Clinical Challenges in Minimally Invasive Surgery: Emerging Robotics and Adapting Laparoscopy – An Interview with Dr. Jim Porter
Behind The Knife: The Surgery Podcast
Behind The Knife: The Surgery Podcast
4.8 • 1.4K Ratings
🗓️ 19 February 2026
⏱️ 36 minutes
🧾️ Download transcript
Summary
Robotic surgery has moved from novelty to norm, and in this episode of Behind the Knife, Drs. James Jung and Joey Lew sit down with urologic pioneer and Medtronic CMO Dr. Jim Porter to dissect how we got here, what the data really say about “the death of laparoscopy,” and where competing robotic platforms like Hugo may take the field next. From ergonomics and education to economics and global access, they tackle both the hype and the hard questions around robotics as the future of minimally invasive surgery.
Hosts:
· James Jung, MD, PhD, Assistant Professor of Surgery, Duke University
· Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actually
Learning Goals:
By the end of this episode, listeners will be able to:
· Describe key clinical, ergonomic, and educational drivers behind the rapid adoption of robotic surgery in the United States and globally.
· Summarize current evidence comparing robotic and laparoscopic approaches for common procedures, including where outcomes are equivalent, inferior, or clearly superior.
· Explain how surgeon ergonomics, trainee experience, and video-based learning influence practice patterns and learning curves in minimally invasive surgery.
· Discuss the role of cost, reimbursement structures, and market competition (e.g., Medtronic Hugo vs da Vinci) in shaping robotic adoption across different health systems.
· Anticipate how next-generation, task- or organ-specific robotic platforms may further change standards of care in minimally invasive surgery.
References:
· Violante T, Ferrari D, Novelli M, Larson DW. The Death of Laparoscopy - Volume 2: A Revised Prognosis. A retrospective study. Ann Surg. 2025 Jun 16. doi: 10.1097/SLA.0000000000006792. Epub ahead of print. PMID: 40518997. https://pubmed.ncbi.nlm.nih.gov/40518997/
· Yu Yoshida, Yoshiro Itatani, Takehito Yamamoto, Ryosuke Okamura, Koya Hida, Kazutaka Obama, Single-incision plus one robot-assisted surgery (SIPORS) using the Hugo robotic-assisted surgery (RAS) system for rectal cancer, Annals of Coloproctology, 10.3393/ac.2025.00787.0112, 41, 6, (586-591), (2025). https://pubmed.ncbi.nlm.nih.gov/41486916/
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Transcript
Click on a timestamp to play from that location
| 0:00.0 | Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you dominate the day. Before we start to show, this episode is going to feature an interview with a prominent leader at an industry partner at Medtronics. |
| 0:29.3 | Because of that, we would like to disclose our conflict of interest of the start of the episode for this discussion. |
| 0:36.3 | Dr. Porter is a chief medical officer at Medtronic, |
| 0:39.4 | and I am an consultant for intuitive surgery. Hi everyone, and welcome back to another episode |
| 0:46.2 | of Behind the Knife. I'm James Jung, a minimally invasive surgeon at Duke University, |
| 0:51.3 | and I'm joined today by Joey Lev, one of our research residents at Duke |
| 0:55.8 | University. So when we talk about minimal invasive surgery today, the landscape of things, |
| 1:01.5 | we're not talking about just the future that's coming. We're talking about a shift that's already |
| 1:06.1 | here. The robotics platform has moved from a nice to have to a dominant force across many procedures and hospitals. |
| 1:14.1 | We're really at an inflection point with robotic platform. |
| 1:17.3 | And to help us unpack what's driving that change and what's coming next, |
| 1:21.6 | we're thrilled to be joined by Dr. Jim Porter, Chief Medical Officer of Robotics and Digital Technologies at Metronic and a pioneering |
| 1:30.8 | minimally invasive eurology surgeon. |
| 1:33.3 | So, Jim, welcome to the show. |
| 1:35.1 | Thank you, James. |
| 1:35.9 | Really, pleasure to be here. |
| 1:37.9 | Okay, so before we get to the meet of the conversation with Dr. Porter, foreground our |
| 1:42.4 | discussion, Joey. |
| 1:43.5 | What don't you talk a bit |
| 1:44.6 | about the paper for discussion today, which is entitled The Death of Laperoscopy? |
| 1:51.7 | Absolutely. This is a retrospective observational study using ACS-NISQIP data from 2012 to |
| 1:57.0 | 2023 to look at utilization of laparoscopic versus robotic technique for a variety of operations. |
... |
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