Titan Medical is already working on the second generation of its Enos surgical robot and showing off the features in a new video. (You can watch the video at the bottom of this page.)

Among other improvements, Enos 2.0 has a new trick up its sleeve. There is a third instrument arm, compared to the two instrument arms

Titan Medical’s Enos surgical robotics system has snake-arm instruments that deploy through a single incision. An Enos 2.0 prototype (pictured here) makes room for a third instrument arm by eliminating the integrated camera and using the 3-D scope. [Photo courtesy of Titan Medical]

in the first generation.

Toronto-based Titan Medical (Nasdaq:TMDI) has not yet filed for regulatory approval of the first generation.

“With the time it takes to bring complex products to market in the regulated medical device industry, you must continuously envision the next generation.” Titan Medical CEO Cary Vance said in a statement.

Titan Medical expects its Enos System to be first-to-market as a single-access, robotic-assisted surgical system, the company said in an investor presentation this week.

The company has previously shared videos with computer renderings of Enos — formerly called “Sport” — as well as surgical demonstrations, but this appears to be the first video showing the system and its latest features in depth and detail.

The Titan Medical Enos surgical robotics system console [Photo courtesy of Titan Medical]

It’s not a bad way to draw more attention to the technology as Titan Medical explores its strategic options, which could include selling the business or another big move. Titan Medical said it met with strategic buyers and investors this week.

“Our focus on purpose-driven innovation has always been at the forefront of our work,” Vance said. “We are excited to share our three-arm design that was independently created by Titan and builds upon technologies developed for our two-arm system and those generated under a previously executed and completed development and license agreement, and addresses evolving customer needs in single-access robotic surgery.”

The Enos robotic surgery system’s instruments and features

The Enos system uses a single port to enter a patient’s abdomen through the belly button for gynecological surgical procedures such as hysterectomies. Titan Medical said it has also optimized the system for urological and other general surgical procedures, but is focused on gynecological indications first.

The Enos has a 25 mm cannula that it inserts through the single abdominal incision. The cannula has an integrated 2-D camera and a steerable 3-D endoscope. The integrated camera is used for insertion, pre-operative abdominal exploration and instrument entry. The endoscope works alongside the other instruments. Both cameras have high-definition resolution and illumination.

In addition to the cameras, the first-generation Enos system can fit two multi-articulating instrument arms through the cannula. Enos 2.0 eliminates the integrated 2-D camera to make room for a third instrument arm.

The Enos surgical robotics system’s suite of instruments includes:

  • Monopolar hooks and shears for dissecting avascular planes and coagulation of small vasculature;
  • Hunter and Maryland bipolar dissectors with an electric current that flows from tip to tip to safely seal larger vessels;
  • Cold instruments such as the mega needle driver, suture cut, tenaculum, fenestrated and lap clinch effectors.

These instruments have a continuous segment design for a broad range of motion in confined spaces while delivering the force and grip needed for surgical tasks, Titan Medical said. They’re designed for fluid movement and to allow the surgeon to do more work in less time with design features such as a minimally bending radius for enhanced triangulation and enhanced instrument travel along the axis. In addition, the arms are strong enough to retrieve larger organs.

Enos 2.0 presents an “opportunity to incorporate third-party instruments, accessories and digital technologies,” the company said in its investor presentation.

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The surgeon workstation has a medical-grade high-definition display screen and a dashboard that illuminates instrument status with interoperative overlays.

Titan Medical’s Enos surgical robotics surgeon workstation [Photo courtesy of Titan Medical]

Titan Medical designed the Enos system’s console with a small footprint. It’s compact enough that surgeons don’t need a dedicated operating room to use it. Plus, there are no external moving robotic arms and relatively few independent components, making the robot easier to drape for surgery — and faster to prepare for the next surgery.

The Future of Single Access Robotic-Assisted Surgery Titan Medical

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