Surgical robotics is not one thing anymore. It is fracturing into specialties. The reps and clinical teams who understand that early are the ones who will have options.
THE EDITOR’S NOTE
A few thoughts from the field before we get into it…
When I first started in med device, robotic systems were relatively new to the market, and I remember I was fascinated by them. The reps made bank, hospitals and doctors wanted them and they could evidently do things that surgeons couldn’t. Fast-forward 25 years to now, and we are seeing robotics take enormous strides.
Have you heard of a robotic system so precise it can suture a blood vessel the width of a human hair?
That is what Medical Microinstruments (MMI) is building. Their Symani system is designed for microsurgery, the kind performed under a microscope on vessels and nerves so small that human hands, no matter how skilled, hit the limits of what they can control. The robot does not replace the surgeon. It filters out tremor, scales movement, and lets the surgeon do things that were not previously possible at that level of precision. There are about 50 Symani systems installed globally. This week the company raised $125 million in Series D funding to scale commercial operations.
That number says something.
Surgical robotics has been a category for over two decades, but it is entering a new phase. The first wave was about proving the technology could work. The second wave, which is largely what Intuitive has been riding, was about expanding adoption into more hospitals and more procedure types. The wave we are entering now is about specialization. Robotic platforms purpose-built for microsurgery. For the ASC. For procedures that full-size systems cannot reach.
I spent my career in orthopedics and sports medicine. I watched robotic-assisted joint replacement go from a concept that surgeons were skeptical of to a standard that hospitals compete on. That transition did not happen overnight, and it did not happen uniformly. The reps who understood it early, who could speak fluently about the clinical rationale and the commercial model, had a real advantage.
The same thing is happening right now across the broader robotics category. This issue is a map.
Glad you're here. Let's get into it.
Andy Knapik, Founder
The Modern Med Rep
INDUSTRY INTEL
What's moving in med device this week and why it matters
Five Things Shaping the Industry Right Now
→ Boston Scientific is splitting its cardiovascular group into two separate divisions effective January 1.
Interventional Therapies and Rhythm Solutions will operate as distinct units. This is a significant structural reorganization at one of the largest cardiovascular device companies in the world. For anyone in the cardiovascular space or considering it, this is the kind of internal realignment that reshapes hiring, territory structures, and commercial priorities. It is worth watching closely.
→ Boston Scientific has filed a second patent lawsuit against J&J subsidiary Atraverse Medical.
The suit alleges that the Hotwire transseptal access device infringes Boston Scientific’s IP. Transseptal access is a key procedural step in left-sided cardiac catheter procedures including ablation. Patent disputes between major device companies are common, but two suits between the same pair in a short window signals that this is a genuinely contested commercial territory.
→ A federal judge ordered Apple to pay Masimo an additional $184.2 million on top of the $634 million already awarded in their pulse oximetry patent dispute.
The ongoing Apple-Masimo case is the most visible example of a broader tension: consumer technology companies moving into physiological monitoring and colliding with medical device companies that hold the underlying IP. The total exposure for Apple now exceeds $800 million in this case alone. For anyone in digital health or remote patient monitoring, this is a story with real commercial implications.
→ Wandercraft has acquired Ekso Bionics, consolidating two of the leading names in medical exoskeleton.
Ekso has been in the exoskeleton space for over a decade, primarily in rehabilitation. Wandercraft brings a personal exoskeleton focus. Combined, the company becomes a more significant player in a niche that is quietly growing as the clinical evidence base for exoskeleton-assisted rehabilitation continues to build. This is a segment worth keeping an eye on.
→ BD secured tariff relief in a deal tied to expanding its U.S. medical device manufacturing footprint.
The deal reflects a trend that has been building throughout 2026: device companies trading commitments to domestic manufacturing for relief from import tariffs. BD makes everything from syringes to medication management systems, and supply chain resilience has become a board-level priority across the industry. More U.S. manufacturing means more U.S.-based jobs, including commercial and operations roles.
MARKET SPOTLIGHT
A deep dive into the segments, companies and technologies shaping the industry
The Next Frontier in Surgical Robotics
The surgical robotics market is no longer a single story. It is several stories running in parallel, and they are moving at different speeds toward different endpoints.
