The new Xi features longer, thinner arms and assisted set-up with text and voice prompts, but perhaps the most vital upgrade is the single overhead arm that carries all 4 of the robot’s instrument arms. The overhead architecture allows the instruments to rotate and move across the patient’s body without having to shift the entire system.
News of the FDA win and U.S. launch of the new Xi system sent ISRG shares up nearly 13% today. Shares were going for $493.89 as of about 3:45 p.m.
"What the da Vinci systems, up to this point, have really excelled at is working in a prescribed region inside the body," Intuitive Surgical mechanical engineering director Paul Millman told MassDevice.com today. "When [surgeons] wanted to work in the pelvis but also work on the left side of the body, or the right side of the body, or back up toward the diaphragm, in these other areas inside the abdomen, then there were certain challenges that previous generations of da Vinci system presented. It could be done, but it was a little but cumbersome."
Da Vinci Xi allows surgeons to move from one surgical site to another in a matter of minutes, without shifting the robot itself, Millman said. Some surgeons have already incorporated the older Si system in complex surgeries, planning elaborate "choreographies" to get the robot in place when needing to access multiple surgical "quadrants," but others have been reluctant to add new complexity to their operating rooms.
"What the Xi does is really simplifies everything for working in these different areas and makes it so there’s no reason that a surgeon, if they want to, couldn’t use it in these different areas within the same procedure," Millman said. "It makes it very convenient for them."
The da Vinci system represents a major buy for a hospital, with the new Xi priced at $1.85 million for a single-console unit and $2.3 million for a dual-console unit, a spokesman told MassDevice.com today. The new Xi, however, comes standard with many of the add-on features that cost extra with previous da Vinci units, including compatibility with Intuitive’s Firefly fluorescence imaging technology, which has yet to win clearance for use in the U.S.
Da Vinci Xi owners will be able to upgrade their systems for a nominal fee to enable the Firefly imaging unit once the technology gets the FDA’s OK.
Intuitive hasn’t thus far pursued any new surgical indications with the Xi device, but hopes to expand the reach of minimally invasive surgery by making it ever more convenient on the surgeon as well as on the rest of the OR team. The Xi system features new guided set-up software that advises staff along every step of the way when preparing the robot for surgery. Once the new system is set up and docked, the rest of the experience is virtually identical to operating the old Si system.
"We want to take away all the hassle, all the guess-work and make it very simple and straightforward for the team," Millman said. "Once they’re docked to the patient and the surgeon’s actually sitting at the console and doing their dissections and doing their suturing, that experience is nearly identical between the Xi and the Si. They don’t have to re-learn how to do the main part of the procedure."