Shaping the Future of the Robotic OR: Engineers Collaborating With Surgeons

In the early days, our team had one mission: expanding access to minimally invasive surgery through robotic technology. To get there, one thing was certain — surgeons and support staff would need to play a critical role in helping us disrupt the status quo. With that, our surgeon-centric approach was put into action and continues to drive our efforts today.

While surgical robotics brought notable advancements, we still saw compelling needs for disruption and innovation. A robotics program was and continues to be a significant investment of both money and resources. Hospitals look for efficiency and cost reductions to treat the greatest number of patients. Since one monolithic robotic system ties up an entire OR, to transform the surgical space, we knew our system needed to be:

More flexible
Less labor-intensive to transport
More ergonomic and open for surgeons

Along with improving efficiency, it was paramount that we provide surgeons with more advanced insights so they could make better decisions. Expanding access to technology that serves that goal adds value not only to the surgery program, but also across the entire healthcare system.

Early collaboration and iterative design

It all began in a high-tech lab in Germany, where our engineering team started early prototyping for what would become the Hugo™ Robotic-assisted surgery (RAS) system. Early prototypes were made from cardboard cutouts and wooden blocks and the design methodically took shape from there. Every 90 days, we tested an entirely new prototype with surgeons. This approach allowed us to tackle tough challenges like:

How to bring a robotic surgical system to the bed
How to make it more approachable for surgeons to use
How to reduce surgeons’ cognitive load so they can focus on the surgery itself

Surgeon insight and evaluation along the way drove every advancement and were instrumental in bringing the system to life.

The power of prototyping

Those 90-day prototyping sprints proved to be enormously effective, allowing us to see how customers interacted with the system as we built it. Each piece of this robotic system underwent the same customer-centric process.

Take the foot pedal, for example. Pressing the activator is the core function, but how soon should the system react to the pedal? We used different-colored LEDs to signal the activation and then conducted a usability study to ensure a surgeon wouldn’t be confused about the LED colors. So, even a simple pedal takes multiple considerations and disciplines to make it more natural and fluid.

Modularity brought flexibility

One of our biggest challenges was creating a system that wasn’t tied to a single OR. Flexibility was central to making accessibility a reality. By developing a more modular prototype with singular arm carts, the system could easily be shared across multiple rooms to increase the robot’s use and the rooms’ utilization. Feedback from customers about portability and flexibility helped us ultimately land on the modular design we have today.

Enhancing team communication

We can all agree that communication among the surgical team is a critical aspect of every surgical scenario. How could our design positively impact that collaboration? The answer was moving away from a closed-console system that constrained surgeons and forced them to look down into a screen. We landed on an open-console design that allows surgeons to see the full room, collaborate with colleagues, and coach each other over their shoulders. Understanding how that design choice could impact the surgical team’s performance in the OR is a perfect example of the many thoughtful decisions that went into making Hugo™ RAS system into the innovative system it is today.

The future of the Hugo™ RAS system

We are at the dawn of robotics and AI. The possibilities are extraordinary. We envision an even greater expansion of this platform’s capabilities, offering surgeons greater control, precision, and dexterity, leading to improved outcomes, reduced surgical errors, and enhanced ergonomics. The OR will no doubt look different in the future, and I’m excited about its potential and Medtronic’s dedication to collaboration with surgeons as part of that evolution. The Hugo™ RAS system is only the beginning.

Engineering is not just about science. It’s about making something materialize so that it can impact the world. That’s why I became an engineer. With hundreds of
engineers and over one million lines of code, I think of the Hugo
™ RAS system as an engineering miracle. It’s truly impressive to see what can happen when everyone works together to bring a dream to fruition.

The Medtronic Hugo™ RAS system is commercially available in certain geographies. Regulatory requirements of individual countries and regions will determine approval, clearance, or market availability. In the EU, the Hugo™ RAS system is CE marked. In the U.S., the Hugo™ system is an investigational device not for sale. Touch Surgery™ Ecosystem is not intended to direct surgery, or aid in diagnosis or treatment of a disease or condition.