The tremendous success of Intuitive Surgical over the past two decades seems clearly to argue that robotics is more than a techy's pipedream. Intuitive has already revolutionized at least one procedure - laparoscopic prostatectomy - and it figures to make significant progress in a range of others, in men's health, women's health, and cardiovascular surgery, to name just a few relevant clinical spaces. Even more impressive has been its success as a publicly traded company; for much of the middle years of this decade, Intuitive's stock was the strongest performer among all medical device public offerings. And perhaps most interesting: until recently, Intuitive was virtually the only robotics company to achieve any kind of success at all. In Vivo interviews Lonnie Smith, the CEO of the company for much of the 1990s and 2000s, to whom much of the credit should go.

The debate surrounding the future of minimally invasive surgery -- whether single-incision laparoscopy will prevail, or whether it is merely a stepping stone to a world of incisionless NOTES procedures - is not really relevant to Virtual Incision, a start-up developing mini surgical robots. The company's founders believe that in vivo robots will free a surgeon of any constraints due to the method of entering the body.

The skill sets of laparoscopy, endoscopy, robotics and even interventional cardiology are all converging to create least invasive surgeries that take laparoscopy as a point of departure but change how surgeons access the abdominal cavity. Start-ups are innovating to supply the new surgical instruments.