Hello everyone, and a warm welcome to Surgical Science's Capital Markets Day 2025. My name is Anna Ahlberg, and I am CFO for Surgical Science. We have a hybrid event here today, meaning that we have both participants on site as well as people listening in digitally. A warm welcome to you as well. The event will also be filmed and put on our website after we have finished here today. It is almost three years ago that we had our first Capital Markets Day in Surgical Science, February 22nd, 2023, and we look forward a lot to be able to present the company and our plans in more depth to you here today. As we have communicated, we have for some time worked on a new strategy for the company and in order to capture all the possibilities that we see on the market.
The strategy is also being reflected in new financial targets for the company, which we announced in a press release earlier this morning. Our agenda today looks as follows. First, we have a shorter chapter that we call Surgical Science Today: Who we are, our purpose and mission, and position today, and after that, we will go into our new strategy, our new strategic plan. Here we will talk about the market, size and growth, and our place on it. We will also talk about our five key market segments. We will do a deep dive into each one of them, look at priorities per segment, and also talk about profitability per segment and see what we can do in order to improve that. We will also touch upon acquisitions in this section.
The strategy is reflected in our ambitions as well as our new financial goals, which we as mentioned sent out as a press release this morning and that we will get back to you during this session. We plan to have a break at 3:15 P.M. for 15 minutes. And after this, we have a chapter that we call Expanding the Market, where we will go more into our sales strategy. After expanding the market, we will have some concluding remarks and then a question and answer session. So we ask you to please wait with any questions until then. And during the question and answer session, we will of course take questions both from the audience present here today as well as from you who are listening in.
We who are here from the management team today are our CEO, Tom Englund, our Chief Revenue Officer responsible for sales and services, Niclas Olsson, and myself. And we also have our Chairman and previous CEO, Gisli Hennermark, in the audience, as well as our Board member and previous Chairman, Roland Bengtsson. Once again, warm welcome. We hope you will find the day interesting and rewarding. And with that, I would like to hand over to our CEO, Tom Englund.
Thank you, Anna. Hi everyone. My name is Tom Englund. I'm very happy to host this first Capital Markets Day for me, both since it was a while since we had our last Capital Markets Day about three years ago, but also because we have just concluded the work with our new strategy and also presented our financial goals. It's an opportune moment for us, of course, to tell this story and speak more about what we plan ahead. Before I start with our first session, Surgical Science Today, I want to comment on the news that we sent out on November 25th regarding Intuitive canceling the Memorandum of Understanding regarding simulation from Surgical Science on their dV5 robots.
The news meant that simulation software from Surgical Science would only be optional and shipped to a select customer set of the dV5 customers, the most important customers that they have, the Intuitive have for dV5, and this recent development is of course disappointing, both because we have announced a Memorandum of Understanding earlier, but of course also that it sows doubts about our customer relationship with Intuitive. At the same time, simulation for robotic surgery, as you will see here in a second, is more strategic than ever, and we work closer than ever with Intuitive than before on the roadmap ahead, and we intend to cover this entire strategic development in the robotics section of the presentation here further on and what plans we have going forward for the segment.
But before we get there, I want to start with a bit of background into Surgical Science today and our business today. At Surgical Science, we have a very important purpose, our why that unites us and engages us tremendously. This purpose is new for us with the revised strategy and has been altered from our previous mission statement, with the main change that we have expanded the market to encompass all healthcare professionals. Our purpose is to unlock the full potential of every medical professional to improve healthcare outcomes and save patients' lives. We believe that our business and target customers encompass all healthcare professionals globally. This is a customer group that ranges in the millions of professionals where we only have scratched the surface and served a couple of thousands of them today.
The impact of our products and services are better healthcare outcomes for patients, ultimately saving patients' lives. This is an important purpose that the entire Surgical Science team stands behind, rallies behind, and is engaged by. Our vision, we believe in a world where medical professionals should train, but also get certified in a simulated environment. We believe that this industry should focus and function in the same way as the aviation industry, where pilots receive their certification in a simulator and where they also need to be recertified every year according to certain procedures and assessment criteria. Today, we are quite far away from this vision, but we feel an accelerated development towards it, and our activities in the strategy, as you will see, aim to take us further towards this future.
The value proposition for simulation is very strong and is growing due to the trends in the healthcare market. With simulation, healthcare professionals can train in a safe and repeatable way to achieve the necessary skills before engaging in clinical procedures. Simulation exercises can be changed in difficulty, and different patient parameters can be adjusted to allow for a variety of scenarios for the surgeon. These exercises can also be based on the proficiency of the surgeons and create a so-called proficiency-based learning journey. Simulation also allows for standardized and quantifiable results, removing subjective assessments that historically were used and the need for proctors or human supervisors. With the introduction of more and more digital tools and advanced instrumentation, simulation also becomes a powerful technology to train in the safe operation and enablement of these tools inside or outside of the body.
And finally, simulation is a scalable and sustainable technology as opposed to the often used wet lab infrastructure where animals or even cadavers today are used. There is a clear movement away from these types of training environments, and they are more and more being questioned. Simulation is the sustainable alternative. Several studies have also shown the superiority of simulation when it comes to shortening training times versus traditional techniques, as well as improving the procedural quality of surgeons. At our website, you can look at 400 different validation studies providing evidence of the validity and reliability of our simulation technology, which has helped pave the way for revolutionizing surgical education and training. The evidence is overwhelming. Simulation is a very powerful technology to teach psychomotor skills, to increase the quality of surgical procedures, and to make surgeons and healthcare professionals more efficient.
There is a range of different training tools for medical education today, spanning from the more simple and traditional tools, such as basic learning and training tools, to more advanced ones, such as high-fidelity simulation. High-fidelity simulation, which is the area that Surgical Science focuses on, strikes the right balance between introductory and advanced motoric training with a high level of realism and flexibility in the scenarios provided. Since it is a simulation, you can get repetitive training to build muscle memory to ensure that you attain the proper proficiency and procedural skills before operating clinically in the patient. Often, these tools and technologies are also used in combination, where students can start out with the basic learning tools before moving on to, for example, simulation.
As you can see to the right, cadaveric and animal training is still in use today, but as I said, is more and more being replaced by more sustainable methods, such as high-fidelity simulation. Apart from the obvious ethical concerns with this type of training, the cost for training is also very high and requires dedicated facilities, such as this wet lab infrastructure. Surgical Science today is the clear world leader in high-fidelity surgical simulation with a very talented team of around 320 people. Our installed base of around 10,000 simulators is bigger than any other company in our market, but at the same time, as you will see, it only represents a small fraction of the potential in the market. We have a broad and strong distributor network, which will increasingly become an asset for us as the company grows and as we pan out into more business segments.
One news since our last quarterly report is that we have consolidated our U.S. operations into our Cleveland office, where we will create a so-called customer center. The aim is to provide an even better support for our U.S. customers from Cleveland, and therefore, as a consequence, we have decided to close our Seattle operations. However, our customer-facing capacity in the West Coast of the U.S. remains unchanged and will improve over time. During the last years, Surgical Science has grown both organically and through acquisitions. The acquisitions of SenseGraphics, Mimic, and Simbionix have all been very successful, and with them, the company has been able to add revenue, products, and customer relations in a very synergistic fashion. The most recent acquisition that we did, Intelligent Ultrasound, in January of this year, it was made on very favorable terms for Surgical Science.
