A medical start-up based in Cambridge in the UK has claimed success in the first clinical trial of a new generation of surgical robots. Doctors at the Deenanath Mangeshkar Hospital in Pune, India used CMR Surgical’s Versius robotic assistants to operate on 70 patients who required keyhole or minimal access surgery for a variety of gynaecological and gastrointestinal problems, some minor and some major. The first 30 patients in the trial have had a 30-day follow-up that showed no adverse events, according to Dhananjay Kelkar, the surgical team leader: “The system has been shown to be highly effective.” The remaining 40 are part of the next phase of the trial. CMR, which was founded in 2014 by five medical engineers, has raised almost $150m in private investment to develop Versius. The system, which typically has three arms in action at the same time, is designed to be more flexible, less expensive and lighter than existing surgical robots. Richard Kerr of John Radcliffe Hospital in Oxford, who chaired the recent Royal College of Surgeons Commission on the Future of Surgery, said hospitals had adopted robotics more slowly than people expected when the technology first became available about 20 years ago. “There is a popular misconception that the introduction of robots into surgical practice equates to the robot actually doing the surgery,” said Mr Kerr. “In fact we are talking about a very posh tool for the surgeon, who controls the movement of multiple robotic arms that can rotate and move in ways that human arms cannot.” The commission’s report, published in December, highlighted CMR as leading a new wave of companies emerging to challenge the market leader — the Da Vinci system made by US company Intuitive Surgical. Other newcomers include Auris Health, Verb Surgical and Corindus. “Versius clearly provides a smaller, more compact, more manoeuvrable and more transportable option than current systems,” Mr Kerr said. Versius was tested first on human cadavers, then on pigs and finally this year on patients. Mark Slack, CMR’s chief medical officer, said the company chose Pune for its first clinical trial because “India has many talented surgeons who are keen to participate in international research — and India is going to be a very big market for us”. The next clinical trial will involve 250 patients who require a hysterectomy or gall bladder removal. CMR obtained European approval for its robots in March. “A lot of patients are still having open surgery when they should be getting minimal access surgery,” said Mr Slack, a surgeon at Addenbrooke’s Hospital in Cambridge. “Robotics will help surgeons who don’t have the hand-eye co-ordination or dexterity to do minimal access surgery.” Surgical robots generally cost more than £1m each. CMR did not want to disclose the price of its systems ahead of their commercial launch though Mr Slack said they could cut the cost of robotic surgery by 40 per cent. According to CMR, the worldwide market for robot-assisted minimal access surgery is currently about $4bn a year and is projected to reach $20bn by 2025.