One thing I learned early in this industry is that the competition never stays still for long. The moment you think you understand who the players are and what they're selling, someone new shows up, a company restructures, or a new technology upends the whole market.

That's exactly what's happening in surgical robotics right now. For more than two decades, there was really one name that mattered in soft-tissue robotic surgery. That's changing faster than most people realize, and it's creating a wave of commercial activity that hasn't been seen in this segment in years.

This week, we go deep on surgical robotics: the companies, the roles, the opportunity, and what you need to know to compete in it or break into it. We also cover some significant industry news that touches everyone in this space, regardless of your specialty.

Glad you're here. Let's get into it.

Andy Knapik, Founder

The Modern Med Rep

For most of the past two decades, surgical robotics in soft tissue procedures meant one thing: Intuitive Surgical and the da Vinci system. Intuitive did not just dominate this market, it essentially created it. The da Vinci platform pioneered robotic-assisted soft tissue surgery and built a commercial infrastructure so deeply embedded in hospital systems that competitors spent years trying to figure out how to get a foothold.

That window is now open. And several serious companies are walking through it.

Soft tissue robotics

Medtronic's Hugo system received FDA clearance for urologic procedures in December 2025 and completed its first U.S. commercial cases in early 2026. Hugo is designed to be modular and cost-competitive, a direct response to one of the most common objections hospitals raise about da Vinci: the price. Medtronic is targeting ambulatory surgery centers and community hospitals, segments where Intuitive has historically been underrepresented. Johnson & Johnson submitted its Ottava system for FDA De Novo classification in January 2026, backed by clinical data from general surgery. J&J expects U.S. physicians to begin performing the first commercial procedures this summer. CMR Surgical's Versius system is already operating in more than 35 countries and is making inroads in the U.S., particularly in gynecology and colorectal surgery. Its compact, portable design makes it practical for hospitals and Ambulatory Surgery Centers (ASCs) that lack the infrastructure to support larger platforms.

Orthopedic robotics

Stryker's Mako system has been the dominant robotic platform in total joints since its launch and remains the gold standard for hip and knee replacement. Mako uses CT-based planning and real-time haptic feedback to guide surgeons within predefined boundaries, resulting in demonstrable improvements in implant positioning and early patient outcomes. At AAOS 2026 meeting in New Orleans, Stryker debuted a handheld version of Mako for knee procedures, extending the technology into community hospitals and surgery centers that have seen the full Mako system as out of reach due to cost and space requirements. Zimmer Biomet's ROSA system competes directly in this space, with strong adoption in knee and spine procedures, and the company has been aggressively expanding its robotics-trained sales force. Globus Medical, following its merger with NuVasive, is investing heavily in its ExcelsiusGPS robotic navigation platform for spine, which is gaining traction in both open and minimally invasive procedures. DePuy Synthes, preparing for its spinoff from J&J, recently named a new global head of robotics and has made robotics a centerpiece of its standalone strategy. The orthopedic robotics space is where the next large wave of commercial growth will come from in this segment, as the technology moves from large academic centers into community hospitals and ASCs at scale. For reps in this space, the ability to speak credibly about robotic workflow integration, case planning, and surgeon training has become a baseline expectation, not a differentiator.

Endovascular and cardiac robotics

Stereotaxis leads in magnetic robotic navigation for electrophysiology and, with the Robocath acquisition, is building toward a full-spectrum endovascular robotic platform. This is a fast-developing area as robotic technology begins to address procedures in the cath lab and EP suite that have traditionally been performed manually.

Surgical robotics is the most sought-after segment in med device right now, and also one of the more competitive to break into. Here's what the hiring landscape actually looks like and how to position yourself for it.

The roles

The three most common entry points are Clinical Sales Specialist, Territory Sales Representative, and Territory Development Representative. Clinical specialists spend the majority of their time in the OR, supporting cases and training surgical teams. Territory reps manage the full sales cycle: surgeon relationships, hospital administration, capital approvals, and contract negotiations. Territory development reps work alongside senior territory reps, focusing on prospecting, lead generation, and pipeline building, a common first step for people breaking into robotic surgery from outside the industry.

What they're hiring for

OR experience is valued but not always required. What hiring managers consistently say they want is someone who is comfortable in a clinical environment, can build credibility with surgeons quickly, and can manage a long and complex sales process involving multiple hospital stakeholders. B2B sales experience, particularly in capital equipment, translates well. Clinical backgrounds, including OR nurses, surgical techs, and device company clinical specialists, also translate well into the clinical specialist track.

The companies actively building teams 

Medtronic's Hugo team is in active expansion as it builds its U.S. commercial infrastructure. J&J is gearing up for Ottava's commercial launch. CMR Surgical is growing its U.S. territory presence. Intuitive continues to hire at volume despite the Q2 softness. Stryker is expanding its Mako footprint. Distalmotion, which makes the DEXTER robotic system, is also posting territory roles in the U.S. In orthopedic robotics, Zimmer Biomet, Globus Medical, and DePuy Synthes are all actively building or expanding robotics-focused commercial teams.

Compensation

Entry-level robotic surgery sales roles typically carry earnings in the $90,000 to $130,000 range. Experienced territory managers with established surgeon relationships and capital sales track records can earn $200,000 to $320,000. Clinical specialists typically start in the $80,000 to $110,000 range with a clear path toward more commercial roles.

Intuitive Surgical's Q2 results surfaced something that does not get enough attention in med device: the direct line between insurance coverage and procedure volume.

When the ACA enhanced premium subsidies expired at the end of 2025, an estimated 23 million Americans were enrolled in marketplace plans, down from 24.2 million in 2025. Many of those who stayed saw their premiums jump significantly. Some patients moved to higher-deductible plans. Others delayed or canceled elective procedures entirely.

This matters for any market or company that focuses on elective procedures. Any time patients face coverage uncertainty or higher out-of-pocket costs, elective procedure volumes soften. That affects the entire device commercial ecosystem, from the rep supporting cases in the OR to the company forecasting territory targets for the year.

The practical implication for device professionals is this: understanding your customers' payer mix and how shifts in coverage policy affect their patient population and procedure volume is increasingly part of being a credible commercial partner. Hospital administrators and surgeons are navigating this in real time. The rep who walks in understanding what's happening and why case counts might be softer than last quarter is a different kind of conversation partner than one who does not.

This week's question came up in a conversation about breaking into surgical robotics, specifically:

QUOTE OF THE WEEK

“Opportunity is missed by most people because it is dressed in overalls and looks like work.”

- Thomas Edison