However, it has weighed on the result for the company during this year and is an important reason for the lower profitability this year. However, we are very satisfied with the acquired assets of Intelligent Ultrasound, primarily within the product portfolio, which opens up new markets for us within ultrasound simulation. We have worked internally a lot with capturing our unique competitive advantages, how we create customer value, and the reasons why our customers today choose to work with us. These insights are described in what we call the Surgical Science Advantage. Customers today choose Surgical Science for a high innovation pace and world-leading products. These products provide unmatched value for our customers, and our customers stay with us in part due to the continuous high innovation pace and value delivery of our team.
We have an ambition to provide amazing customer experiences with a high degree of authenticity and clinical accuracy, and we want to make our customers advocates for us and medical simulation. The fact that we have a broad product portfolio and large global support structure means that we can become a turnkey partner for our customers as well for simulation infrastructure and operations. With services such as simulator fleet management solutions, we can ensure uptime and correct deployment of simulators across simulator assets across the world for our customers, and the combination of these strengths will become even more important in a market where we will address a broader customer category and not only to the early adopters.
The four strengths in combination is also what is necessary to enable our customers to move from operating single unit simulators to the deployment of larger fleets of simulators internally, and therefore the market then to increase further in size. One of our biggest prides internally is that we have some of the world's most prominent research institutions and hospitals, as well as med device companies and robotic surgery companies as our customers. Our company was founded more than 25 years ago, and many of these companies have been with us for many, many years. This means that we have a high ratio of returning customers, which is really, really great. And many of these customers, especially in the med device space, are also very big, meaning that there is a future opportunity for continued growth for each customer.
Having a customer roster like this also acts as a powerful reference as we progressively go deeper and deeper into the market. We would like to conclude this chapter with a video highlighting one of our customers, Andrew Eyre, Medical Director at the STRATUS Center for Medical Simulation in Massachusetts, United States, as he explains the value of simulation and the Surgical Science Advantage.
The STRATUS Center for Medical Simulation is the simulation center for Brigham and Women's Hospital in Boston, Massachusetts. We focus on a whole wide variety of skills and courses. We do a lot of non-technical skills. We work a lot with high-fidelity mannequins, but we also do a lot of procedural training, especially with our surgical colleagues. The landscape of medical education has really changed over recent decades.
It used to be acceptable to kind of learn on the patients, but in order to do it safely, there are better ways to train and learn than we had many decades ago. Simulation has become a critical part of that training algorithm. It lets people practice and train and learn from mistakes in ways that don't hurt patients, but also don't cause damage to themselves as providers. We used to kind of expect and accept that some errors and some mistakes would happen. That's really not acceptable anymore. And simulation has made it possible for us to bring people up to a level of competence. And so using simulation, people can learn exactly what the techniques are, learn exactly how to approach a procedure. And so it's really made the patient safety movement jump light years ahead. Our center is one of the older centers in the United States.
We've been doing simulation for about 20 years, and we really pride ourselves on finding the right tool and the right technologies for what we're trying to do, and while there are lots of companies out there, Surgical Science has proven itself to be really at the forefront. The technologies are user-friendly. They have a wide variety of products that really fit the types of skills and content that we're trying to teach, but also, the service has been phenomenal. When we have issues that come up, if we have questions or concerns, or if we're looking to change our simulators, that team has really been there and shown that their support has been there for a very long time and has built a real relationship with our center and staff.
This concludes our first chapter, Surgical Science Today.
We will now move into our next chapter, Strategic Direction and Value Creation. In the Strategic Direction chapter, we will explain our financial goals, our view on the high-level market, and also our targeted segment and strategic high-level goals. And then in the Value Creation section, we will go deeper in each of the targeted segments, which in some ways can be seen as businesses within the business, and explain our goals and priorities for each of these segments. As you have seen from this morning's press release, we have issued new financial targets for Surgical Science. Revenue growth shall amount to 10%-15% annually, with an Adjusted EBIT of at least 15%. We estimate that these targets will be met in 2027.
As a consequence of the previously communicated news about the company's customer Intuitive, profitability and some sales growth is expected for 2026, although not in line with the targets. Furthermore, we intend to grow deeper in our already existing market segments, which are minimally invasive surgical simulation, medical device simulation, and surgical robotics simulation, and then on top, we have an ambition to scale ultrasound simulation into a business which is significantly bigger than today, and we also have an ambition to grow our smallest segment, emergency medical simulation, from inception stage into a real business. The goal of this new strategy is to create an even more stable foundation for the company with five distinct business segments and exposure to a significantly larger total market than before.
We will leave these goals for now and add significantly more detail and plans, and then come back to the financial goals in the end of the presentation. Speaking about the market, Surgical Science operates in the healthcare education market. This is a huge market, which represents everything from various programs within university education, different educational platform companies, platform technologies, educational technologies, learning management systems, healthcare training by pharma companies, et cetera, et cetera, et cetera. Medical simulation, the red sliver there, is a subset of the educational technologies and content segment, which is the beige color. Our internal estimates, supported by various market reports, show medical simulation to be a very, very small part of this very large market, approximately 2%. This is an illustrative picture to show that medical simulation still is a very small part of the total healthcare Ed market.
The healthcare education market is set to grow at a fast pace in the coming years, driven by a few mega trends, such as aging populations, increasing complexity of care, and workforce pressure. And medical simulation then is a very suitable technology and tool to address the consequences of these trends. If we then dive deeper into the global medical simulation market, where Surgical Science operates, we estimate this market to be around SEK 25 billion size. This market comprises of mannequin-based simulation or patient simulators, screen and web-based simulations, where you learn through a computer app or interface, physical or task trainers or so-called anatomical models, and finally, immersive and device-integrated simulation, which is what we do. We assess that the market addressable to Surgical Science and our products and services is around SEK 9 billion.
Here, there is an opportunity for us both to take market share in already existing segments, so the red part in the left bar, where we sell products today, but we can also grow into other product categories, which are the other colors than the red in the graph. As you know, Surgical Science has two overarching business areas: Educational Products, catering to training in hospitals, simulator centers, and universities, and Industry OEM, where we cater primarily to medical device and surgical robotics companies. We assess that Educational Products constitute the larger part of the addressable market today. Industry OEM constitutes a fifth to a third of the market, but with a much faster growth than the educational market. And then also, as an asterisk here, I would like to say that it can be quite deceiving with market assumptions in a fairly small market with low penetration.
In a sense, the market is created by the main players, and market sizes and growth rates will be very dependent on the market success of the individual companies and their initiatives. We will now move away from our market estimates and instead focus on the strategic direction of the company. We have taken a decision to actively target five distinct market segments in our new strategy. As you know, we have historically reported on the split Educational Products and Industry OEM in our financial reporting. We believe that this traditional split, though, is too broad and somewhat a too general view of our target segments, and we have therefore broken down the market further into five prioritized segments. Minimally invasive surgery simulation is our biggest segment today, representing around 30%-35% of our sales.
The ultrasound simulation segment has become large due to the acquisition of Intelligent Ultrasound and now represents 15%-20% of our sales. The customer base is somewhat similar to that in minimally invasive surgery simulation, but we are also addressing much larger customer subsegments here with different product categories. Emergency medical simulation is our smallest segment, very much in incubation mode. In this segment, we address customers in the emergency first responder and defense areas. And the large order that we announced earlier this year for a government agency in a Southeast Asian country belonged in this segment. Surgical robotics simulation is our second largest segment. Here we act as a supplier and OEM partner to the robotics companies, and our solutions provide safe and efficient onboarding and proficiency development of the surgeons on the robotic platforms of our customers.
