It has been a busy start to the year for Intuitive Surgical, with shares in the company trading high on the back of a positive 2024 and a promising 2025 outlook.
The developer of the highly successful da Vinci surgical robot, the company has long enjoyed a dominant market position in the surgical robot market.
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But 2025 is shaping up to be one of the more unique – and consequently significant – years in the sector’s history. Potential new entries from competitors and wide-ranging policies from a new US administration that impact the entire healthcare industry could affect the market soon.
Medical Device Network investigated what could be in store for the surgical robotic market in 2025.
Intuitive’s outlook and latest launch
Intuitive has the largest share of the global robotic surgery market, according to analysis by GlobalData. The market was estimated to be worth $2.9bn in 2024 and is forecast to reach $9.2bn by 2034.
GlobalData analyst Graysen Vigneux says: “Intuitive Surgical remains the clear market leader, holding nearly 60% of the global market in 2024. While competitors are emerging, Intuitive’s da Vinci system is the most widely adopted platform and benefits from a strong installed base, surgeon training programs, and continuous innovation.”
In January 2025, shares in Intuitive reached their highest all-time share price since its US listing in 2000, and the company now boasts a market cap of $206.6bn. Intuitive posted Q4 2024 revenues of $2.4bn, up 25% from the same period the year before. The positive end to the year meant the company brought in a total 2024 revenue of $8.4bn, representing a 17% increase from 2023.
During a presentation at the JP Morgan 2025 healthcare conference, Intuitive Surgical’s CEO Gary Guthart said its 2025 target is to reach the full market launch of the new da Vinci 5 in the US. The system is the company’s latest version of its robot, which gained US Food and Drug Administration (FDA) clearance in March 2024.
The full launch of da Vinci 5 in the US is expected to be a major growth driver for the company. Dr Bruce McIntosh, a surgeon who has been using da Vinci systems for 13 years, says the latest system is a big upgrade.
“One of the key things that we have with da Vinci 5 is case insights. Cases are all de-identified and uploaded into a cloud. Artificial intelligence and machine learning make comparisons to best-in-class practice, and the system can look at variabilities and bookmark parts of a procedure. I think that that's one of the key components of this next generation - it's going to allow us to really drive everyone into best-in-class [practice].
“Additionally, there are some efficiencies in the setup. I can now do [setting adjustments] myself. There is an ergonomic component as well, you have a more controlled posture, which can lead to improved longevity for surgeons.”
In a bid to consolidate its market presence, Intuitive secured further robot distribution channels in European countries. The company said in January it is buying businesses to establish a direct presence in Italy, Spain, Portugal, Malta, and San Marino.
And Dr McIntosh, who has a longstanding working relationship with Intuitive, alludes to more development plans in store for this year.
“Intuitive talks about the computational power of this new robot relative to the old ones. There’s a reserve capacity for all the add-on features that will help with the efficiency and safety of cases. I don’t have clarity on what it will look like, but I know they’ve been working on multiple different new applications and extensions of the robot as we use it now.”
Intuitive declined to comment on its 2025 plans to Medical Device Network.
Medtronic’s potential rivalry in US market
Medtronic’s Hugo robot poses the main challenge to da Vinci given the company's size. Hugo has been in use in Europe since 2022 and the company states the system is in hospitals across more than 25 countries and five continents. Though still used in fewer procedures than Intuitive, Medtronic’s market share is not insignificant.
Dr Ben Challacombe, a urological surgeon at Guy’s and St Thomas’s Hospital – the first trust in the UK to adopt Hugo and now the largest surgical robotics user in the UK – says Hugo is “certainly getting a foothold.”
Our 50th HUGO RAS @TouchSurgery case @GuysUrology yesterday. & Our first Clinical case observership. Rarps kidneys, partials and more. There’s a spare seat for you in 2024! @prokarurol @nairajesh @GSTTnhs @MedtronicUK pic.twitter.com/fknnqtWz7V
— Ben Challacombe also on bsky (@benchallacombe) December 30, 2023
Dr Challacombe points to unique features such as the system’s modular build and open console setup.
He states: “You can have two or three or four people around you and, if they've got the 3D glasses on, they will get the same view. From a teaching perspective, moving your hands and showing a movement is much easier on Hugo than on other consoles.”
“On the technical side, the vision is amazing. Most people who look at it would say that the vision is so crisp, it's almost slightly better than a da Vinci screen.”
Hugo is not yet available in the US, but Medtronic is eyeing an initial US Food and Drug Administration (FDA) submission this year.
