Background on surgical robotics and why it's hard
I've been involved with surgical robotic since 1999- Johnson & Johnson had a fledgling cardiovascular division (CardioVations) and at that time there was huge interest in beating heart surgery - minimally invasive valvular surgery and technologies like Heartport. But in those days there were also two struggling robotic companies - Computer Motion and Intuitive Surgical. One a boom robot with a frame that the arms hung from, the other a bed rail mounted system. Both were in their nascent phases and were pre - merger. Both were struggling to find an application in the cardiovascular space. At that time I was part of CardioVations and assigned alongside Sandra Rasche as a team to investigate on behalf of JNJs cardiac division - the potential of surgical robotics. I spent time in London at several hospitals watching cases with computer motion, and then to Dresden to watch cases with Intuitive. Eventually we had Intuitive bring a DaVinci to Ethicon Endo-Surgery at the European Surgical Institute.
Myself and Sandra immediately saw the future. We'd understood that this was more than the heart, even though it was impressive in that. But we understood that this would be a tool used in multiple laparoscopic and thorascopic procedures. We were pretty giddy with excitement. Back then the acquisition price was relatively tiny.
We put together a justification for why Ethicon Endo should have bought Intuitive. I may be fuzzy on the memory - but I do think some other teams were also looking at this as well from the US side. We presented our thoughts and excitement to the management team - and surprisingly were shot down. People scoffed at the idea of spending vast sums of money to "buy the robot". Then they could not figure out "why" would any skilled laparoscopist need this? - the complexity and the expense. You have to go back in time when Ethicon Endo and US Surgical were utterly booming. And they both had articulated hand held lap instruments (that no one wanted). 3D vision seemed silly, as no one had issues with 2D - and above all "What's the benefit?"
JNJ passed on them and well... the rest as they say is history.