Future of Surgical Robotics: Steve Bell on AI, Startups, and Trends

Welcome to this edition of MedTech Maestros, where we delve into the future of surgical robotics with industry veteran Steve Bell .

With over 35 years in medical devices, including roles in giants like Ethicon, Inc. (J&J) and startups like Orqis Medical and CMR Surgical , Steve provides a unique view on how AI, startup innovation, and new trends are reshaping the landscape of surgical robotics.

From Pioneering Sales to Shaping the Future of Robotics

"I wanted to work on real startups rather than fake startups within a company."

Steve began his journey in the early days of the medical devices industry at Ethicon, where he played key roles in sales, management, and marketing, launching endosurgery and transitioning the field from open to laparoscopic procedures. After 16 years, he ventured into the startup world to make a deeper impact. "I wanted to work on real startups," he says. Steve’s experience includes work in heart failure technologies at Orqis Medical and significant contributions to CMR Surgical, where he helped shape the company into a major surgical robotics contender.

Today, semi-retired but highly active, Steve shares his expertise on LinkedIn and mentors emerging companies, guiding them on fundraising and medical device innovation.

The Rise of Smaller Robots: Surgical Robotics Beyond the OR

"There were about 40 companies that tried, but very few succeeded."

Steve witnessed firsthand how the surgical robotics space has transformed. "Back in the day, there was just Intuitive [Surgical]... they dominated the soft tissue space," he explains. Intuitive ’s Da Vinci system became synonymous with robotic surgery, but as patents expired around 2013-2014, new players began entering the market. "There were about 40 companies that tried, but very few succeeded," Steve notes. Companies like Titan Medical Inc. and Senhance emerged as competitors but struggled to gain significant market share.

Today, there are over 36 robots either on the market or nearing launch. "There’s a huge diversity now," Steve says. From large systems like MMI to handheld robots like Virtual Incision, the landscape is rapidly expanding beyond traditional operating rooms into smaller clinical settings. "Ambulatory surgery centers or clinics are becoming big markets for these smaller robots," he adds.

The shift from large ORs to smaller surgical spaces is being driven by both technological advancements and changing healthcare needs.The next big wave in robotics is intervention-based systems that actively prevent errors during surgery. "What’s coming now is intervention... robots will intervene to stop people from making mistakes," Steve predicts. This shift toward more autonomous systems could revolutionize how surgeries are performed by minimizing human error.

Startups vs. Strategics: The Battle for Innovation in Surgical Robotics

"In a startup, you either grow or die, in bigger companies, you have vast resources but also fractured work streams."

Having worked in both startups and large corporations, Steve offers unique insights into how these two types of organizations approach innovation differently. "Most startups don’t have a legacy business to defend," he explains. This allows them to focus solely on creating the best possible robot without worrying about cannibalizing existing product lines. In contrast, companies like Medtronic and J&J often take a more defensive approach because they have billions invested in traditional surgical tools like staplers and sutures.

Startups also tend to move faster when it comes to product development. "In a startup, you either grow or die," Steve notes. The speed at which risks are retired during development is critical for survival in smaller companies. "Out of India, you've got SS Innovations with Sudhir Srivastava, MD and his son and the team there are doing fantastic things." Startups are more willing to take risks and iterate quickly through trial and error—something that larger companies with more bureaucratic processes struggle with.

However, large strategics have their advantages too—namely resources and established regulatory pathways. "In bigger companies, you have vast resources but also fractured work streams," Steve explains. This can lead to slower innovation cycles but provides stability that startups often lack.

How AI is Transforming Surgical Robotics

AI is revolutionizing surgical robotics, enhancing precision and safety. One key application is imaging and video segmentation. Robots can now identify structures, instruments, and steps in real-time. “AI can segment videos, tag them, and enable easier navigation,” Steve explains, with companies like Intuitive and CMR leading the way. This allows surgeons to review their performance more effectively, driving continuous improvement.

"AI can segment videos, tag them, and enable easier navigation."

Beyond imaging, AI aids predictive maintenance and perioperative guidance. It predicts mechanical failures before they occur and assists surgeons in real-time by warning against critical errors. “If a surgeon is about to cut a major vessel, AI can intervene and stop the robotic arm,” Steve shares. This capability not only prevents disasters but also supports more precise surgical outcomes.

AI-powered data ecosystems are also transforming training and performance benchmarking. Procedural data is analyzed to identify skill gaps, with tailored simulator exercises helping surgeons improve. “It’s about empowering surgeons through self-improvement,” says Steve. By democratizing surgical precision, AI raises the standard of care, making advanced techniques accessible to more practitioners and improving overall outcomes.

The Uncharted Future of Surgical Robotics

Steve sees promising developments on the horizon, particularly in stroke management and telesurgery. Stroke interventions are especially promising: “Stroke is a major, cost-intensive problem where time is brain,” he emphasizes. Remote robotics could enable timely interventions in stroke patients, potentially improving outcomes.

"What's coming now is intervention... that is the robot will intervene to stop people making mistakes."

Another growth area is dental robotics, with companies like Lupin Dental making precision tools more affordable and accessible. “Dental robots can apply CNC-style precision,” Steve notes, helping dentists perform intricate procedures with accuracy.

Steve also highlights emerging players like Andromeda Surgical led by Nick Damiano and their work with robotic systems designed for delicate procedures such as prostate. "If they get it right... tele-robotics could be a game-changer," he predicts.

The advent of “Xbox surgeons”—tech-savvy, data-driven new surgeons—is also driving demand for robotic systems. "Hospitals that lack robotics may struggle to recruit these younger surgeons," Steve observes. This generation expects data-rich, technologically advanced environments, making robotics essential for hospitals aiming to attract top talent.

In this edition, Steve Bell’s insights provide a clear view of the next phase in medical robotics: smaller, AI-enhanced systems, a new generation of tech-oriented surgeons, and the expansion into specialized areas like stroke and dental care.

Thank you for joining us on this journey through surgical robotics’ future with Steve Bell! Stay tuned for more from MedTech Maestros, where we bring you insights from the innovators shaping tomorrow’s healthcare.