At a Glance
- Urology captures largest market share at 27% of surgical robotics revenue in current year;
- Hospitals integrate robotic systems into core platforms with 55% adoption rate; and
- Endovascular robotics emerges as blue ocean opportunity with minimal competition.
Medical device manufacturers, investors, healthcare providers, and patients see surgical robotics as one of medicine’s new frontiers — one which promises to open access, streamline workflows and efficiency, reduce complications associated with open procedures, improve predictability, and maybe even cut costs. Robotic surgery combines human surgeons’ skills with the power of robots to reliably and safely perform the simplest to the most complex minimally invasive and interventional procedures.
Authors write in a paper published in Cureus that while robotic surgery’s roots go back to the mid-20th century with the idea of using machines in surgery, true progress came in 1985, when the PUMA 560 robotic system performed neurosurgical biopsies. “The watershed moment in the history of robotic surgery occurred with the introduction of the da Vinci Surgical System in the early 2000s. Developed by Intuitive Surgical, this system revolutionized minimally invasive surgery by providing surgeons with enhanced dexterity, precision, and improved visualization,” the authors wrote.
MD+DI looks in-depth at the global surgical robotics market, exploring:
- market drivers and growth;
- market segments;
- technology components;
- end users;
- market leaders and emerging players;
- AI and other trends in innovation; as well as
- challenges and future outlook.
Market drivers and growth
Estimates on the market’s size and projected growth depend on where you look. The U.S.-dominated surgical robotics market was estimated to be about $4.31 billion in 2024 and predicted to reach $9.6 billion by 2033, according to Grandview Research, which published that the Asia-Pacific is the fastest-growing surgical robotics market. Research and Markets reported that the global market for surgical robots was $9.3 billion in 2024 and projected to reach $16.4 billion by 2030.
Growth Global Insights predicts the global surgical robotics market will be more than $56 billion by 2034. More than 60% of large hospitals worldwide have integrated surgical robotics into their core platforms, and robotic-assisted procedures make up more than half (55%) of complex surgeries at healthcare systems in developed countries, according to Growth Global Insights.
Patient demand, robotic technology advances (including Artificial Intelligence (AI)), increasing adoption of robotics technologies, an aging population, rising surgical complexity, and many other factors are fueling the market’s growth. However, the market faces challenges on its way to maturity, including regulatory, reimbursement, and cost hurdles.
Market segmentation analysis
The urology segment captured the market’s largest revenue share (more than 27%) in 2024. General surgery, gynecology, orthopedics, cardiothoracic, neurosurgery, otolaryngology, and bariatric or metabolic are among the other key market segments for surgical robotics, Grandview reports.
Soft tissue surgeries, including those in general surgery and urology, benefit from robotic standardization and improved ergonomics, says surgical robotics expert Dave Saunders, Vice President of Product Engineering at Boston, MA-based AiM Medical Robotics. In the cardiovascular space, one benefit of minimally invasive surgery is that surgeons can access the heart in a minimally invasive way, without having to crack the sternum, Saunders told MD+DI. Surgeons and patients alike stand to benefit from robotic orthopedic surgeries, including total joint replacement, Saunders said. “Joint work definitely benefits from careful planning, sizing, and alignment. So that’s an area where you get to spend some time with surgical planning software and then take that to the OR and have the robot help you execute that very consistently,” Saunders said. Simulation planning can help surgeons determine optimal implant sizes for patients’ hips or knees, so they do not have to open and ultimately waste implants that are no longer in sterile packaging because surgeons open and size them in the operating room, he added.
Robotics manufacturers are also making news in ophthalmology, oral and maxillofacial surgery, endovascular, and many other surgical and interventional specialties. “… when I looked at starting a surgical robotics company, I wanted to find a space where it’s what I call ‘blue ocean,’ that (a) there are clear unmet needs; (b) it’s a big market in terms of existing procedures; and (c) there are not many competitors or no competitors at all, with a very differentiated offering,” Harel Gadot, CEO, President and Chairman of Microbot Medical, maker of the Liberty Endovascular Robotic System, told MD+DI.
