China Comes for da Vinci

For two decades, one machine defined robotic surgery: Intuitive Surgical’s da Vinci. When China’s Toumai launched in 2022, its own maker acknowledged there was still “only one widely commercialised laparoscopic surgical robot available for use worldwide.”^[1]

Intuitive’s dominance is real and profitable. Its installed base reached 10,189 da Vinci systems by March 2025, a single da Vinci 5 costs between $1.8 million and $2.5 million, and disposable instruments make up roughly 85% of the company’s revenue, a razor-and-blades model with a two-decade head start.^[2][3]

A Chinese robot, not da Vinci, performed the world’s first FDA-authorised intercontinental surgery, 17,000 km from console to patient.

The challenger from Shanghai

MicroPort MedBot’s Toumai won Chinese approval in January 2022 as the first home-developed four-arm laparoscopic surgical robot, explicitly positioned to cut the cost of robotic surgery.^[1] It has since passed 130 global orders and 10,000 procedures and secured clearance in more than 30 countries.^[4] Its differentiator is remote surgery: in April 2025 it enabled Europe’s first robot-assisted telesurgery, and on 14 June 2025 a surgeon in Orlando performed a prostatectomy on a patient in Angola, the world’s first FDA-IDE-approved intercontinental telesurgery, across a 17,000-kilometre link.^[4][5]

The strategic wedge is not to beat da Vinci on its own turf but to redraw the map. Price opens emerging markets that a $2-million system was never going to reach, seeding an installed base and a stream of disposable-instrument revenue on the same razor-and-blades logic that made the incumbent so profitable. Telesurgery adds a second axis entirely: if a specialist in one city can operate on a patient a continent away, the scarce asset becomes network access, not proximity, a proposition with obvious appeal to under-served health systems. Neither displaces the incumbent in the West; together they establish a credible second pole.

How this reaches a portfolio

Surgical robotics is a textbook high-moat market, regulatory, clinical and installed-base barriers protect the incumbent, which is exactly why a credible challenger matters. China’s angle is twofold: price, which opens emerging markets da Vinci never priced for, and telesurgery, which turns a scarce specialist into a networked one. The thesis is not that Toumai displaces da Vinci in the West, but that it establishes a second pole in a market that had one. We track approvals, procedure volumes and the emerging-market installed base.