And finally, we have an exciting field of medical device simulations, where our customers are medical device companies who use simulation both to provide safe and efficient onboarding for their customers, which is similar to the robotics companies. But these med device companies also use our solutions and simulators as a tool for their sales and marketing teams to demonstrate features and benefits of their products in a safe and efficient manner. Looking at our business models, these vary depending on segment. For MIS, ultrasound, and EMS simulation, so one, two, and three, we develop and sell simulator hardware together with software modules. For surgical robotics, we engage with our customers in development projects and then our paid licenses for every robot that ships with our simulation.
And for medical device simulation, we also engage first with our customer in development projects to build bespoke simulators for these companies, and then we sell them custom-developed simulators throughout these often very big organizations. Service and support is always an integral part of any offering. Our outspoken ambition, and this is very important, is to make each segment profitable on their own and for these segments to contribute to the overall profitability of the group. Today, as you can see, robotics simulation has the highest relative profitability due to the license business model. There is limited relative profitability improvement potential from where we stand in this segment today. but all the other segments contribute to a far lower degree to the overall profitability.
One big opportunity and major objective with this strategy is to increase the profitability in all the other parts of the business aside from surgical robotics. There is a very big upside here and tangible improvement potential in these areas of the business. In order to reach our financial goals and eventually double the size of the company as we have as an internal ambition, we have defined six strategic objectives that will serve as our long-term goals for the coming years. Our first goal clearly states our ambition for continued growth by delivering world-leading products within our target segments. The second goal is to ensure that our customers become happy, satisfied users with our technology and simulation so that they can achieve their goals by proper onboarding, infrastructure around the simulators, and the necessary knowledge.
Thirdly, we have as an outspoken ambition to make simulation a standard practice within healthcare education, both as a training, but very importantly, also as a certification tool. This will have a big impact on how deeply we can penetrate the market. One goal is centered around the ability to bring up new businesses from inception. Here we are working actively to reach product-market fit now for the emergency medical simulation segment. We foresee continued growth for our company. We want to ensure that we grow in a scalable and a financially efficient way so that we can both grow, but also maintain a good profitability in line with our financial goals as we are doing so. And finally, we would not be able to achieve anything without our exceptional team, our exceptional people in Surgical Science.
This objective is both efficient. It is both about how we are most efficient in our internal collaboration and processes, as well as how we develop our organization as the company grows. As I pointed out in the previous slide, one of our strategic objectives is to develop world-leading products with an ambition to create an amazing customer experience, and as an example of an amazing customer experience, we would like now to introduce to you the RobotiX Express , our latest addition to our product offering, which you can see here physically on the stage to the left of me. RobotiX Express is a portable simulator that makes robotic surgery training more accessible, enabling healthcare professionals and trainees to build skills efficiently, affordably, without taking time away from the operating room.
The simulator is compact and lightweight, as you can see, has a small footprint, enabling training wherever your surgeons are without the need for a dedicated facility. Previously, robotic surgery training could only take place on the robotics console, which competed then for the time the console was used for clinical work. We have now described our addressable market, our financial and strategic goals on the highest level, and we've also presented our five prioritized market segments. Now, in the value creation chapter, we will do a deep dive in each of these segments of the respective opportunities that we see in our plans for each segment in more detail. As a backdrop for the presentation of our value creation plan, first, some data points. Surgical Science shows a 14% growth in SEK year- to- date, quarter three versus previous year.
We have had a revenue CAGR of around 11% since 2021. Revenue growth in industry has been significantly stronger than that of Educational Products. Our industry customers, which predominantly are med device and surgical robotics companies, have shown more resilience in their spending during the economic downturn. On the other hand, hospitals and s im centers, our customers in Educational Products, have seen a lot of their budgets for CapEx cut, which has affected our sales performance in this segment. Our profitability, which has been around 20%-25% in the previous years, has gone down during this year to around 10%.
The main reasons for this negative development are a shift in revenue stream mix away from licensed revenues towards more hardware, the acquisition of Intelligent Ultrasound, which was at the time of acquisition a non-profitable company and still weighs on our results, and finally, unfavorable currency effects. As I've already pointed out, we have historically divided our business into two business areas: Educational Products and Industry OEM. And Educational Products comprise of around SEK 500 million or half of the company's revenues. But as I've already mentioned, we have then divided this segment further down into three subsegments: minimally invasive surgery, ultrasound simulation, and emergency medical simulation. And we will now present them a bit in more detail, each of them. Our first segment, minimally invasive surgery simulation, is our biggest segment and comprises around 35% of our total revenues today.
It covers solutions for surgeons and physicians to train in many different kinds of procedures related to minimally invasive surgery. We have four main product categories in this segment: laparoscopy, endoscopy, endovascular, and robotics. Endovascular and robotics are the fastest-growing product segments, whereas endoscopy remains flat and laparoscopy is decreasing in sales. Minimally invasive surgery techniques have for many years now grown in importance and are many times favored from traditional open surgery. We also see an acceleration towards MIS away from open surgery clearly. This development has, in turn, driven the need for simulation in order to teach MIS surgery in an efficient way. However, there is still a large skills gap and massive training need for surgeons and healthcare professionals in this field. This training need is growing as the shift towards MIS is increasing.
Of an estimated 1.2-1.5 million specialty surgeons globally today, only a minority still have received formal MIS training. The value of the technology is also evident since more and more hospitals and residency programs increasingly require that their students go through simulation classes before performing MIS procedures clinically, which further drives simulation adoption within the segment. Now, moving over to ultrasound simulation. Our ultrasound simulation business has increased in importance with the acquisition of U.K.-based Intelligent Ultrasound and now constitutes around 20% of the company's revenues. Ultrasound and ultrasound simulation is an image-based technology, which is a different tech stack than what we use for, for example, minimally invasive surgery simulation. The customer base includes both hospitals and sim centers, but also much broader than that, with, for example, nursing schools, sonography programs at health schools, emergency departments, and so on.
In the beginning of the year, we concluded the acquisition of Intelligent Ultrasound, and we have not been satisfied with the financial performance and sales growth of the ultrasound simulation product category in the past year. As such, the acquisition has weighed heavily on the group profitability. However, with the acquisition of Intelligent Ultrasound, we have become the clear world leader in ultrasound simulation in terms of sales and with a significantly broader product offering than before. We can now use this combined product offering to sell to existing customers, as well as addressing completely new segments and customer groups that we couldn't address before. Point-of-care ultrasound, or POCUS, is an application where ultrasound is used at the bedside by physicians as an early diagnostic tool, and this area is growing rapidly. Hospitals and training programs are increasingly mandating POCUS competencies for residents and nurses.
And we also see that training needs extend beyond traditional user groups, such as doctors, to also now nurses, first responders, medical students. They all represent fast-growing cohorts for us. Surgeons are also now increasingly expected to use ultrasound for new applications, such as guidance procedures in, for example, nerve blocks, ablations, different types of biopsies, and not just as a diagnostics tool anymore. Finally, we see a strong and increased focus on women's health generally, and there is a rising demand for early pregnancy assessment, infertility diagnostics, and maternal-fetal monitoring. All these factors are driving the demand for ultrasound training and ultrasound simulation tools. We have a high ambition here internally for this segment, and we believe that we can see considerable growth in the years to come.