The endovascular space was a clear blue ocean. “If you explore the endovascular space, there are three (3) main segments: peripheral, coronary, and neurovascular. Among the three of them, there are about six (6) million procedures in the U.S. alone. That is almost as big as the soft tissue market, and many of these procedures are urgent or emergent. It’s a big market,” Gadot said.
And there are unmet needs, including shortages of endovascular physicians, technicians, and nurses in the specialty. The interventional radiologists, cardiovascular or neurovascular physicians who perform endovascular procedures, face continuous radiation exposure and often lose workdays when they have exceeded work-related radiation exposure limits. They wear heavy lead vests to limit the exposure, which creates additional physical strain, Gadot said. “Other challenges include the need to increase precision, which can be very important when you deploy a stent or do an embolization for cancer. And there are many areas where you can improve efficiencies in the [angiography] angio suite. For example, the use of a single operator instead of multiple people needing to be in the room just to hold the instruments…,” Gadot said.
Finally, robotics competition in the endovascular space is limited to nonexistent. “When I started Microbot, there was one company, Corindus Vascular Robotics, that was bought by Siemens Healthineers (2019) and was off the market. If you look at the endovascular space in the U.S. today, there are literally no players in the endovascular robotic space,” Gadot said.
What components go into surgical robotic technology?
The holy grail of a robotics system is the integration of hardware, software, disposables (instruments used for a procedure), imaging, and data, according to Gadot. Surgical robotic systems usually include a big piece of hardware. The da Vinci system, for example, has a sizeable control center that surgeons put their faces into to access virtual reality goggles that deliver incredible visualization inside the patient’s body, according to Saunders.
The robot’s laparoscopic arms hold surgical tools. “When we think about the hardware component of a surgical robot, it needs to take into consideration everybody else and all the other equipment that’s in the OR,” Saunders said. Surgical robots tend to have lots of consumables, depending on the nature of the robot, including specialized drapes. “… the control module for the laparoscopic rods for da Vinci is not for unlimited use and has to be replaced,” Saunders said.
Among other consumables, instrument adaptors that hold surgical instruments like drills, as well as accessories that come along with each procedure and are an expense category for robot operations, according to Saunders. Saunders describes the robot as a Trojan horse because what is on that robot is a big computer, running millions of lines of code to drive the system’s arms. “When the laparoscopic rod goes into the patient’s body, and you move that rod around, you don’t want to tug and jerk on the insertion point of the skin. That’s one of the most cognitively difficult aspects of laparoscopic surgery. The da Vinci does all of that automatically. It knows right where the rod is intercepting the patient’s skin, and it’s always rotating the rod right around that insertion point to minimize the amount of tissue trauma. “That’s software,” Saunders explained.
Software incorporating AI and computer vision can open a surgeon’s field of vision beyond what’s possible without robotic technology. “The software enables the surgical robot to be a co-surgeon in many ways to the surgeon. We’re combining the computational ability of a computer with the intuitiveness and training of the surgeon,” Saunders said.
While many of today’s surgical robots fit into these component categories, Microbot’s Liberty Endovascular Robotic System has changed the game in almost every way. “[Our] robot is small (fits in the palm of your hand) …. It is single-use, which means it comes off the shelf completely sterile, so it takes only a couple of minutes by the time you open and prepare the robot and the time the physician is ready to commence the procedure,” Gadot said. “At the end of the procedure, it’s a one-time use. You just put it back in the box and throw it in the garbage. No need for re-sterilization, drapes waste, and behavior change.”
Microbot’s Liberty has a robotic driver, the part that drives all the instruments needed to do an endovascular procedure; a remote control that is wireless and connected through Bluetooth to the robotic driver operated from up to 30 feet away. “The nice thing about it is it allows you to be in the control room, behind the glass, sitting down, with no radiation and with no lead vest. So, you get rid of the radiation exposure risks and eliminate the physical strain,” Gadot said. “On top of that, there is a very small arm that allows you to add access to the body anywhere you want. It was important to us that we would not change the behavior of the physician. If they like to have femoral, radial, or tibial access to the body, they can move the robot to whatever access spot they want to choose, without having the robot dictate what to use for them.”
