The medical-device giant is positioning its Hugo RAS system to compete with Intuitive Surgical’s da Vinci systems.
Did you know that over $1.6 trillion of America’s $4.9 trillion healthcare expenditure in 2023 went to hospitals? You can add up all the spending on physician and clinical services and prescription drugs, and it’s still less than we spend on hospitals.
Over the past 25 years, hospitals have been learning they can retain more profit from the surgical procedures they perform if they first invest in one of Intuitive Surgical‘s (ISRG +13.93%) da Vinci systems. Hospitals have been beating a path to Intuitive’s door to get their hands on its machines, but it isn’t the only company developing and marketing surgical robots.
In 2014, Medtronic (MDT +0.00%), a giant in the medical-device arena, acquired Mazor Robotics, a company focused on spinal surgeries. More recently, it’s been developing its Hugo robot-assisted surgical (RAS) system to tackle procedures typically performed with da Vinci systems.
Strong uptake of da Vinci machines pushed shares of Intuitive Surgical up by about 23,300% since its initial public offering (IPO). Here’s a look at what Medtronic’s accomplished recently to see if investors can expect similar gains on the back of the company’s Hugo systems.
How Medtronic is performing against Intuitive Surgical so far
Intuitive Surgical recently reported 10,763 of its da Vinci systems were installed as of Sept. 30, 2025. Worldwide procedures performed using da Vinci systems rose by 19% year over year during the third quarter. Lung tumor biopsies performed with its relatively new Ion system jumped 52% higher year over year.
System sales are significant, but Intuitive makes most of its money from sales of instruments and accessories that must be replaced before each procedure. Intuitive Surgical reported third-quarter sales that surged 23% higher year over year to an annualized $10 billion.
Assessing the market performance of Medtronic’s robot-assisted surgical systems isn’t easy. It lumps Mazor-related sales into its cranial and spinal technologies division. Hugo-related sales are folded into a division called surgical and endoscopy. Management still isn’t sharing many details regarding the number of systems installed or how many procedures they’re performing.
During Medtronic’s fiscal first quarter that ended on July 25, 2025, surgical and endoscopy sales rose 4.4%, while cranial and spinal technologies revenue climbed 5.5%. Annualized sales for both divisions climbed to an annualized $11.3 billion.
On the surface, it may seem like Medtronic is competing well against Intuitive Surgical, but this isn’t necessarily the case. The reporting divisions that house Medtronic’s surgical robots contain many non-robotic products. If the company’s share of the surgical-robotics market was growing rapidly, it’s unlikely that management would want to keep those numbers a secret.
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An uphill battle
In April, Hugo met its goals in a clinical trial that tested its ability to complete urologic procedures, including prostatectomies. The results show Hugo leads to dramatically fewer complications versus old-fashioned, non-robot-assisted surgery, but this won’t necessarily lead to uptake in this arena.
Intuitive’s da Vinci machines perform a lot of urologic procedures, too. So far, it’s hard to say that one system is any better than the other. A recent meta-analysis of eight different studies regarding prostatectomies showed postoperative outcomes, including complications, were statistically similar for patients who were operated on by a da Vinci system or a Hugo system.
Intuitive Surgical’s already existing footprint is an enormous advantage that could prevent Hugo from gaining a large share of the surgical-robotics market. Hospitals that already have one surgical team trained to use a da Vinci system have a strong financial incentive to continue choosing Intuitive Surgical for subsequent systems.
As a leader in the medical-device industry, Medtronic benefits from economies of scale. Plus, its giant global salesforce is ready to market any medical technology it acquires from smaller start-ups, which often want to avoid hiring international sales teams.
Medtronic’s advantages could allow the company to continue recording steadily growing profits for decades to come. That said, I don’t expect its Hugo systems to overcome Intuitive’s head start when it comes to prostatectomies and related procedures.