However, we are at the same time realistic that there is further work to be done when it comes to both creating awareness for our new target groups, as well as some further development of our product offering to capture some of the new use cases and customer groups. We will now look at a video where a few of our key opinion leaders speak about the value and strong rise of point-of-care ultrasound and the importance of proper POCUS simulation.
Point-of-care ultrasound is changing how care is delivered. By bringing imaging directly to the bedside, clinicians can make faster, more accurate decisions in critical moments. Point-of-care ultrasound is probably the one medical advancement that has brought the provider back to the patient's bedside. It's a dynamic process making these critical decisions, especially in the more ill patients.
You're trying to get them ready essentially when the training wheels come off, right? When they're not with an expert user, how are they going to be able to identify the pathology? How do you integrate all the things that you're learning? And then, more importantly, how do you make good medical decisions? And if you're having to do that all on the fly, real-time, with an unstable or critically ill patient, cognitively, you have to make a lot of mistakes. Using POCUS effectively requires more than access. It demands skill, confidence, and practice. High-quality simulation helps build the skills to use POCUS without the pressure, offering hands-on practice in realistic, risk-free environments where mistakes become learning moments and skills turn into second nature. It's low-stakes training with the simulator. You don't have to worry about pushing too hard.
You don't have to worry about feeling silly because you've never touched a probe before, and then the beautiful complement that simulators offer with pathologies that you would never see anywhere else. A big part of what we do is yes or no binary answers. Is there an effusion? Is there a pneumothorax? How are you going to recognize a pneumothorax if you've never seen one, well, that's the beauty of simulation. POCUS empowers clinicians. Simulation prepares them. Together, they're improving patient care, one scan, one decision, one learner at a time. We have to believe that we've trained them well and that they're really, really smart already and that they'll be able to use the ultrasound training that we gave them by using a high-fidelity simulator that's really intuitive and easy to use. We can fast-track that learning so much.
Get in touch with our experts in healthcare simulation and kickstart your POCUS learning program today.
The next segment, and the smallest one, still in incubation mode, is emergency medical simulation. Here we focus on development and sales of simulation training solutions to give defense medical professionals and first responders the necessary skills and knowledge to manage medical emergency situations. We kickstarted this segment and the ambition in this area with a large order to this defense ministry in a Southeast Asian country, and our ambition is to continue to grow with sales towards customers, both in the defense sector, but also take the product and create a version for civilian use as well. This version will be sold to first responders, emergency staff, and other blue light personnel, which represents a different customer category than that for, for example, MIS.
Our products here consist of mixed reality and virtual reality solutions where you manipulate mannequins and tools physically with your hands while being in a virtual environment of your choice, for example, at the site of a car accident or in an emergency room of a hospital. These solutions provide a high level of immersiveness and realism, and they are very flexible in that they provide easily adaptable scenarios with quantifiable and immediate performance metrics and results. The opportunity within these segments we consider to be very, very big for Surgical Science. Within defense, the spending is rising rapidly, and EU member states have increased defense budgets by 17%, reaching a record EUR 279 billion, and these are expected to grow by an additional EUR 80 billion per year by 2027, according to Goldman Sachs.
We are already active in this space, and as I said before, with a major deployment for a Southeast Asian defense customer, and we also have additional defense and national readiness projects currently in the pipeline. On the civilian side, only in the U.S., there are over 250,000 employed emergency medical technicians and paramedics, and estimates suggest total over a million licensed or certified EMS personnel, underscoring the potential for training, recertification, and upskilling. This creates a recurring sustainable demand for high-quality training solutions, including initial refresher, advanced skills with scenario-based simulations. One reason as to why we see a particularly strong interest for our mixed and virtual reality solutions is that defense and emergency organizations increasingly require training formats to reduce their reliance on proctors and supervisors, formats that offer repeatability and also that provide immersive scenario-driven environments, which are ideal conditions for VR-based digital simulation platforms.
We will now have a look at a video where one of our products within emergency medical simulation: Emerge X VR. This product is designed to teach specific emergency procedures in a VR environment, which provides a high cognitive load for the trainee and a very realistic training scenario. Now we'll turn our attention over to our industry segment. This segment comprises the other half of Surgical Science's revenues and has been growing around 20% CAGR during the past years. Industry is made up of two subsegments, robotic simulations and medical device simulation, and we will now describe the segments and the opportunity for us in more detail, starting with robotics simulation. The robotics simulation segment constitutes our second largest segment with around 30% of total sales, with revenues from development projects and licenses.
Depending a little bit on how you define it, the market ranges from anywhere from 100-400 different companies. However, if you only regard soft tissue robotics and look at the major players, there are about 20-30 of these companies. Robotic surgery is at an inflection point with even stronger projected procedural growth than currently seen, driven by the value advantage over open surgery and also the value advantage over general minimally invasive surgery, and also by increased competition. It is very clear that robots will be a key part of the infrastructure in the operating room and in hospitals of the future. When all these robots come to market, there is a massive training need for surgeons to accelerate the product adoption and also, of course, for the new robotic companies to market their respective products.
Proof of this need is that only around 100,000 out of the 1.2 million specialty surgeons, or one in ten, has been trained on robotic surgery, whether it be on a da Vinci system or any other manufacturer. Furthermore, the digital innovation of the robotics companies will pick up speed as the pace of hardware innovation decreases, and this is a natural progression that has happened in many different markets outside of robotics. Robotics companies see that digital innovation represents an opportunity for differentiation and continuous value delivery, enabling also the possibility for large recurring revenue streams. Simulation has an important role to play in the learning journey for robotic surgeons. A generic learning pathway, as you can see here on the slide, typically consists of several steps, with more basic system introduction and early training, followed by advanced training and procedural support.
Simulation is crucial for the surgeon in the early stages when learning the ropes of a new robotic system and to build the necessary muscle memory. Simulation is also then used later in the learning journey as the surgeon should learn specific procedural steps where quality and efficiency of these steps are paramount. Historically, these later parts of the training journey have also been carried out with cadavers or animals, and these methods, once again for sustainability reasons, are now being replaced by simulation and anatomical models. Many robotic companies, if not all, run initiatives to reduce the dependence on cadavers or animals in their training. Historically, the simulation has been used by robotic surgeons in the early phases on the previous slide of training with a focus on teaching the introductory motoric skills of the surgeon.
This is what we on the previous slide referred to as system introduction and qualification. However, the trend is now shifting towards more advanced simulation and also towards supporting surgeons much later in their training journey. The surgical robot can be seen as a sensing unit, which collects large amounts of data from its instruments and from the scene camera, much in the same way as an autonomous vehicle collects a lot of data from its environment around it. This data can then be used to produce insights for the surgeons on his or her clinical efficiency and improvement areas. All major robotic manufacturers today have this type of capabilities within their digital offering. Intuitive calls it Case Insights. Medtronic calls it Touch Surgery.
These insights can then be used to recommend different areas for improvements and simulations that the surgeon should focus on, and the surgeon can then train on these areas in a simulated environment over and over again until the performance is improved and the surgeon can go back into the operating room again. Simulations will also in the future be adapted to the proficiency of the surgeon with more difficulties or changing environments, specific patient characteristics, emergency situations that might occur, meaning that even very experienced surgeons will find training value from the simulation. This means that simulation will become part of a continuous learning journey throughout the career of the surgeons, and this is what we mean when we, for example, in the press release that we sent out, say that simulation will become an integrated part of the digital ecosystem of the robotic surgery companies.