Microbot’s technology has all the software, as well as data collection capabilities, needed to provide the data necessary to enhance procedures once Microbot reaches a large volume of users. Microbot does not include proprietary instruments, meaning guidewires, microcatheters, and guiding catheters. Rather, users can use their preferred instruments on the robotic system.
End users
In 2024, inpatient hospitals and health systems accounted for the largest market revenue share in surgical robotics, according to Grandview Research. Most surgical robots remain at teaching hospitals, with some systems migrating into secondary hospitals, according to Saunders. The problem is that many of today’s robotic systems are not well-suited, because of their size and need for setup, for ambulatory surgery centers (ASCs) where cookie-cutter surgeries are done in high volumes. This includes spine surgery, according to Saunders.
The handful of spine robots on the market that do pedicle screw placement do not integrate well in ACSs like Texas Spine Institute, where surgeons sometimes do eight (8) to ten (10) surgeries daily, according to Saunders. ACS centers don’t have time to set up navigation while the patient is under anesthesia. “That could take eight (8) to ten (10) procedures and turn it into six,” Saunders said.
There is increasing market pressure to move surgical robots into ambulatory care; however, first the technology will have to evolve so that it’s less costly, more mobile, and does not cut into volume and throughput. One (1) company banking on smaller size, mobility, and only minutes of setup is Distalmotion, which is looking to capture the outpatient robotic surgery market with its Dexter surgical robot, according to an article in MD+DI.
Competitive landscape
Gary Guthart, PhD, Intuitive’s Executive Chair of the Board of Directors, shared during the J.P. Morgan Healthcare Conference 2025 that in 2024, alone, more than 2,680,000 procedures were performed on da Vinci systems, with nearly 17 million procedures performed on da Vinci technology to date. The company placed more than 10,670 Intuitive systems in hospitals worldwide.
Medtronic announced in October 2025 the start of an investigational device exemption (IDE) U.S. clinical study to evaluate the safety and effectiveness of its Hugo RAS in robotic-assisted gynecological procedures. Hugo RAS also has IDE clinical studies in the U.S. in urology and hernia repair, both of which have met their primary safety and effectiveness endpoints. The company recently won FDA clearance for Hugo.
Johnson & Johnson MedTech has the MONARCH Platform, which the company claims is the first flexible, robotically assisted platform for bronchoscopy. The MONARCH Platform for Urology will be commercially available in the U.S. in 2026, according to J&J MedTech, which announced in October 2025 that it is using AI-driven simulation in the MONARCH Platform for Urology, “where virtual operating room environments can be created to assist clinical teams in setting up the robotic system before starting a procedure.”
In 2025, Johnson & Johnson MedTech also announced the completion of the first cases in the clinical trial for the OTTAVA Robotical Surgical System for Roux-en-Y gastric bypass surgery.
Stryker’s Mako SmartRobotics is the company’s fourth-generation Mako System. MD+DI reported in August 2025 that Stryker is seeing success in its robotics portfolio. Stryker reported having reached two million robotic procedures performed with Mako. “We are the clear leader in orthopedic robotics and continue to launch new applications such as revision hip …,” said Jason Beach, VP of Finance and Investor Relations, according to a Seeking Alpha transcript of the earnings call. “We expect sustained momentum from installations and utilization to continue to drive growth in our hips and knees businesses. The launches of Mako Spine and shoulder are going well and remain on track for full launches ….”
Smith+Nephew’s portfolio includes the CORI Surgical System, which offers intraoperative image-free or image-based registration. That allows the surgeon to choose whether or not to perform a pre-operative MRI scan. In 2024, the company launched Coriograph Pre-Operative Planning and Modeling Services, providing personalized solutions for surgeons and patients across partial and total knee arthroplasty procedures.
Zimmer Biomet features neurosurgical and orthopedic robots in its portfolio. Renshaw is in the space with its neuromata stereotactical robot for neurosurgery. AiM Medical Robotics is developing a neurosurgical robot that can operate in the presence of the giant magnet of the MRI to do image-guided procedures, as recently covered by MD+DI.
