Robotic surgery in India has quietly moved from a rare, premium offering available at a handful of metro hospitals to a capability spreading into Tier-2 cities at a pace that would have seemed unlikely five years ago. Two forces are driving the acceleration at once: a global wave of new soft-tissue robotic platforms challenging a two-decade-old monopoly, and an Indian-built system priced to make robotic programmes viable for hospitals that could never have justified an imported system’s capital cost.
The Global Backdrop: A Monopoly Breaks
For roughly two decades, Intuitive Surgical’s da Vinci system has effectively defined soft-tissue robotic surgery worldwide, with limited credible competition in general surgery specifically. That changed on July 22, 2026, when Johnson & Johnson’s Ottava system received FDA de novo authorisation for ten general surgery procedures, establishing a new device class and formally ending da Vinci’s uncontested run in soft-tissue robotics. Ottava’s engineering pitch centres on a smaller operating-room footprint — 30 to 50% less than traditional cart-mounted systems — plus a “twin-motion” feature that synchronises table and arm movement, reducing the manual repositioning surgical teams need during complex, multi-quadrant procedures.
Medtronic’s Hugo system has been moving in parallel: it received FDA clearance for urologic procedures in December 2025, with the first US commercial surgery performed at Cleveland Clinic in February 2026, and Medtronic filed further submissions in June 2026 to extend Hugo into general and gynaecologic surgery. Hugo has already been used in tens of thousands of procedures globally.
This matters for India for a straightforward reason: as global platform competition intensifies and prices come under pressure internationally, Indian hospitals evaluating capital investment decisions are weighing a wider set of options than “da Vinci or nothing” for the first time in years.
The India-Specific Story: SSI Mantra’s Spread
The more consequential story for Indian hospitals, though, is domestic. Over 170 da Vinci systems are now installed across Indian hospitals — but the faster-growing figure is the homegrown SSI Mantra, developed by SS Innovations, which has now been deployed in over 160 centres across the country. Critically, Mantra’s spread isn’t confined to metro flagship hospitals; installations now reach Tier-2 cities including Indore, Kochi, and Coimbatore, extending robotic surgical capability to hospital networks that previously had no realistic path to offering it.
The reason is straightforward: Mantra costs roughly one-third to one-half of an imported da Vinci system, which fundamentally changes the capital-planning calculation for mid-sized hospital networks. That price gap doesn’t automatically mean parity in track record — but it does mean the technology is being clinically tested at meaningful scale. A multi-centre study spanning 3,694 consecutive cases across 78 Indian centres between 2023 and 2025 validated Mantra’s use across more than 100 distinct procedure types in urology, gynaecology, oncology, and cardiac surgery.
Nationally, the surgeon-training base has grown alongside the hardware: India now has more than 850 robotic-surgery-trained surgeons, supported by dedicated training programmes at Apollo, Medanta, Fortis, and AIIMS Delhi — including a publicly funded robotic surgery training programme at AIIMS Delhi, which matters for expanding the surgeon pipeline beyond private-hospital networks alone.
The Company Behind the Numbers
SS Innovations’ own growth trajectory gives a useful read on demand momentum. The company installed 30 new SSi Mantra systems in the second quarter of 2026 alone, up from 23 in the same quarter a year earlier, taking its cumulative installed base to 224 systems across 12 countries by the end of June 2026. Second-quarter revenue rose 39.4% year-on-year to $13.9 million, with first-half 2026 revenue reaching $25 million, up 65.6% year-on-year. Cumulative procedures performed on the platform passed 12,272, including 637 cardiac operations, 222 pediatric procedures, and 175 telesurgeries.
That last figure is worth pausing on. SS Innovations’ newest system, the SSi Mantra 3, received CDSCO approval specifically for remote surgery and teleproctoring — a regulatory clearance that opens the door to genuine telesurgery and remote surgical education, not just robotic assistance inside a single operating room. It’s a capability with particular relevance for a country where specialist surgical expertise remains concentrated in a relatively small number of cities. The company’s international expansion illustrates the same pattern at smaller scale — its installation at B&B Hospital in Kathmandu marked Nepal’s first surgical robotic system of any kind.
What Apollo’s Numbers Suggest About Adoption Depth
Milestone counts from individual hospital systems help illustrate how deep robotic adoption has actually gone, beyond installation counts alone. Apollo Hospitals in Chennai crossed 8,000 robotic surgeries in early 2026 — a volume that reflects a hospital system where robotic surgery has become routine clinical practice for a meaningful share of eligible procedures, not an occasional showcase capability reserved for select cases.
What This Means for Patients and Hospital Administrators
For hospital administrators evaluating a robotic surgery programme in 2026, the practical calculus has genuinely shifted. The choice is no longer binary between an expensive imported system and no robotic capability at all — a domestically built, CDSCO-cleared, multi-centre-validated system exists at meaningfully lower capital cost, backed by a training ecosystem that has scaled alongside it. For patients, the expansion into Tier-2 cities means robotic surgical options — generally associated with smaller incisions, reduced blood loss, and faster recovery for eligible procedures — are becoming available closer to home rather than requiring travel to a handful of metro centres.
For device makers and investors watching the space, the more interesting long-term question is whether India’s dual-track model — global platforms like da Vinci, Ottava, and Hugo competing at the premium end alongside an indigenous, cost-optimised alternative scaling into the mid-market — becomes a template other price-sensitive healthcare markets look to replicate.
What to Watch Through 2026–27
Worth tracking over the coming year: whether SS Innovations secures the US FDA and EU CE Mark clearances it has been pursuing, which would materially change its addressable market beyond India and the handful of countries where it currently operates; how quickly Ottava and Hugo enter the Indian market, if at all, and at what price point relative to da Vinci; whether Tier-3 city and district-hospital adoption follows the Tier-2 pattern already underway; and how telesurgery specifically evolves now that regulatory clearance exists — because remote surgical capability, more than incremental cost reduction, may end up being the more structurally significant shift for a country with India’s specialist-distribution challenges.
References
- The Robot Report, “SS Innovations reaches 4,000 robotic surgeries with SSi Mantra robotic system,” May 2025
- Surgical Robotics Technology, “SS Innovations Reaches Milestone of 100 Installations of the SSi Mantra Surgical Robotic System,” July 2025
- MedicalVault, “Robotic Surgery in India: Da Vinci, Mantra & Cost Guide,” April 2026
- Tech Times, “J&J Ottava FDA Clearance Breaks da Vinci’s Two-Decade Soft-Tissue Monopoly,” July 2026
- MissionIR, “SS Innovations International Inc. (NASDAQ: SSII) Is Turning India’s Surgical Robotics Opportunity Into a Global Growth Story,” September 2026
- Seeking Alpha / GlobeNewswire, “SSi Mantra Expands Global Footprint: Nepal’s First Surgical Robot,” 2024