The incumbent: Intuitive Surgical. Intuitive is not going anywhere. The da Vinci platform is the dominant robotic surgery system in soft tissue procedures globally, with more than 9,000 systems installed worldwide and a procedure base that spans urology, gynecology, general surgery, thoracic surgery, and more. The company recently published data showing better outcomes across 13 procedure categories compared to conventional approaches. Its commercial model is built on system placements followed by high-margin disposable instrument revenue, which means that once a hospital buys a da Vinci, Intuitive has a durable recurring revenue relationship. For people entering surgical robotics sales, Intuitive remains the largest single employer in the category and the benchmark everything else is measured against.
The challenger wave. Medtronic, J&J, and CMR Surgical are all competing in the soft tissue robotic space with platforms designed to challenge Intuitive’s dominance. None have matched Intuitive’s installed base yet, but the competitive pressure is real and the commercial opportunities at companies building market share are significant. Reps at challenger companies often carry more responsibility earlier and have more direct influence on how accounts are converted.
Orthopedic robotics: maturing fast. We have covered this in prior issues. Stryker Mako and Smith+Nephew CORI are the leading platforms in joint replacement. The growth story now is about converting the 80 percent of orthopedic surgeons who have never used a robot, primarily through compact systems designed for the ASC environment. This is a commercial expansion play, not a technology introduction play, which changes what the sales conversation looks like.
The microsurgery frontier: MMI and Symani. This is the story most people in the industry have not tracked yet. Medical Microinstruments developed the Symani Surgical System for reconstructive microsurgery, specifically the procedures performed on vessels and nerves measured in millimeters or less. Think lymphatic reconstruction, nerve repair, perforator flap procedures. The robot filters out physiological tremor and scales the surgeon’s movements so that fine motor tasks that are at or beyond the limit of human dexterity become controllable. With $125 million in new funding and roughly 50 systems installed, Symani is transitioning from early adoption to commercial scale. This is the kind of early-market moment that creates careers.
Neurosurgical and spine robotics. Globus Medical’s ExcelsiusGPS and Stryker’s Q Guidance system are bringing robotics to spinal procedures, primarily for pedicle screw placement and navigation. Brain-computer interface company Bridge Neurotech just emerged from stealth with $13.5 million to develop non-invasive ultrasound sensors using Butterfly Network’s chip-based technology, pointing toward a future where neural interfaces do not require open surgery. These are longer commercial timelines, but the direction is clear.
The pattern across all of these:
Robotics expands the procedural envelope. It lets surgeons do things they could not do before, or do familiar things with greater precision and less variation. Every time that happens in a new specialty, a commercial infrastructure needs to be built around it: clinical specialists, capital sales reps, training programs, proctoring networks. That infrastructure is where careers get built.
CAREER OPPORTUNITIES
Where the jobs are, what’s paying, and how to position yourself to get there
What a Career in Surgical Robotics Actually Look Like
Industry Foundation: Capital equipment sales and disposable/consumable sales are fundamentally different commercial models. Understanding which one you are in changes how you sell, how you are measured, and how your compensation works.
A capital sale is a large, one-time purchase that requires institutional approval. Robotic surgery systems can cost anywhere from several hundred thousand dollars to well over a million, and the decision involves finance committees, OR leadership, surgeons, and often hospital administration. The sales cycle can run 12 to 24 months. You are building a business case, not closing a deal. A disposable or consumable sale happens after the capital decision: once the robot is in the hospital, the rep sells the instruments, trays, and supplies used in each procedure. This is a recurring revenue model with a shorter call cycle and a different kind of relationship with the customer. Most surgical robotics companies have both roles, and understanding the distinction is essential before any interview in this space.
The Med Device Career Decoder covers both commercial models in detail and helps you identify which one fits your background and selling style. Find it at themodernmedrep.com.
Surgical robotics roles generally fall into three tracks, and knowing which one you are targeting before you apply matters.
Capital sales representative. This is the person responsible for placing the system. Long sales cycle, multi-stakeholder selling, significant deal size. You need to be comfortable with complex organizational navigation, presenting to committees, and sustaining momentum over months or years. Prior capital equipment experience is often preferred, though candidates with strong consultative selling backgrounds from other industries can compete. Compensation tends to be base-heavy with a meaningful bonus tied to placements, which are infrequent but large.