The investigational technology could reduce the need to move a neurosurgery patient between the MRI and the adjacent OR. “We are hoping to see literally hours be cut from certain kinds of image-guided cranial procedures,” Saunders says.
There are many emerging players with robotics pipelines, from CMR Surgical’s Versius system, a small, modular, and versatile surgical robotic system used to perform cholecystectomy via soft tissue minimal access surgery, to eCential Robotics, a French and U.S.-based company with an open surgical platform combining 2D/3D imaging, real-time navigation, and robotics for bone surgery.
For many of the companies developing surgical robots, it is a mistake to approach the market with the aim of bettering humans with more precise surgery, according to Saunders. Rather, the goal should be to make minimally invasive complex surgeries more predictable and accessible, he says. Sure, there are market segments outside of soft tissue surgery, in ophthalmology, for example, where precision has a different bent, and the robots will likely aim to do the procedures with greater precision, according to Saunders.
However, for the most part, “the robot doesn’t need to beat the top surgeons, it only needs to allow more surgeons to deliver the same level of care. It’s that shift that can drive adoption and growth,” Sanders said.
Competitive strategies and market positioning
Saunders says manufacturers should strive to stay out of the $2 million robot market. Rather, they should develop more affordable technologies. He recommends manufacturers focus on an unmet need like high-precision microsurgery, with lower-cost robots that hospital departments can purchase. “Find innovative ways to sell your robot or place it. If your robot is inexpensive enough, you can potentially still own the robot (I have a trademark called digital surgery as a service (d-sas)) where you place the robot and only charge for the individual procedures,” Saunders says. “…if I’ve got a surgical robot with a low cost of goods, I might be able to still own and place 100 surgical robots and only have to carry maybe $5 or $6 million of debt on the books. That’s doable economically for the surgical robotics company.”
The biggest driver for up-and-coming companies should be to find ways to bring surgical robots into ambulatory care surgical centers. “We still need trained surgeons, but by bringing in good tools, we can enable higher work volumes, lower cost, and greater consistency. Outcomes should always be the same. Everyone benefits from that performance curve,” he says.
Areas with unmet needs, according to Saunders, include robots that assist with transoral thyroid surgery, as well as transsphenoidal surgery, such as pituitary gland resections – procedures that involve going up the nostrils. “We now have a growing market for joint replacements with tiny joints like fingers and toes, but none of the robots are able to provide assistance there,” Saunders said. “We have robots that do pedicle screws for spine fusion, but those same robots aren’t providing other types of spine surgery support for things like discectomies, tissue decompression, and other soft tissue procedures that surgeons would love to do in a minimally invasive setting.”
Innovation trends, technological advances
The innovations and trends shaping surgical robotics include miniaturization and portability. Other aspects that continue to evolve include technologies with improved dexterity, haptic feedback, and image guidance systems, according to a report by DiMarket. “Augmented reality (AR) is an emerging technology that enhances the real-world environment with computer-generated graphics, adding 3-dimensional (3D) virtual objects into the user’s view of the real world,” according to authors of a paper published in 2025 in JAMA Surgery. “In surgery, AR can enhance the surgeon’s viewpoint by adding graphics of patient-specific anatomy that is normally hidden under the skin until an incision is made or dissection occurs.”
This is a paradigm shift in surgeons’ ability to visualize the anatomy, they write. While true touch remains out of reach in today’s surgical robotics marketplace, companies are making progress in creating haptic feedback. Saroa (Riverfield, Tokyo, Japan) claims its robot reproduces a sense of force using flexible and delicate air pressure control. The focus on improving haptic feedback for Saroa, which is used in thoracic surgery (excluding cardiac surgery), general gastrointestinal surgery, urology, and gynecology, is a goal for manufacturers industry-wide.
Sensor technologies and sophisticated control systems are among the solutions for improving haptic feedback, according to a Boston-Engineering blog. One potential way to do that is with force-sensing instruments that allow surgeons to feel tissue resistance, texture, and compliance. Another is by incorporating machine learning (ML) and AI to interpret and augment haptic feedback, according to the blog.