We would now like to listen to our Chief R&D Officer, Ariel Ben Moshe, as he explains the future developments in robotic simulation and the use of AI in our development efforts.
Advanced AI technologies is something that we are actively pursuing and developing in Surgical Science R&D to make personalized recommendations for surgical training a reality. We are using huge data sets and training advanced models that will offer a personalized recommendation for the follow-up training after each simulation session. Imagine that those technologies could also be connected to performance from real surgeries in real ORs and allow closure of the training loop between the real OR and the simulation. Advanced AI technologies is something that we are constantly using in the R&D for Surgical Science.
It helps us code better, be more efficient, design a huge variety of anatomies for our simulated cases, and allow us to bring advanced user experiences like interactive voice recognition, supporting multiple languages to our products.
I want to add that the use of AI in our development work will benefit not only robotic simulation, of course, but all the different product areas that we have. This picture represents a list of the most important robotic surgery customers globally, and all of them are customers to Surgical Science. In terms of market share of the installed base, Intuitive still dominates the market with more than 10,000 systems installed.
It has taken considerably longer for the challengers in the market to come out with their robots than was previously estimated, and this also has had an effect on the license revenues that we predicted for Surgical Science when we, in 2022, established our financial goals. We then thought that it would be significantly higher than they are today. However, now many robotic companies are actively selling their products on the market. Among Surgical Science's customers here, it's only J&J, Johnson & Johnson with their OTTAVA platform that are not yet selling their robots in any part of the world, and focus now for these companies is, of course, to get their robots approved for more procedures and also to globalize their sales efforts.
The latest news that we have here is that Medtronic, one of the largest med device companies in the planet, with a huge project to bring out the Hugo robot, last week got their FDA clearance for general sales in the U.S. for urologic surgical procedures. And this is a major step for the company, and it will drive Medtronic's robot volumes a lot. It is important to note that Intuitive will keep a very high market share here of the installed base for the year to come, both due to their already, of course, large installed base, but also due to their market success with existing products, most notably the latest released da Vinci 5. And this concludes the robotic simulation chapter. Now I would like to move over to the med device simulation chapter segment.
Our customers in this segment represent some of the largest med device customers in the world, and these companies use simulation both as a means to train their customers in the safe operation and installation of their medical devices, but also as a sales and marketing tool at events and customer meetings to showcase the features and values of their products. Simulation is mostly the only way that the med device companies have to demonstrate their equipment without placing it physically into the patient, and as such, simulation has become a very important training tool as well as a revenue-generating tool for these companies. There are several trends pointing towards the increased use here of our technology. Medical devices are becoming more complex, requiring simulation-based onboarding for safe adoption. These steeper learning curves for the more complex devices drive demand for faster and more efficient training.
Med device companies are also launching many more new and sophisticated products than before. And finally, there is this trend towards sustainability moving away from animals and cadavers, similar as in the robotic space. Most of our companies here today are within the endovascular or cardiovascular field, and therefore you can see our endovascular products such as ANGIO Flex Pro and ANGIO Mentor Suite are in the highest demand for this segment. Our customers in the med device segment represent some of the most important med device companies globally, and we have long-standing relationships with many of them. Many of them have been our customers for years and use simulation as an integral tool in their marketing and educational efforts, and they devote significant internal resources to operating their simulation infrastructure. The power of the customer base is also visible in our sales results towards this segment.
Sales within medical device simulation has grown steadily during the past years, and you can see how the development revenues, which is the light blue bar, is a driver for increasing simulator sales, the dark blue bar, in the years thereafter. One example of this is the large order, potentially the largest single deal in the company's history that we announced with our Quarter Three report just earlier here for one of the world's biggest med device companies. This development project is currently underway, and it will be completely completed in 2026. After that, we will equip the customer with the simulators that we have developed for the customer, and we believe that that revenue stream will go on for at least four years thereafter.
The number of development projects that we do for our customers is also a very clear lead indicator for ensuing simulator sales, of course, which is a testament to our long-term relationship. Sorry. As you can see, these projects have grown steadily in the past years, and we have a high degree of repeat customers, which is a testament to our long-term relationship and the customer success that we create, and finally to the importance that simulation has for these companies. We see a very, very strong potential to keep growing this segment, given that the trends in the market are so favorable for simulation and for Surgical Science.
The product launch pace in this field is very high, and only in the cardiovascular segment that this graph depicts, there are around 12 new device launches or devices that get FDA approval in the U.S. every year, so once every month. These devices come in many different varieties and are increasingly complex in their operation and installation, and they put much higher demands on the surgeons to receive proper training. At the same time, as you can see on the bars, there is a high rapid growth in the number of patients who actually receive these devices as well, depicting the sales of, in this case, cardiovascular devices. Several large med device companies show really good growth numbers in this area, and this in turn means that the number of surgeons who have to be trained in installing them is also increasing.
I want to end this deep dive with a movie of how one of our customers, California-based med device company PROCEPT, is using simulation in their sales and marketing efforts. You can see pictures from PROCEPT's sales convention where the sales and account managers receive training with the Surgical Science simulators on how to do product demonstrations of the company's water ablative prostate surgery tool, and then PROCEPT's sales team, they use these simulators in their day-to-day interaction with customers, so each sales representative has one of our simulators, both to do product demonstrations, but also to demonstrate important features that ultimately generate revenue for the company. S o this concludes our deep dive into our five different market segments. We have described the segments and our market opportunity in more detail.
Now what we have done is that within our strategy, we have then defined a set of strategic priorities for each segment, which we are now executing on. For MIS and ultrasound, the priorities are to increase our profitability, to drive penetration, to drive market penetration, and get deeper into the existing market segments. We also have the plan to launch amazing new products designed to provide more value for our customers and to capture a wider set of customers' personas. For emergency medical simulation, we intend for the segment to prove itself as a running business and to bring the product offering from the defense side to the civilian market. For robotics and med device, we work to continue with our successful key account strategy to continue to provide our distinguished customers with superior value.
And for robotics simulation specifically, to close this loop, to go on this learning journey, and to make simulation an integrated part of the digital ecosystem in the continuous learning loop. The financial goals that we today communicated are based on organic growth with no acquisitions factored in. However, we are continuously considering acquisition opportunities which can contribute with either customer base, product diversification, synergistic products, market access, or strategic intent. Sorry, strategic talent. This is the same perspective and plan that we have had on inorganic growth also before with the older strategy, and it remains unchanged then with the new strategy.
I would like to end this chapter, strategic direction and value creation, by speaking a bit about our profitability improvement efforts, since this is an important part of our strategy and the financial goals, and since we feel today that it's only the robotics segment that has an acceptable profitability level. We are currently conducting a set of different activities to improve our gross margins. We are doing various changes to our product portfolio to drive volume and to improve the product mix. We are also more actively working with price increases and price management with various activities to increase our average sales price or ASP, and then in parallel, we conduct another set of activities to reduce our cost of goods sold or the production cost of our products.
