Olympus, with the world’s largest installed base of endoscopy systems, is making a push into robotic gastrointestinal surgery as part of a broader transformation initiative under new CEO Bob White.
The Tokyo-based endoscopy giant co-founded Swan Endosurgical last year to develop an endoluminal robot to treat lesions and cancers in the GI tract and recently formed a partnership to distribute EndoRobotics’ endoscopic robotic devices for gastroenterology.
Keith Boettiger, executive officer and head of the gastrointestinal solutions division, delved into the company’s robotics strategy in an interview with MedTech Dive.
This interview has been edited for length and clarity.
MEDTECH DIVE: With the Swan EndoSurgical initiative and EndoRobotics distribution deal, what is Olympus building in surgical robotics?
KEITH BOETTIGER: We're really taking a two-pronged approach when it comes to endoluminal robotics. These two things are definitely related and connected, but we see one as longer term.
With Swan EndoSurgical, we're investing in platform innovation that has the potential to fundamentally change how endoscopic procedures are performed. Then, in parallel, the partnership with EndoRobotics allows us to bring a more immediate solution to the market that helps physicians perform more complex therapies.
If you follow the disease trends around colorectal cancer, you'll see that it's the second leading cause of cancer globally today — close to 900,000 deaths per year — and importantly, the incidence is increasing with the younger population.
Procedures like endoscopic submucosal dissection, or ESD, are growing globally as well, with about 200,000 cases done per year. The vast majority of those are concentrated in Asia, so the gap is really evident in the U.S., where adoption rates for ESD are limited. It's a very technically demanding procedure. It takes probably 200 to 300 procedures to achieve proficiency, which creates a pretty big barrier to scale.
That's where we see robotics coming in, enabling technologies that help to democratize those procedures and really improve access to care for patients. Robotics will make the learning curve easier. It'll make these complex procedures more repeatable, and then we'll be able to expand significantly around the globe.
How will Swan’s platform compare to other robots in endoscopic procedures?
There's a number of companies that are doing interesting work in this space, and it's a positive sign that there's real momentum building around endoluminal robotics. That said, it’s still really early, and when we survey the landscape, most approaches are focused on addressing specific procedural challenges. I'd say our perspective is slightly broader.
We're focused on building a platform that integrates into the overall endoscopy ecosystem and can scale against multiple indications over time. The solution that we're working on will be a scalable platform and slightly broader than what we see in the market today.
What indications are the initial focus for your robot?
We're prioritizing high volume, high impact GI interventions first. I mentioned ESD earlier. That's our initial focus. We continue to do research and work to identify what would be our next indications after that.
If you look at the soft tissue procedures that are done around gastric surgery today, we think over time, with an endoluminal robot, we'll be able to shift more and more of those procedures to less invasive, less painful procedures for patients, where you can use an endoscope to see and identify and diagnose issues, reach those issues with that endoluminal robot, and then treat.
We're moving toward a model where physicians can detect, diagnose and treat disease in a single setting. Given the rise of diseases like colorectal cancer and the push toward earlier, less invasive intervention, this has the potential to fundamentally change outcomes and reduce the need for surgery in the long term.
How will patients benefit if more care shifts to endoscopic procedures enabled by the endoluminal robot?
There's millions of colon and gastric surgeries performed annually worldwide. Advanced endoscopic procedures, ESD, are just a small fraction of that volume. Our focus is to close that gap by improving maneuverability and enabling more precise, repeatable interventions. Then we can start to reduce the dependence on operator skill and start to expand access.
When I think about innovation, and about bringing new products in medtech, I always think about how we can improve care for the patient and improve access to care for patients. There’s endoscopists doing amazing things around the globe, but a lot of that skill set is unique to those individuals. When you start to bring endoluminal robots into the market, you really start to democratize the ability to do those procedures, and ultimately that's best for patients.
We think more procedures over time will be done with an endoluminal robot, and that'll start to reduce the number of laparoscopic and open surgical procedures that are happening in the world.
Olympus has been working to resolve three warning letters from the Food and Drug Administration and an FDA import ban on some devices manufactured in Japan. Where do those efforts stand?
We continue to work openly with the FDA to have our warning letters and the import alerts lifted as soon as we possibly can. We continue to build our quality transformation work, and we have a strong focus on further strengthening the systems and processes within Olympus, including critical areas like endoscopic reprocessing.
Ultimately, we see that foundation as essential for maintaining safety, consistency and trust across all of our business. Overall, we have a really strong focus on patient safety and making sure that our systems and processes are in place to meet the regulatory requirements. We openly and transparently work with all the regulators to ensure that we're compliant.
