us with IBM ’ s Thomas J . Watson Research Center in Yorktown Heights , New York . A researcher there , Dr . Russel Taylor , had just created the first computer language to allow the programming of robots . They were looking for a demonstration project .
Did you have trouble securing funds ? After a successful demonstration project with the Thomas J . Watson Research Center , IBM agreed to fund the initial investment in Integrated Surgical Systems . For second and third rounds of financing , there was no problem securing funds , mainly because of IBM ’ s reputation . The financial history of the company is long and complicated and impacted , to a large extent , by being the first to apply to the FDA for use of an autonomous robot in surgery .
In the past 40 years , do you believe the health care industry has embraced robotics ? Yes … finally , but it took many years . As with any disruptive technology , it takes a long time for the mainstream to embrace it . Today acceptance is growing exponentially , but the majority of hip and knee replacements are still done manually . Surgical robots are expensive , but offer long-term savings by the potential increased longevity with lower failure rates and less complications .
- By Russell Nichols
PHOTOS COURTESY OF DR . WILLIAM BARGAR with strong university connections , funded with non-dilutive funding , says John Peters , board chairman and president for the Sacramento Angels , a group of individuals who invest in early-stage emerging technology companies in Northern California . Also , medtech is rich with potential for diverse applications : surgical , wearables , diagnostics , business processes , therapy-related tech and more .
The catastrophe that was Theranos hasn ’ t deterred investors , either . The scandalized blood-testing startup was seen as a wake-up call , Peters says ; a reminder for angels to do their due diligence investigations . The Sacramento Angels favor putting their money behind companies where the heavy lifting and research and development has been mostly done . They don ’ t prefer companies with long multiyear timelines toward regulatory approvals . The further a company is from regulatory approvals , Peters says , the more the risk of future delays and additional capital raises , which dilutes the investment of the earlier investors .
Risk management is crucial for angels , he adds . Members build diverse portfolios with 20 to 40 companies
50 comstocksmag . com | September 2022