Medtronic bets big on benefits of robots in operating room

Medtronic is hoping to boost its presence in the growing spinal-surgery market with the $1.6 billion acquisition of a robotics company whose system it already distributes worldwide.

Its acquisition of Mazor Robotics and its Mazor X robotic guidance system fits well with Medtronic's much-touted "value-based" health care initiatives. Although buying one of Mazor's advanced surgical planning and guidance systems may cost six figures upfront, the expense should be recouped over time as procedures become more precise, resulting in fewer post-surgical problems and long-term costs.

The deal announcement, published Thursday night, describes Mazor's Mazor X and Renaissance surgical systems as transforming spinal surgery "from freehand procedures to accurate, state-of-the-art, guided procedures."

Proponents say the systems can improve the speed and accuracy of surgical procedures, reducing margins for error and making spinal surgery outcomes more reproducible.

The system creates a three-dimensional surgical blueprint customized to each patient's anatomy based on medical imaging, and then uses a robotic arm to position tools and implants in the right locations and trajectories over a patient's spine.

Medtronic and Mazor first announced a limited partnership in 2016 that was intended to escalate over time, as the two companies collaborated on ways to integrate Medtronic spinal products into Mazor's robotic guidance platform. In August 2017, Medtronic became the exclusive worldwide distributor of the Mazor X system, with more than 80 of the systems successfully installed since launch.

The global market for spinal surgery products is expected to grow at nearly 6 percent per year, reaching $16.7 billion in sales by 2025, driven by increases in spine disorders among older adults, according to market researchers.

On Thursday, Medtronic announced that it "aims to accelerate the advancement and adoption of RAS [robotic-assisted surgery] in spine to the benefit of patients, providers, and the health care system more broadly."

Medtronic CEO Omar Ishrak has told investors that the deal to combine Medtronic's "high value" single-use surgical components with Mazor's durable capital equipment will be a winning combination in the long run.

"The integration of capital equipment — in this case, the robot with implants and our sort of high value consumables — is a unique competence that we are delivering. And it's something that would set us apart and use our scale to really create these markets in a new and differentiated way that will set us completely apart from competition," Ishrak told investors during Medtronic's earnings call last month.

The acquisition of Mazor is expected to close by the end of January. Medtronic has agreed to acquire all outstanding shares in Israel-based Mazor in the all-cash deal. Factoring in Medtronic's existing ownership interest in Mazor and the cash acquired through product sales, the acquisition has a net value of $1.3 billion.

Medtronic said it doesn't have plans to disrupt the Mazor team through the deal: "We intend to further cultivate Mazor's legacy of innovation in surgical robotics with the site and team in Israel as a base for future growth," Medtronic restorative therapies President Geoff Martha said in the announcement.

Ori Hadomi, CEO of Mazor Robotics, said in the announcement that integrating the surgical systems and team with Medtronic would "maximize our impact globally through Medtronic's channels, advance our systems' leadership position in the marketplace, and drive the realization of our vision to heal through innovation."

Bloomberg reported that Hadomi was questioned last year by the Israel Securities Authority in connection with an investigation into possible insider trading based on the company's relationship with Medtronic. Although that investigation is still underway, Martha told Bloomberg that it is unrelated to Medtronic's offer.

The deal to acquire Mazor will "modestly" dilute Medtronic's adjusted earnings per share, "but given the current strength of Medtronic's business, the company expects to absorb the dilution," the announcement says. Medtronic projects that the deal will generate a double-digit return on invested capital by the fourth year, and increase thereafter.

Medtronic stock closed up less than a percent Friday, at $97.85, while shares in Mazor shot up more than 10 percent to $58.15.

Joe Carlson • 612-673-4779