Clinical sales specialist. Once the system is placed, the clinical specialist is in the room. You support cases, train surgical staff, troubleshoot, and drive procedure volume by deepening clinical adoption. This role requires comfort in the OR, strong clinical knowledge of the specific procedure types the robot is used for, and the ability to build trust with surgeons and OR nurses under pressure. This is often the entry point for people with clinical backgrounds who want to move into the commercial side of robotics.
Clinical education and proctoring. Most robotic surgery companies run formal training and proctoring programs to bring new surgeons onto the platform. Clinical education roles manage that process: coordinating training, facilitating proctored cases, building the surgeon relationship at the learning stage. People with strong OR backgrounds and a talent for teaching often find this role extremely satisfying. It is also a path that can grow into clinical sales or sales management.
Where to start if you are new to robotics:
The clinical specialist role is the most accessible entry point for people with adjacent experience. Strong OR sales backgrounds, clinical specialist experience in a related segment, or scrub tech and surgical nursing backgrounds that have transitioned into industry are all competitive starting points. Know the platform you are targeting. Know the procedures it is used for. Know why surgeons choose it and what the learning curve looks like. That preparation is what separates the candidates who get interviews from the ones who do not.
THE MED INSIDER
One thing every med device professional should know this week
The Proctoring Model: What Is It and Why It Matters for Your Career
If you are going to work in surgical robotics, you need to understand proctoring before your first interview. It will come up.
When a surgeon adopts a new robotic platform, they do not simply start using it independently. Most robotic surgery companies require a formal credentialing and proctoring process before a surgeon can operate without supervision. The specifics vary by company and by hospital credentialing requirements, but the general structure looks like this: the surgeon completes didactic training, usually at a company training center. They complete simulation modules. Then they do a series of proctored cases, meaning cases observed and evaluated by a surgeon who is already credentialed on the platform, often while the company’s clinical team is present.
The proctoring model exists for good reasons. Robotic surgery platforms have real learning curves, and patient outcomes during that learning curve are a genuine clinical concern. Proctoring is how companies and hospitals manage that risk in a structured way.
For device professionals, the proctoring model matters for several reasons. First, clinical specialists and clinical education teams are deeply involved in the proctoring process. Understanding it is part of doing the job. Second, proctoring relationships create some of the strongest bonds between device reps and the surgical community. Being present for a surgeon’s first cases on a new platform, handling things smoothly when something unexpected happens, being the steady and knowledgeable presence in the room: that builds trust that lasts for years. Third, how a company manages its proctoring program is a meaningful indicator of how seriously it takes clinical outcomes. It is a question worth asking in interviews.
Good interview question:
"Can you walk me through how your proctoring program works and what the clinical specialist’s role is during proctored cases?" The answer will tell you a lot about what the job actually involves day to day, and asking it signals that you already understand how robotic surgery adoption works.
FROM THE FIELD
Your Questions, Answered
This week’s question comes from someone with a strong foundation looking to level up:
“I have been in OR sales for three years, capital and disposables. I know the environment and I have good surgeon relationships. I want to move into surgical robotics.
What do I need to know that I do not already know?”
Honestly? Less than you might think, and more than you might expect.
The OR experience is genuinely valuable. You already know how to read a room under pressure, how to support a case without getting in the way, and how to build trust with surgical staff. Those things are hard to teach and you have them. That is a real advantage over candidates coming in from outside the clinical environment.
What is different in robotics, and what you need to close the gap on before you interview, is the capital sale dynamic if you are targeting a capital rep role, and the specific platform knowledge for whatever system you are pursuing. Three years in OR sales means you understand how hospitals buy things. Robotic systems are a different kind of buying decision: longer cycle, more stakeholders, more political. If your background is primarily in disposables, study how capital decisions get made. Talk to people who have done it.
On platform knowledge: go deep on the specific system you are targeting. Not just what it does, but why surgeons choose it over alternatives, what the learning curve looks like, what the proctoring process involves, and what the common clinical objections are. You do not need to be a clinical expert yet. You need to demonstrate that you have done more homework than anyone else they will interview.
That combination, OR credibility plus genuine preparation on the specific platform and commercial model, is what gets you the offer.
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QUOTE OF THE WEEK
“The secret of getting ahead is getting started.”
- Mark Twain