Talking to Medical Device Network, Rajit Kamal, vice president and general manager of robotic surgical technologies in Medtronic’s surgical business said: “We intend to submit to the FDA in Q1 calendar year 2025 for a urology indication for the Hugo system.
“In parallel, our hernia and gynaecology studies are rapidly enrolling, and we plan to apply for those indications closely after urology.
Kamal adds that the hundreds of clinical cases in US hospitals give Medtronic “confidence for entering the US market”.
Studies show Hugo performs the same as da Vinci across key procedure parameters, and a significant advantage is that it comes at a slightly lower price point than its competitor.
“It’s very difficult to be as good and cheaper,” explains Dr Challacombe.
“One of Medtronic’s things has to be to be slightly a better deal and better reimbursement. My stock phrase would be that they're almost as good and that they're cheaper. This frees up space on more expensive and technical procedure lists.”
Vigneux foresees that Medtronic “poses a potential challenge to Intuitive’s dominance”, explaining that “Hugo is designed to be more modular and cost-effective, making it attractive to hospitals looking for alternatives to the da Vinci system’s high upfront costs”.
Medtronic’s main hurdle to cracking the US market, however, is Intuitive’s head start.
“Given Intuitive’s entrenched position, vast installed base, and long-standing reputation, Hugo is more likely to capture new customers rather than immediately displacing Intuitive’s existing market,” says Vigneux.
McIntosh echoed the sentiment, saying that with Intuitive’s 20-year head start, it is going to be hard for the company to come out of the gate and match them.
“Medtronic’s Hugo I'm sure will find a niche. I think that in the near and mid future, however, Intuitive is going to be the leader, and everyone else is going to be scrapping for some piece of the market,” says McIntosh.
But the clearest indication of where Medtronic sees itself in the growing robotics field has come from its CEO Geoff Martha during a presentation at the JP Morgan 2025 Healthcare conference.
“We’re confident in our positioning to become a strong number two player in the surgical robotic space. Usually, we’re targeting number one, but right now we’ll just target number two here, and I think that’ll be pretty good,” Martha said.
Johnson & Johnson (J&J) is also muscling into the space with its Ottava surgical system. The company has remained tight-lipped about the system and its plans for 2025, though it has won an FDA investigational device exemption (IDE) to start a clinical trial.
In a statement to Medical Device Network, J&J said: “We are preparing clinical trial sites to receive Ottava systems, enrol patients, and begin surgical cases. We are pleased with the progress we’re making with the OTTAVA programme and remain confident in our ability to deliver a differentiated general surgery robotic system based on insights from clinicians.”
Vigneux says, however, that J&J faces similar challenges to Medtronic: “Unlike Hugo, Ottava aims to offer a fully integrated, flexible system that competes on workflow efficiency and reduced footprint in operating rooms. However, regulatory approvals and surgeon training adoption remain key hurdles, and Intuitive’s decades-long head start in robotic surgery gives it an advantage.”
CMR Surgical, a British company that received a valuation of $3bn in 2021, received FDA approval for its surgical robot Versius in gallbladder removal in October 2024. Globally, Versius is the nearest rival to the da Vinci line in terms of performed procedures. How they will fare in the US will depend on distribution channels, with Medtronic’s presence in the US already established.
Stryker, which already has an FDA-cleared robotic arm called Mako for knee and hip operations, has flirted with interest in soft tissue robotic surgery.
In a July 2024 earnings call, CEO Kevin Lobo said: “It’s an area that we like as a space. It’s complicated, and there is room for more than one big player.”
It’s not just pure play medtech companies looking to take a piece of the robotic surgery pie – technology giant Sony unveiled a prototype microsurgery assistance robot in May 2024 to tease a future entry into the sector. The company has been busy working with university departments and medical institutes to further develop its technology.
Market pressures abound
Away from intra-market competition, Intuitive, Medtronic and J&J, along with other medtech companies, share common challenges in 2025. A considerable pressure, and one that’s been around for more than a year, is the increasing popularity of weight loss drugs. Intuitive admitted in January that the effect of GLP-1RA drugs on bariatric surgeries will remain a challenge this year.
There are also the continuing effects of the weaker economies in China, a headwind felt by many companies across the medical device industry.
There are then the supply chain implications of President Donald Trump’s tariffs. Whilst medical technology might escape with fewer problems than pharmaceuticals, industry bodies have warned that US medtech innovation could be stifled with impaired R&D, higher layoffs, and higher device prices. It may well be that rather than intra-market competition, macro-economic challenges pose the biggest disruptive force to the surgical robotics market.
