Strategies to sell against "Boom" multiport main frame surgical robots

In the first of a series of "how to sell against" I'm going to give my thoughts on some strategies and tactics you could use to sell against boom robots like the da Vinci.

Don't worry I will do the next articles on how to sell against all the formats of robots.

A boom structure Robot

Concentrated Mass

Single boom robots come with one common feature. Concentrated mass.

That means that the bedside boom has to support all 4 arms - and that means that to have all the weight hanging off - away from the central boom it needs to have a big solid boom and a big amount of weight at the base of the boom. It needs to be stable and not tip over.

The manufactures will all tell you that "weight" increases stability - but even smaller - lighter robots with the right software can be stable. So it is true for many booms - but not exclusive to them.

So the first thing I would be selling against is MASS.

I would be looking for any hospitals where such a concentrated mass could be above the maximal load weight of the floor. Let me explain concentrated vs distributed mass.

If you have 4 arms but each is on a small cart - and each cart weighs 200Kg.

Then the total mass is 800Kg but it is distributed evenly across the floor of the OR in 4 points. Over a very large surface area.

Where as a single boom at 800Kg is all concentrated on one single point.

That means booms have a higher concentrated mass in one point of the OR and that makes a difference in structural engineering.

The mass effect is way more important for "floor ratings" on a boom robot.

In many operating rooms the floor is more than capable to take the mass concentration - however in some ORs especially in older buildings... that can become a limiting factor. And need to be checked.

I would be searching every Hopsital where mass is important - and making sure that they were high up my priority list. Older hospitals - smaller clinics - converted buildings.

I would then be paying every one a visit asking "So why do you not have a robot today?"

Access to upper floors

Based on the mass effect - I would also be seeing where any hospital may have an impact for getting the system either up stairs or in elevators.

Older European hospitals for sure will have some weight limits for a concentrated mass - even in certain service elevators. I'd be stratifying all my clinics and hospitals that would struggle to get above 400Kg loads up to higher floors.

This could be a double whammy if you want to have a system that is mobile between floors.

All day long (if I had a modular system, a miniature system or light system) I'd be rooting out the places where a full on "heavy" and concentrated mass could not go - or be moved. Weak floors - elevators and anywhere where mass would be an issue.

I'd be questioning "Do you really want all that structural estate hassle when you can simply use my robot?"

Size & Height

All that mass is actually caused by a big size.

If I had a small system or a micro system, I would be pushing hard against "filling the operating room with massive structures." I would be making strategies that highlight why my small system is "compact" or "Low footprint." Stressing how every inch of floor space counts...

Now remember you may have the bedside unit(s) and the tower and the console. So you need to be a careful about how much you claim to reduce size -- but every inch/cm counts.

I would then be segmenting my customers by site of care, and size of that site of care. I would be prioritising places like small ASCs, or clinics, or older structures with very small operating rooms where some of the big boom systems just might not fit.

I'd be stressing that "You can now have access to a robot even in this small place because we are different."

Now you have to be careful - because if you are a modular robot - but a "massive" modular robot - you may actually have more footprint than a single boom robot. So be careful.

But... what you most likely will be able to talk about is height. By design modular robots and mini robots are way lower than boom robots that come up an over. (Except for maybe Asensus).

The fact modular robots come "up from the floor" and Mini robots are on the patient - means that they often don't go as high as most booms. In some older ORs ceiling height is an issue and a big boom robot can struggle to fit into the room. So again I'd be looking for smaller - lower structures and helping them get access to robotics by delivering my smaller - lower system.

One side advantage I'd be concentrating on - regarding height - would be that structures come up (on some systems) lower than the bedside teams head height. This is less intimidating, reduces the risk of a sterile drape touching a non-sterile surgical cap, and gives a sensation of more access above the patient (true or not the sensation is there.)

I'd be pointing out height and architecture to bed side teams (who complain of this) all day long.

Choice

One of the biggest human motivators in purchasing decisions is that of "Choice." As surgical robotics has been dominated for 20 years by a "boom design" I would be playing upon the human emotions of "Choice."

That can manifest in a few ways, and I'd be pushing the buttons of the surgeons, bedside teams and Hopsital management.

First I'd just say "Be different" asking of they want to be another one of the 8000 boom robots - or want to show their independence in choice (Mini or modular).

If I had a modular robot, then talk about Choice in "freedom to decide" where the arms come from. I'd be saying that due to the independent of arms on carts "The surgeon chooses angles of approach." Much more like laparoscopy. So I'd be doing lots of questioning on "Why haven't you switched all your lap to robotic today?" If I get any hint of "I feel constrained by the arms and port placement" - then straight in with "We give you back that choice."