An innovation and potential challenge is cloud-based computing in surgical robotics. While many see cloud-based surgical platforms as an innovation, Saunders says that it is a bad idea. A surgical robot that goes to the cloud to do its processing is vulnerable to cyber attacks and internet outages, he argues. “Anytime we increase the distance between the thing we’re doing the thing and where the computing occurs creates an opportunity for somebody to get in the middle and steal or fake the data,” Saunders says. “We need to have equivalent computing powers locally. We’re not going to build a trillion-dollar data center for every hospital, so we need to have those computing technologies miniaturized. That will happen.”
Single-port robotic surgery is disrupting multiport robotics in specialties like urology. The goals of single-port robot-assisted radical prostatectomy, for example, are to minimize surgical trauma, enhance cosmesis, and expedite recovery — while preserving oncologic and functional outcomes, according to a paper published in the World Journal of Urology. While single-port robot-assisted radical prostatectomy has the potential to transform prostate cancer treatment, technological challenges related to the learning curve, instrument crowding, and cost need to be addressed for broader adoption, the authors write.
Artificial Intelligence (AI) integration in surgical robotics
While there is a lot of talk about AI’s growing role in surgical robotics, the reality is AI’s impact is limited, largely due to regulation, Saunders says. “The FDA doesn’t have a clear path for how to get high-risk AI cleared. When I say high risk, I mean if I want a surgical robot to do any aspect of surgery with any kind of autonomy, it means I want to put a weapon in the hands of a robot…. The risk is high,” he explained.
Still, change is coming. AI and Machine Learning (ML) are transforming surgery beyond traditional risk prediction to real-time clinical support and intraoperative assistance, according to authors of the paper “Artificial Intelligence in Surgery Revisited: A 2025 Guide to Understanding and Applying AI Models in Clinical Practice.” The same authors address the AI objectives of computer vision (CV) and natural language processing (NLP), which aim to understand, recognize, classify, and/or reproduce visual media (CV) or human language data (NLP).
“Recent advances demonstrate AI’s growing ability to process text and audiovisual data to streamline documentation, enhance intraoperative decision-making, and even perform basic operative tasks through robotic automation,” according to the Authors. “Surgical machine learning has expanded far beyond prognostic modeling, with deep learning now enabling real-time intraoperative tools that enhance safety, efficiency, and training, particularly in laparoscopic and robotic-assisted surgery.”
SurgeryLLM is a large language model framework that incorporates domain-specific knowledge from current evidence-based surgical guidelines when presented with patient-specific data, according to the authors of a recent Brief Communication. “The successful incorporation of guideline-based information represents a substantial step toward enabling greater surgeon efficiency, improving patient safety, and optimizing surgical outcomes,” the authors write.
There is a lot more to come, where AI is concerned. Saunders has participated in research looking at future AI capabilities in surgery and describes it as “like magic.” AI research into cochlear implantation shows AI locating the complex web of nerves that make the surgery difficult, and on a 3D model reconstruction from a CT scan of the patient, and drilling safely through to the access point. “Instead of 60 to 90 minutes of drilling, which is what it takes to do a mastoidectomy, you can do it in potentially between five (5) to 15 minutes with incredible safety benefits. There is additional technology that would help place the cochlear implant as safely as possible with optimal hearing,” he says.
Johnson & Johnson Medtech announced in June 2025 that it started the Polyphonic AI Fund for Surgery to help develop AI solutions for before, during, and after surgery. The fund, a coalition including NVIDIA and Amazon Web Services (AWS), will focus on proposals that support AI model development, data engineering and management, and AI governance. Johnson & Johnson MedTech is using the collaboration to advance AI innovation that can reach global operating rooms by creating high-quality data sets enriched with AI-based annotations. “NVIDIA’s purpose-built solutions, including the NVIDIA IGX edge computing platform and the NVIDIA Holoscan platform, are designed to help accelerate outcomes throughout the ecosystem and speed the development and deployment of AI-accelerated applications in a secure and scalable manner,” according to the company news.