As we noted in our last quarterly report or in our latest quarterly report, we have started seeing positive effects already from this work, although the results are somewhat hidden due to the negative currency effects that we have at the same time. But we believe that this positive impact will increase even more in the quarters to come. We are also working very actively to improve our organizational efficiency and ability to do more work and create more output with the same or fewer people. One of the initiatives that will have the biggest impact is to unite our software and hardware development around a set of platforms. On the hardware side, these platforms will enable us to make configuration of base designs, which will be important both to reduce our production costs, but also to be able to significantly increase our volumes.
On the software side, a consolidation of our software platforms will enable faster development times with more reuse of existing software assets. This, in turn, will also drive our ability to handle more simultaneous customer projects and faster response time for our customers. In parallel to these platform initiatives, we're also working across the organization with various projects to improve our organizational overall efficiency. These range from general digitization efforts aimed at making the entire team more efficient, so we can increase our agility and scale sales and number of customers while maintaining or only slightly increase our staffing. And then finally, we have another set of activities specifically aimed at improving our sales efficiency. And Niclas Olsson here, our Chief Revenue Officer, will explain more about these after the break.
To conclude, profitability improvements in the parts of the business outside of robotics is a key part of the strategy, and we have in this last part of the chapter given more detail on how these profitability improvements will be achieved. And that concludes the strategic direction and value creation chapter. We are about five minutes ahead of schedule, but we will keep the agenda as it is and allow for a 20-minute break instead of a 15-minute break and meet back here then at 3:30 P.M. according to the agenda. So see you soon.
Welcome back. We will now move on to the next item on the agenda: expanding the market, which will be presented by our Chief Revenue Officer, Niclas Olsson. We operate in an underpenetrated market with generally low awareness of medical simulation, meaning great potential for us as a company.
A key to how much and fast we can grow in the coming years is related to how we can develop and build strong and efficient sales channels. Therefore, we have a lot of focus on this in the strategy, and I welcome Niclas to present this in more detail.
Thank you very much. I'm a little bit of the kind of wild card here because I'm a typical sales guy, so I will try to curb my enthusiasm and show you the facts, and I've been instructed not to move across this line or that line to stand still, so I will do my best here. We are in a very interesting situation now where we have built, I would say, by far the most superior sales and sales channel network in the industry. We have, I would say, five regions from the Americas.
We are separating USA from the Americas, given the kind of impact we have from the business in the U.S. solely. We have EMEA. We have U.K. as a direct market. We have APAC and China isolated for the same reason due to the impact and the success in China. We are servicing the Americas and the U.S. market from our Cleveland office, and as Tom mentioned, we are building now a customer interaction center in Cleveland to be able to work closer to our customers. We are servicing EMEA from Gothenburg, and we have a sales office now in Cardiff as well in the U.K. From Tel Aviv, we are servicing APAC and from Shenzhen, the China market. We are also expanding our services out of the Shenzhen office, and in the future, we will see how much more we can cover of the APAC market.
We have a fantastic sales and service organization. We are recruiting actively from competitors. We are by far the most attractive employer in our industry. We have a lot of people joining us from the customer side, especially then when it comes to industry business. Today, we have approximately, I would say, + 90 distributors scattered around the world, and in most markets, significant markets, we have a, I would say, two to three partners to be able to balance and to be able to utilize our strategy in a better and more aggressive way. What is really going to change for us when it comes to sales and service is technology. I hope that you had a chance to play with the RobotiX Express here. It is a game changer. And why is it a game changer, well, first and foremost, because it's a customer-driven project originally.
We had a discussion with Karolinska here in Stockholm, and they said that it's so difficult to get console time for our surgeons. We have to stay long hours to train on the system. Couldn't you build something that the surgeons can bring home and they can practice when they put their kids to bed and when they've had their dinner? So that's how this project started. And this has turned out to be, how do you say in English, a kioskvältare, a product with very great, huge interest from this product. And when we are now combining an ultra-portable product with AI features, AI features such as learning management tools, we are building in insights. It means that the surgeon can learn what am I doing wrong. And when we are selling this product, we try to compare it with a golf simulator.
If you have a simulator that only tells you that you are hitting a stroke, it goes as far, but you never get feedback. What can I do better? How can I become better and what is really interesting with our products and our technology? If we look into it from a historical perspective, we have taken beginners to proficiency but then what? The market that we have addressed is approximately 160,000 beginners a year. That is what is being produced, surgeons being produced a year but by implementing learning tools and individual measurements and guidance and proctoring, as we say in the healthcare space, we are expanding the market to, I would say, approximately 1.6 million professionals and what evidence do we have of that? Well, one of the first customers of this simulator is a U.S. surgeon that called us up and ordered one unseen.
The listing price for this simulator is approximately $65,000 in the U.S. This is what people are willing to pay for a product that they can use as a personalized tool. As we say, how do we make the best ones even better? That's why we talk about our strategy is expanding the market significantly. Looking then into sales and service, how will we accelerate the growth? How will we drive growth from where we are today? As mentioned before, we have sales and channel development, our distributor network. We are running a lot of efficiency programs in sales, implementing new IT tools, AI-supported tools when it comes to quotes, when it comes to managing the business. Even as important part here is to drive simulation as part of medical training.
How do we make it, as Tom said before, an integrated part of the healthcare system? You can fly a plane without ever, you can't fly a plane without recertification, but you can do surgery 20, 30 years after you went to med school without any recertification, and we see a huge interest today from medical institutions, universities, colleges, etc., provide us tools so we can certify our surgeons and our staff in general. No other organization has the same product with reach as we have, so when we are launching a new product today, we can use our sales channels to quickly get them out on the market, and a little bit of a sunshine story here is that first Latin American customer of the RobotiX Express was a Peruvian hospital.
That was a big surprise to all of us that we could reach Peru in a few weeks after launching a new product. Talking about penetration, we have done a quite interesting study on, we are the biggest by far company in simulation, but how much have we penetrated the market? I think these figures are pretty stunning that in the U.S., where we are doing really well, we estimate the number of prospects to approximately 6,000 customers in the U.S. For anyone that's into the details, we know that there's far more hospitals in the U.S. If you add then ambulatory surgical clinics, colleges, universities, the figure is far higher. The way we calculate it is that these are the ones that are relevant to us and our business.
Still, we only have, I would say, a 10% penetration of the market for various reasons. If we then go to a region like APAC, we have approximately 16,000 relevant prospects in APAC. India has approximately 50,000 hospitals. We are being very conservative here. When we are now launching products with lower price points for building scale, we know that where we have to focus a lot going forward are in the under-penetrated markets. With the global perspective, we have so far 5% of what we think should be the market for us, even with a conservative approach. There are now many initiatives in the world when it comes to medical training. One of the reasons is that the age curve, a lot of surgeons today are getting to the tail end of their career. How do you educate people on new technology without technology?
That is a bottleneck today, so for example, in Mexico, it's just been announced that they will be building approximately 1,000 sim centers across Mexico. We don't think that we will sell 1,000 simulators, but it will for sure, and we have already seen an uptake in Latin America now this year. Coming then into the area of how do we manage, how do we work with all these distributors and all these channel partners? We are launching a concept that we call the Partner Path. Partner path means that we have to provide different services. If you are a small channel partner to us in Colombia, you can't expect the same service level as you should do in China if you are a major channel partner in China.
