I think the list of approved, or at least common procedures for the FireFly equipped daVinci is still pretty small. It still hasn't been available for that long. If I'm not mistaken, approval was initially only for kidney surgery. FireFly can provide value for prostatectomy but I suspect that it's use for DvP is still fairly rare. As I understand it, DaVinci FireFly is not yet approved for nerve visualization during DvP, only perfusion. Ditto for tumor visualization in kidney surgery. We are getting these numbers with one hand tied behind out backs so to speak
ISRG's colorectal, lung and many other procedures that would benefit most from FireFly are still relatively new and/or low volume. The burst/focus on General Surgery is still pretty new. Although there have been General Surgery procedures for a long time, it has only recently become an area of focus. Once ISRG gets their stapler out General Surgery will get even more attention.
I think 50% is pretty good for this stage of the game although as I have written in the past it seemed at one point that they may eventually make FireFly capability more or less standard. Even then it would have taken a while for the FireFly capability to gain traction. It will be interesting to what Arun has to say about consumables / utilization.
I was on vacation last week and have only skimmed the ISRG CC Transcript so far. My initial impression is that FireFly is right on track. I think it will prove to have been a great deal for both companies.
Given that it has only been an option for the daVinci system for a little over a year now, I think that is a pretty good percentage. Also, given that Spy has focused on plastic reconstruction, obviously not done with daVinci, and that SpyScope has not yet been launched in an arena (colorectal) where daVinci might be used, my sense is the awareness of the surgeons using daVinci hasn't kicked in, yet. As the indications that daVinic is used for expands and the reputation of Firefly/Spy expands, I assume the rate of Firefly being included in system sales will expand. Also, I assume that the hospitals can also purchase Firefly later - it doesn't have to be part of the original system purchase.
I think that NVDQ is counting on ISRG to drive adoption in colorectal rather than the other way around. Colorectal is still an early (low volume) procedure for ISRG, albeit a rapidly growing one. As I undestand it, FireFly is used in only a fraction of those cases. I think in the not too distant future colorectal will be a strong contributor for ISRG and that FireFLY will be used on virtually every colorectal procedure.