Overcoming barriers to surgical robotics adoption
Cost is a huge hurdle for robotics companies to overcome. Gadot told MD+DI that Microbot’s Liberty robot eliminates the high acquisition cost of capital equipment by being single-use. “One of the things that hospitals don’t want to do is invest in $1 or $2 million in capital equipment where you still don’t know where it fits within your workflow, if at all,” Gadot says. “The beautiful thing about Microbot’s LIBERTY device is that there is no capital equipment, so no upfront ‘risky’ investment. You can buy 10 or 20 systems, use them, see how they fit in the workflow, and continue buying them as needed based on how they fit into your workflow.”
LIBERTY Endovascular Robotic System/Image courtesy of Microbot
Microbot changes the business model in the hospital, from purchases for surgical robotics systems that go through hospitals’ capital expense budgets to, potentially, department operational budgets — a more efficient and faster process for all parties involved, Gadot says. Cost is an especially important consideration since reimbursement codes for robotic surgeries and interventions are lacking, according to Gadot. “We need to continue to generate evidence on clinical and economic value across all robotics,” Gadot said. “Hospitals are hesitant to buy the technology because they’re uncertain about their revenue margins with its use. As an industry, we need to work on that.”
Things appear to be changing. In early December 2025, Robotics company MMI (Medical Microinstruments, Inc.) announced that the American Medical Association (AMA) had issued a new Current Procedural Terminology (CPT) code for lymphovenous bypass (LVB) surgery. “The Centers for Medicare & Medicaid Services (CMS) also finalized and released a payment rate for LVB procedures performed in the outpatient setting to be reflected in the CY 2026 OPPS Final Rule. Together, these actions create initial reimbursement for a procedure that, until now, required billing under unlisted surgical codes,” according to the press release.
The new Category III code goes into effect in the U.S. on January 1, 2026.
“This new code is intended to capture both manual and robotic-assisted lymphovenous bypass surgeries and allow procedure data collection needed to further advance reimbursement pathways,” according to MMI. The impact of the evolving regulatory environment can’t be underestimated, as “Stringent regulatory approvals (e.g., FDA in the US, EMA in Europe) significantly impact market entry and growth, favoring established players with robust regulatory compliance frameworks,” according to DiMarket’s report Surgical Robotic System and Consumables’ Role in Shaping Industry Trends 2025-2033.
FDA regulates Renin-Angiotensin System (RAS) systems, monitors their use for safety, and has cleared many devices in the U.S. A recent review article, Advancements and challenges in robotic surgery: A holistic examination of operational dynamics and future directions – ScienceDirect points to the “pivotal role,” of operational management of robotic-assisted surgeries (OM-RAS) in the future success of RAS. “OM-RAS is a multidimensional challenge, encompassing complicated aspects such as workflow optimization, performance enhancement, skill assessment, and cost-benefit analyses. While current research predominantly emphasizes technological advancements and simulations, the review spotlights the need for a balanced focus on healthcare logistics, skill evaluation, and cost-effectiveness to realize the full potential of RAS in clinical practice,” the authors write. Still, another challenge that does not make most lists of hurdles for RAS is not only training surgeons on RAS but also making sure they keep up their surgical skills despite robotic technology. “… how do we maintain clinical experience in case of an emergency? What if the physician is so used to using the robot that they forget how to do open surgery? I do believe that in this case, for example, we can learn from the aviation space. Over 95% of the flight is done by the automated pilot, so how do we maintain pilots’ skills? Very simple: simulators and continuous education,” Gadot said.
Summing up a fast-changing landscape
Is surgical robotics the future of surgery? Absolutely, Saunders said. “It’s an enabling technology that turns any surgeon into a superhuman practitioner,” Saunders told MD+DI. “I think that over time we’ll see incredible cost savings, performance curves flattening, and all trained surgeons capable of even the most complex minimally invasive procedures that right now are reserved for the elite.”
REFERENCE: Medical Device and Diagnostic Industry (MD+DI); 04 DEC 2025; Lisette Hilton