The Partner Path concept means that we are setting up different service models depending on the potential, depending on the performance. If you fly first class with us or business class or economy, it depends on potential performance and how much you co-invest in this. To support the Partner Path, we are now launching something that we are very excited about. It's the Partner Portal. We are digitizing our sales efforts here. So partners can log on, they can use our tools, our way of coming up with the right configuration for products. They can do their quoting, they can place their orders, etc., on the Partner Portal. And this will give us a completely new way of scaling the business. Instead of educating everyone in various meetings, we do campaigns, digital campaigns. And looking into then Edu, I would say that it has different challenges versus industry.
Education customers buy less frequent than industrial customers. Our channel partners need to have access to the right information to successfully close a deal. So with this tool, we can scale, we can work with electronic orders, we can provide faster support. On our side, we have real-time visibility of what is really going on on the market, and we can direct resources, etc., based on the activity on the market. And we can also make sure that what's being sold is compliant with our way of doing business. And we are, of course, onboarding new distributors regularly when we are growing into new markets. Industry is potentially even more interesting. The challenge working with industry is that we are making a big project with one of the top three companies in the United States. They spend sometimes millions of dollars on developing a technology with us.
But how do they get awareness out to their daughter companies around the world that this technology is now available? And what is really interesting is that this program is endorsed by the biggest companies. Help us to make it visible what we can buy from Surgical Science. And every time I visit a new market or a market, I have the same feedback from the big med device companies that why are we not informed what is available for us? Because the med device companies, they use our technology predominantly to train and educate their customers, but also to sell their products and in some cases to do R&D work. So if I work in an R&D department of a large med tech, how can I be aware of what's being done in another side of my company?
So we are working very closely with the big companies to set up what we call these kind of private rooms where we put all the available assets for them in one secured area where they can provide us data and we can provide them products. When it comes to really driving credibility and adoption, working with medical affairs is very important to us to work with the leading institutions. We have ongoing projects with Cedars-Sinai Medical Center in Los Angeles, with Cleveland Clinic in Cleveland, with Rigshospitalet in Copenhagen. This is how we build the trust for that our technology represents their reality, and with this credibility, we can turn our products into commercial successful platforms. There are many, I wouldn't say alternatives, but today with different digital tools, etc., and we have all seen what's going on now with AI-generated content. It's still extremely important to have scientific-based products.
And that's why we are working very closely with the medical affairs. There is a number of associations around the world, and we are working with, I would say, most of them. And the associations are the ones that set the standard for a specific discipline. And even here, working with an association, it strengthens our credibility. And their opinion leaders can, of course, then hopefully talk in our favor. One of the latest agreements we have is with ESGE, the European Society for Gynaecological Endoscopy. They have training programs for robotic surgeons, and they are present in 156 countries. So to be accredited from this association, you have to do a skills test, and you have to do it on a RobotiX Mentor from Surgical Science, and you have to do it on our software. Why is this important?
Because when we look at the number of new robotic entrants, there will be in the future more players on the market. Which platform to use to certify a surgeon? And we see a trend now that more and more you turn into agnostic solutions like Surgical Science. So here is where we see a great opportunity going forward that we have our own platforms that opens up for surgeons to practice in their homes, practice at the hospital without taking productive time out of the consults in the hospitals. So to sum it up, to wrap it up, I would say that we are in a very favorable place for scaling up our business with a new technology. We strongly believe that this AI-enabled technology, where we go from being proficient to be the best you can be, it's a game changer for us and our industry.
That instead of treating everybody in this room as one mass, we will look into every individual and we can design specific programs for you to become the best surgeon you can be. And we already today see evidence that this is generating a lot of interest from the market. And very excited about our potential. So that was pretty much everything from me. Thank you.
Thank you, Niclas. So we start to reach the end of our long presentation, and we have come to the concluding remarks. And as a short recap then, this strategy that we have presented today defines our five key market segments: minimally invasive surgery simulation, ultrasound simulation, emergency medical simulation, robotic simulation, and medical device simulation. These five market segments represent a significantly bigger addressable market than previously in the previous plans.
The strategy also involves significant profitability improvements in all segments apart from robotic simulation. And we have for each of our market segments defined a set of strategic priorities that aim at both creating customer market success, of course, but also contribute to our financial goals. Then we have started to work on projects to drive growth and improve our profitability. And these initiatives will have continued positive impact in the quarters and years to come. And finally, Niclas has in his chapter explained how we intend to expand the market through a set of specific activities aimed at increasing simulation penetration and driving simulation adoption. We have today also updated our financial targets. The revenue growth of 10%-15% will in the coming years come from both growth in existing as well as new segments.
The strategy implies that the company will target a significantly larger market and more revenue streams than previously. We aim for at least 15% Adjusted EBIT. As we start delivering according to these goals and to also the strategic plan, our ambition is to continuously increase our financial goals. We have today also announced that the company will start working on a transfer of listing from First North Growth Market to the Nasdaq Main Market in Stockholm. We will initiate this work during the beginning of next year. The main reason why we're doing this is that we believe that we belong on the main market. We have been listed now at First North since 2017, and we feel that we live up to the governance standards of the main market and that we are ready as a company.
We also believe that the main market listing will open the Surgical Science share to many more investors. Certain investors have rules that prevent them from investing in companies outside of the main market, and this means that Surgical Science now will open up for them. And finally, being on the main market improves our capital management flexibility with more tools, such as, for example, repurchasing of our own shares. And this, ladies and gentlemen, concludes our presentation for today. Thank you for listening. Thank you for listening to our story, how we will continue to build Surgical Science and create value for our customers and shareholders. Our team, I can tell you, are extremely excited, very engaged, and looking forward to the journey ahead. And with that, we would like to open up for Q&A.
So we now move on to our question and answer session.
And if you are in the audience and have a question, please raise your hand and wait until you have been handed a microphone. Once you have it, kindly state your name and organization and then ask your question. If you are joining us online, please feel free to submit your questions in the chat box below the video. And we would appreciate it if you ask one question at a time. Ulrik.
Thank you very much. And thanks, Tom and Anna, I'm Ulrik Trattner from DNB Carnegie . I guess I'll address the million-dollar question. The moat of your procedure-specific simulation in sort of the news flow of Intuitive choosing to insource or sort of in-house develop basic skills simulation, how confident are you?
Especially given the presentation that you have recently told us that is becoming a more integrated part, software becoming a more integrated part, what hinders Intuitive to develop procedure-specific simulation in-house?
Thank you. Great question. If you remember the slide that I showed with the different steps in the learning journey of the surgeon on the robotic simulation chapter, you have the early steps, which is more of the basic simulation, leading up then to the later steps, so the further steps where you have the more advanced procedural type of simulation, the ones that we provide with Surgical Science now towards Intuitive. We think that the basic simulation tools, they can be done in engines such as Unity or Unreal, very similar to the type of computer graphics that computer game development that you have with other companies.
Whereas the more advanced procedural type of simulation requires real-time physics engines and a considerably more advanced and complicated tech stack, and we think that there is, given this other trend that we see on this continuous learning journey where the surgeon will practice more and more later in the more advanced type of scenarios, there is a very strong case to be made that procedural simulation will become a very important part of that entire digital offering, and then, of course, your question is, okay, so if you can do it, can somebody else do it, and here I would say that there is a couple of different answers. First, this has taken the company many years to get to the position that we are today, and we have quite a talented team, so I think we have a strong head start.
