Can Medtronic Finally Challenge Intuitive Surgical's Robotic Surgical Systems Dominance?

Medtronic (NYSE: MDT) is one of the world's largest medical technology companies, but it spent years on the outside looking in at the robotic-assisted surgery market. That officially changed in December 2025, when the U.S. Food and Drug Administration (FDA) approved its Hugo robotic-assisted surgery platform for urologic procedures.

A couple of months later, doctors at the Cleveland Clinic successfully used it for the first time. The FDA's approval indicates use for prostatectomy, nephrectomy, and cystectomy procedures. Hospitals perform approximately 230,000 of these annually in the United States.

Image source: Getty Images.

The approval was a shot across the bow at Intuitive Surgical, which pioneered the industry with its da Vinci system and now dominates the market. Now the real work begins, as Medtronic fights for its share of a market that researchers estimate could grow from $13.8 billion last year to $63.7 billion by 2035.

Can Medtronic finally establish itself as a successful challenger and unlock the potential of this fast-growing market? Here's why it could have an uphill battle -- and why that's not as bad as it sounds.

Intuitive Surgical's head start truly matters

Medtronic's FDA approval for Hugo comes roughly 26 years after Intuitive Surgical got its first approval for the da Vinci system, its flagship robotic-assisted surgery platform.

Intuitive Surgical was one of the only games in town for many years, allowing the company to amass a massive user base. Today there are 11,395 da Vinci systems installed in hospitals worldwide, and they have performed millions of procedures. Hospitals spend up front on the system, then invest money for years in supplies, parts, and maintenance. Each hospital's staff also requires extensive training to use the platform. Those monetary costs and the learning curve make switching difficult.

As Intuitive Surgical installs more systems, it further cements its position as the market leader. Medtronic's Hugo is still only approved for urologic procedures, while the da Vinci system performs urologic, gynecologic, and general surgery procedures. While Medtronic just applied to expand Hugo to gynecologic and general surgeries in the U.S., that happened only days ago.

Medtronic may struggle to sell Hugo against the da Vinci system until it has the approvals to perform all the procedures that the da Vinci can. Intuitive Surgical continues to place systems, including 431 in the first quarter of 2026 alone. The gap in installed bases is widening, and Medtronic probably won't change that in the foreseeable future.

Why there's hope for Medtronic yet

Medtronic can still enjoy tremendous success with Hugo, even if it's not a market leader.

Hugo is only getting started in the United States, but the system is already available in more than 35 countries. Hospitals worldwide have performed tens of thousands of procedures with Hugo to date, and Medtronic CEO Geoff Martha disclosed on the company's recent earnings call (for the fourth quarter of its fiscal 2026, which ended April 24) that procedure volumes are growing two to three times as fast as the market. It's fast growth on small numbers, but it is promising.

Those numbers could grow for years to come. Robotic-assisted procedures account for just 5% of the world's surgeries at this point, so there's still a lot of the eventual market up for grabs. Medtronic probably won't overtake Intuitive Surgical, but it can grow alongside it.

Remember, Medtronic is a diversified healthcare giant with sprawling product portfolios across its cardiovascular, neuroscience, and medical-surgical segments. It's hardly an underdog, and still much larger than Intuitive Surgical. Analysts estimate that Medtronic will generate $38.8 billion in total revenue this fiscal year, more than triple Intuitive Surgical's $11.7 billion in revenue.

No, Medtronic may not challenge Intuitive Surgical's dominance in surgical robotics, but it doesn't need to. Simply having a presence and growing alongside the robotics-assisted surgery market can be a win for one of the world's top healthcare stocks.

Justin Pope has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends Intuitive Surgical and Medtronic. The Motley Fool recommends the following options: long January 2028 $520 calls on Intuitive Surgical and short January 2028 $530 calls on Intuitive Surgical. The Motley Fool has a disclosure policy.