Intuitive Surgical, Inc. | Advancing Surgery with Robotics

On June 15, the BIE cohort had the opportunity to visit and tour Intuitive Surgical’s headquarters and manufacturing facility in Sunnyvale, CA. Founded in 1995, Intuitive Surgical Inc. designs and manufactures the da Vinci robotic surgical system that assists surgeons in performing minimally invasive surgeries.

History of da Vinci robotic arms demonstrating iterative design, with BIE cohort in demo room in the background

Upon our arrival, we were welcomed by Dale Bergman, research programs manager, and Dr. Simon DiMaio, the Director of Research. Dr. DiMaio presented an overview of Intuitive Surgical, including the growth and impact that their core product, the da Vinci surgical system: nearly 4,000 systems are in service in over sixty countries, and millions of procedures involving the da Vinci have been performed since its introduction in 1999. Knowing that we were bioengineers, he also emphasized the importance of three important aspects of design: market desirability, technical feasibility, and commercial viability, the intersection of which result in a viable product. We also learned about the extensive safety measures that were integral to the design of a medical device as complex as the da Vinci system; every joint of the robotic arms on the patient cart contains at least two sensors for redundancy, and a significant proportion of the software code is dedicated to fail-safe functionality.

Dr. DiMaio explains the hardware of the da Vinci system. Pictured are the vision system (L) and patient cart (R)

After Dr. DiMaio’s presentation, Ms. Bergman and Dr. DiMaio led the cohort to the demo room containing a fully functional da Vinci system and simulator. He explained the da Vinci surgical system’s three components: 1) the surgeon console, through which the surgeon sits and operates up to two robotic arms simultaneously through the view of a camera on a third arm, 2) the patient cart, which is rolled up to the bedside and contains four articulating arms that may be inserted into the patient for laparoscopic surgery, and 3) the vision system, which contains a monitor reflecting the surgeon’s view and connects the surgeon console and patient cart together. Following a brief explanation of the controls, we excitedly had our hands on the controls. As we manipulated small wires and plastic rings onto small rubber structures, we realized the design lived up to the company’s name: it was intuitive.

BIE fellows and proteges each had the opportunity to operate the surgeon console and discussed its user-friendly interface

In last part of our visit, Ms. Bergman led us to a manufacturing building where the da Vinci system was made. We learned that the design of manufacturing processes itself was a crucial part to the successful commercialization of a product. Each technician was trained in a specific role, each workbench was organized carefully to minimize error and increase efficiency, and each sector of the production can be modulated based on customer demand to meet production goals. Ms. Bergman emphasized the importance of quality control and testing as well — before each unit is shipped, technicians spend hours performing tests cases to ensure the robotic arms work just as intended.

At the conclusion of the visit, Ms. Bergman gave a brief background of the history the company, which started from a DARPA-funded project intended to develop technologies to enable robotic surgery to be performed remotely. Though the da Vinci system still requires surgeons to physically be in the same room, the need that it addresses, to assist surgeons in minimally invasive surgeries, showed us how flexibility, adaptability, and creativity were important in the biodesign process. Overall, we found our visit to Intuitive Surgical, Inc., to be an exciting example of the importance and impact of user-focused biodesign in advancing healthcare.

The BIE cohort with Dr. DiMaio in the demo room