David McNally
President and CEO, Titan Medical

Though Intuitive Surgical remains the most dominant player in the realm of robotic-assisted surgery, the field may soon become more crowded. Titan Medical is one of the manufacturers working hard on bringing forward a new option for the OR. They are currently in the pre-commercial phase with their SPORT Surgical System, but they promise it’s on the fastest possible track.

To learn more, Surgical Products interviewed David McNally, president and CEO of Titan Medical.

What’s different about the Titan Medical’s SPORT Surgical System?

Our system is based on a fundamental, multi-articulating arm technology that allows us to deploy snake-like arms — along with a camera — through a single incision that is expected to be 25 mm in diameter. We are focused on single-incision surgery in the abdominal area in single- and multi-quadrant surgeries. The system consists of a surgeon workstation and patient cart, and the patient cart has a single boom — unlike some multiport systems — with a single arm that then suspends the camera insertion tube, through which the multi-articulating arm, end effectors, and the camera are deployed into the body.

I’d say in terms of differentiating features of our system, they begin with the multi-articulating arms with disposable end effectors that allow the surgeon to experience first-use quality during each surgical procedure. The mobile patient cart can be easily moved from operating room to operating room as well as within hospital facilities. Our surgeon workstation is designed for upright positioning of the surgeon in a very comfortable manner. It is adjustable for outstanding ergonomics and comfort for the surgeon. And the 3D, high definition visualization is delivered with a flat panel display, which provides the opportunity for 3D viewing by not only the surgeon but also fellows and residents who can see exactly what the surgeon is seeing. 

(Image credit: Titan Medical)

Is the goal for the device to be more mobile than competing systems?

Yes. We are designing the system to be transportable and compact with respect to both of the major components — the ergonomic workstation and the patient cart — so that the solution is physically right-sized for smaller hospitals in the U.S. and Europe, as well as outpatient surgery centers.

Will it be also be more economically feasible for those facilities? For smaller hospitals, footprint and mobility are issues, but cost is a major concern, too.

We’re mindful of price point with respect to the capital equipment — which further manifests itself in annual service costs after the first year of warranty — as well as the consumables, those being the disposable and reusable components of the system that drive per procedure costs. We are carefully studying the market and pricing and we believe that we can position ourselves to provide savings versus the entrenched systems in the marketplace today.

Have you built surgeon feedback into the process of developing the system?

We have engaged surgeons from the beginning in providing us with feedback with respect to the surgeon workstation as well as the patient cart.  It is noteworthy that we’ve involved bedside clinicians who are also stakeholders in the robotic surgery suite and essential to performing consistent safe procedures. So we’ve gained insight from the entire operating room staff to ensure that we have ergonomics that are friendly for the surgeon operating the workstation as well as the clinicians who are involved in delivering the patient cart and the camera insertion tube to the patient.

(Image credit: Titan Medical)

Where is Titan Medical going in the process of bringing this to market?

With 30 years of experience in medical device commercialization, I was brought in to take the company's clinically-inspired technology and apply a disciplined approach to product development.  Based on the experts I brought in since the beginning of the year — including an experienced vice president of research and development and an experienced vice president of quality and regulatory affairs — we believe that we can both complete product development and navigate the regulatory processes for commercialization sometime in 2019 for a limited commercial launch that year in both the U.S. and Europe. Those are our best projections, of course assuming that — based on the experience of our team — we can successfully navigate processes with known pathways established by those that are already in the market.

Do those manufacturers who’ve already made it to market with robotic surgery systems clear the way for you somewhat in the regulatory process?

Yes. We have great respect for Intuitive Surgical and what Intuitive has accomplished in market penetration and procedural depth with the da Vinci. We are also excited to see other competitors, such as TransEnterix, that have entered the marketplace, and we believe that helps to further validate the presence of robotics today and its potential for growth in the future.

We are excited to be in the position to be a fast follower in the footsteps of the others that have paved the way for robotics to be a tool for improving clinical outcomes. They’ve also helped to evolve robotics into a desirable technology in terms of patient demand, and even in attracting surgeons to hospitals. So even as we have the benefit of those elements, we have also had the opportunity to see the pros and cons of preceding platforms that allows us to stand on the shoulders of giants as we deliver our single incision solution.

Anything you’d like to add?

We are inspired by what surgeons are telling us about the potential for our system. With our newly expanded executive team which has a background including robotic experience, we could not be more excited for the opportunity that lies ahead.