The Medrobotics Flex demonstrated that flexible transoral access was clinically feasible. But clinical feasibility did not translate into a sustainable business. Medrobotics was liquidated in January 2022.
The question is whether EndoQuest has solved the technological limitations of Flex without inheriting its commercial limitations. Is there a market? I think this is the most interesting strategic question.
The Flex had a relatively restricted market: principally transoral surgery, with some additional transorifical applications. It was difficult to justify purchasing a dedicated robotic platform for a relatively limited number of procedures. EndoQuest has a potentially different proposition: colorectal ESD, upper GI endoluminal surgery, bariatric procedures, other natural-orifice surgery transanal and transvaginal), and potential for standard transoral surgery (TORS).
However, the clinical evidence is still early. Its PARADIGM trial is focused on colorectal ESD, and the two transoral gastric reconstruction procedures reported on today represent its first clinical experience in the upper GI tract. However, there is something particularly interesting here. Most of the newer robotic platforms entering the market are designed primarily for soft-tissue surgery through abdominal or thoracic ports. Even when they offer single-port configurations, they are not necessarily designed for transoral surgery. EndoQuest is different because its architecture is inherently compatible with natural-orifice access.
The system does not currently have FDA clearance for TORS, and these procedures have not been established as clinical applications, but importantly, its manufacturer explicitly lists tonsillectomy, pharyngectomy and laryngectomy among potential transoral applications. This is new.
J Granell. Nov 5, 2026