TECHNOLOGY AT WORK

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Citi GPS: Global Perspectives & Solutions February 2015
obliges individual combatants, and belligerent parties in general, to distinguish
between legally legitimate and illegitimate military targets; in other words, it needs to
be shown that automated weapons can adequately, and with a high level of
certainty, identify the correct target. Morally, robotic weapons are not unethical in
themselves, but their development and deployment raises a number of substantive
ethical concerns, for example relating to justifications for killing in warfare. While a
legal ban and a moral consensus on automated weaponry is unrealistic,
policymakers must ensure that the development and deployment of such weapons
occurs only within carefully restricted contexts.
Opportunity in Healthcare
Justin Morris
European Med Tech & Services Analyst
Atif Malik
European Semiconductor Analyst
Robots are already being used in surgery,
but not without controversy
Robots are already being used in a variety of healthcare applications. Robotic
surgery will make new forms of minimally invasive surgery possible, which could
reduce patient scarring, rehab time, post-surgical complications and deaths.
Intuitive Surgical is the leading supplier of robot assisted surgical systems, while
Hansen Medical also specialises in robotic surgery. In 2013 there were 523,000
surgeries performed using Intuitive’s da Vinci Surgical System (the majority of
procedures being in the areas of gynaecology and urology) on an installed base of
>3,000 machines worldwide (>2,000 in the US), compared with only about 1,000
robotic surgeries worldwide in 2000.
The use of robotics in surgery has not been without controversy, with some studies
cited in the Wall Street Journal actually finding an increase in adverse events with
robotic surgery and questioning whether the potential benefits of robotic surgery
outweigh the additional costs given that the price of the systems range from $0.9-
$2.5 million, with additional consumables of $700-$2,300 needed for each
procedure, according to Intuitive. However, a study published in the February 2015
issue of Health Affairs, found that in terms of quality-adjusted life-years gained, the
benefits of robotic assisted partial nephrectomy surgery for kidney patients
outweighed the healthcare and surgical costs to patients and payers by a ratio of
five to one. 64
In the field of medical robots, advances are aimed at creating a seamless
connection between humans and robots such that robots can assist in human
functions. Japanese company Cyberdyne, with its hybrid assistive limb (HAL)
device, uses an exoskeleton with sensors to detect electrical signals from the body
and helps transmit these to the brain, helping people suffering from paralysis to
walk again. Citi’s Hidemaru Yamaguchi suggests HAL can be used for numerous
neural and muscular disorders, including stroke, which affects up to 25 million
patients globally, Parkinson’s disease (4 million people) and multiple sclerosis (2.5
million).
Brooks Automation’s Life Sciences division provides automated sample
management platforms for biologic sample storage in a controlled environment and
automates the process of retrieving specifically selected samples from within the
storage containers. The automated controlled storage environment ensures that
samples are preserved within a narrow temperature band to maintain sample
integrity (manual retrieval has an increased rate of degradation due to temperature
fluctuations, as more samples than needed are typically removed at one time to find
the correct sample) and provide absolutely accuracy in the identification and
selection of samples during storage and retrieval (manual retrieval has a 10% error
rate).
64 Intuitive Surgical press release.
© 2015 Citigroup