Choice also (for academics) brings publication opportunity - so I'd be at every teaching institution asking "Are you are boom training hospital or want to teach the options of all formats?" Teaching hospitals are way more open to multiple formats to show they are "open minded in choice."

I'd be saying "There is a window on being first to publish... Booms have already covered all of the publications possible..."

Finally I'd just be going to every surgeon that had "rejected robotics" a quick search on Google and Youtube will find many of them - and then (knowing that even they know robotics is now the future) give them an avenue to get into robotics with an "alternative closer to their lap" than being embarrassed to finally have to move to a boom robot. I'd give them a great excuse to get into robotics in a "different way."

Port placement or staying at the table

One of the key differences between boom robots and modular robots (again depending if they have Z rails or not) is that the surgeon inserts the ports and then bring the arms to the ports. So verses boom robots - surgeons get to operate more "their way." With a critical thing like more freedom of port placement. This allows them to follow their own laparoscopic principals. etc etc.

If a surgeon is insisting to "stay in the paradigm of lap" then a modular system will absolutely help them do that.

Some modular systems also help some surgeons stay at bedside more. There are a few specialities and many operators that want to do more of a "Hybrid" (bad word) - or "blended" surgery of lap and robotic. Modular systems make it easier to do that as you can choose how many arms are at the bedside at any point of the procedure. So a surgeon can work with just say the scope arm. Choice.

Even more so, some systems like Dexter - will allow genuine "blended" surgery - with the surgeon never having to scrub out. And for some surgeons that allows them to be robotic without "abandoning" the laparoscopy they love (and are often known for.)

I'd be finding surgeons that prefer this kind of flow of surgery and be pumping them hard on my benefits.

For modular robots - Flexibility

The whole idea of modular roots is "Pick n choose". How many arms, where the arms go, when the arms enter or leave the field, where the ports go. Ipsilateral or contralateral approaches etc etc.

I'd be digging in deep to understand how "constrained" a surgeon feels by a boom robot - and then pushing that button hard and espousing those massive benefits of modular systems.

For the OR staff I'd be all about not having a "huge heavy boom to move" and jump into flexibility for mobility. Lighter - easier to move - smaller components that can go in elevators one at a time. Storage of smaller components. More convenient for you - no big motorised bases to move.

I'd talk about getting a few consoles and a bunch of arms - and doing flexible mix n match working. Talking the flow of the patients- starting lap (same ports) and binging in the arm on the cart to this ports, at the right time. I'd be talking scheduling flexibility - through put - efficiency that a modular system brings.

For mini robots - complexity

One of the keys to mini systems (for me) such as Virtual Incision - is that you go from having to manage several ports to (in theory) one port. Okay one robotic port. You don't have the big capital set up - draping - servicing and a whole ton of "headaches" associated with main frames. (This would apply to boom or modular by the way.)

I'd be looking for procedures and sites of care where they want small trays (not mainframes) for the bedside unit. I'd be pushing that it is always sterile - always ready to go. Multiple bedside systems ready at all times so that every OR can be robot ready.

I'd be talking convenience - and "Hey over at the main block go for it with the Boom robot. But here in this ASC - the right robot may be a mini robot - that is ideal for this procedure."

I'd be heavily into the reduced decisions needed on set up - the reduced complexity for bedside teams - the reduced complexity for tear down - sterilisation - and the reduction in consumable waste.

I would not be trying to claim to be as "Capable" as a boom - but position myself as a side by side alternative for the right setting - right procedure.

Less complex - lower footprint (not no footprint).

I'd be a little cautious on costs - as the whole cost equation of boom robots is changed with leasing - so you need to be wary of that and work out the genuine cost per case v cost per case. (it's going to surprise many people. Especially if you ever want to make a profit.)

In fact, nowhere in any of the above would I ever mention "lower cost." If there is one thing I've leaned - there is no such thing as cheap robotics - ever !

Don't talk cost... you will ultimately regret it.

Summary

Boom robots are here to stay and will likely dominate for the next decade. So My approach to marketing would be to look for the gaps (they are big gaps). Understand which people don't use robots today - and see if that is heavily linked to architecture -size and mass. Find out the deep reasons why (as above) and then be positioning my system as a valid alternative.

I'd definitely be looking for lap surgeons that have painted them selves into the "anti robot" corner and cover them to "anti boom" - and allow them to join the robot party by a side door.

I'd make sure I find the right applications - in the right locations - with the right minded user and lean into those reasons.

No rubbishing the competition - no price bashing - no company bashing. Find the gap - sell the reason your architecture fills that gap. There's lots of room.

Note: In these articles I'm not talking specifically how to position yourself against a "company" as that is another set of strategies.

This article is for educational purposes only.