It's considerably more difficult to build this type of procedural simulation than the more basic skills. Then, thirdly, it might not necessarily be in the interest of the respective robotics companies to do this type of simulation by themselves because it goes back to what Niclas said about the generic trainers and the training driven by the societies rather than the robotics companies and creating credible certified standards that you can certify surgeons against. That should be done then with neutral bodies rather than the manufacturers themselves.
Our plan here is, of course, to lean in and continue to have a very high innovation pace and make sure that we can be part of this continuous learning journey and be a very proactive supplier towards the robotic companies at the same time as we're working together with the medical associations to develop these standards and certification processes, as well as innovating and developing our own tools such as the RobotiX Express that we have shown.
Just a follow-up, what is a reasonable penetration rate of procedure-specific simulation? Prior to the announcement, I think Intuitive went out and told that they had a roughly 30% penetration of their installed base. But that also included basic training.
That is difficult to tell because it depends not only on kind of the value of these different technologies, but also how Intuitive plans to sell it, to which customer cohorts and so on they plan to sell it. That's why we will not comment on a specific procedural or a specific attach rate, but rather that we have given a quite large range instead in the financial impact that this news has for our company.
If I can squeeze in one also sort of follow-up, did you get any sense or any heads up that Intuitive was developing a basic skills simulation for the da Vinci 5, given that you were a part of the development of the da Vinci 5?
We work very closely with Intuitive. We have done so for years, and we have an intimate relationship with their development teams.
We have never disclosed or had any discussions about this type of changes from a commercial standpoint, but of course we know what they're working on sort of. But no, it was a surprise for us, the change in the MoU. And of course, not a big disappointment for us. That hurts us in the short term. But I think I hope that you also feel now that in the long term, it can actually have a lower impact given that we see that procedural simulation has such an important part to play in the digital ecosystem of these players.
Thank you. I think.
Oh, okay.
So I can continue?
Oh, we are running out of time.
Thanks everyone else in the room. RobotiX Express .
Obviously, I understand what you're planning to do here, taking it sort of into a generic segment, trying to open up sort of the minds and the skills of resident surgeons and the ones not getting the ability to sit down in a da Vinci, for instance. But the software itself looks very similar to that of what Intuitive is offering built into their dV5 system now with the basic skills. So what customer segment are you planning to address here?
The customer segment that we're planning to address with the RobotiX Express is kind of the broad beginner base as Niclas had in his triangle there, the pyramid, as well as a certain set of the professionals. And what you need to do is you need to be able to offer the entire kind of offering, simulation offering to cover that entire learning pathway.
And then, of course, in the beginning, when you're learning the ropes of a robotic system and you get to understand how to handle the clutch, for example, or how to handle the instruments, I guess there is a limited kind of differentiation that you can do in terms of the exercises. And it's about actually making the simulation fit the specific robotic modules. So what we have not shown here, for example, is that this generic trainer can also be equipped with different types of grippers and different types of clutches to fit the different robotic models. So in that sense, it's going to be more of a specific, it can be a more specific robotic experience for one specific manufacturer. So in that sense, it's flexible.
As you go more into the procedural simulation, there is a wide variety of different types of procedure and different types of critical steps that you can simulate. There, I think it will differ from manufacturer to, sorry, from robotic company to robotic company. Also we will continuously develop that part. There is a lot of room and opportunity for continuous value delivery when you get into the more advanced procedural content.
I play around with it, and I got the understanding that it doesn't include haptic feedback. I guess if you're a new surgeon trying to sort of apply robotic surgery, that haptic feedback is by far the most important skill set in order to get started with robotic surgery. How much of a problem is it that it lacks haptic feedback?
Of course, we have done a lot of customer interviews before conceptualizing the product. One of the discussions is around the need for haptic feedback. There's only a few, very few robotic platforms that have haptic feedback today. Most of them have not. You can also learn the introductions well without haptic feedback. It also has to do with striking this balance between accessibility, portability, and, let's say, more realism or more proximity to the actual robotic simulator. In that case, if you want to practice haptic feedback, you can do that on a procedural simulation from Surgical Science on, for example, a console instead. Those are the type of balances we always have to strike in product development as we develop our products.
Great. Thanks so much, Simon Larsson from Danske Bank.
I was just curious because you said that you wanted to improve the product mix, right, going forward. So what does this really entail? Is it more software content or more standardized hardware and bringing gross margins higher? Or yeah, what does?
It's a range of different, it's a good question. It's a range of different activities. And we sort of touched on them in different parts of the presentation. One of it is this platform thinking, both on the hardware and the software side, right, that makes us have fewer product variants and a few base models that we can base a lot of different products on. And then the same goes with the software, having a few platforms that you can then build from with reusable software assets that will also help margins. Then it can also be things like, let's call it product-related decisions.
So, saying, for example, that we are a company that should be in the high-volume production and not in the, let's call it, Swiss watch manufacturing, where we only produce a few simulators a year of a specific product, and that means then reshaping the product portfolio to actually go for the higher-volume products and for, of course, also the higher-volume segments. Those are some of the initiatives that we're doing.
Yeah, perfect. Also, I guess then the new financial targets, 10%-15% for the group. Is it fair to assume still then that we will have higher growth coming from the med device OEM side and a bit lower from the education? Or how do we end up at the 10%-15% as we go forward?
I mean, Anna, please feel free.
But the 10%-15% is, if you look at the momentum right now, the momentum is much stronger for industry than for Educational Products. And we have said that Educational Products can also have a double-digit CAGR, but it has been lately hampered by the kind of budget situation and the budget shortages that we have in the hospitals. So also again here, we have taken försiktighetsprincipen, and I don't know, principle of caution, and said that sort of the average is 10%-15%. And we feel that it's important that we can start delivering on these targets and then we can progressively increase them as we go. But you're right that we definitely foresee industry and med device and also robotics, once the new robots come up, to have a significantly higher growth rate than either.
Maybe a final one, if I can squeeze that in.
I think you mentioned the big med device contract that you won in Q3, that it will sort of last for four years as it rolls out in terms of products. Is that a typical sort of timeline or product lifecycle for that type of product?
Or Niclas, what do you say about that?
I mean, I would say that when it comes to med device simulation, first and foremost, we have the development phase and then we have the rollout phase. But then we also have the. We can't hear so that they can see you. Oh, you can't see me. You can't hear me. We have three phases: develop, build, deliver, and then we have maintenance and support. So it actually goes on and this is a very sizable project. So normally we have design and build, maybe is a two-year phase.
This one is significantly longer, but we see a trend that more and more of these projects are coming due to the shift from using cadavers, I mean, human cadavers and animals, so there is a trend today in the industry to go away from that space into the digital space. Did I answer your question?
Yeah, yeah, yeah, I think so. I think so. So yeah, maybe then to conclude, so a four-year sort of lifecycle or rollout is maybe a bit on the longer side than compared to.
And also given the size of the project, of course.
Yeah, makes sense.
What will happen also is that some projects will, some med device products, what happens is that they have some sort of mid-life kicker, so after a few years, they come up with improvements.
And then they come to us and we make improvements, a new development project. And then the hardware simulator can perhaps stay another couple of years. So that extends the number of years from four, perhaps five or six. And then it also gives us an opportunity to sell new software modules onto those simulators as well. And I think it's a fantastic situation that we're in, in these kind of med device companies because as the innovation pace is so high, as I showed, there is ample room for growth within each of them, right? So it's more like our internal capacity sometimes to handle these projects that actually puts a limit for how many we can do.
Very clear. Thanks so much.
I think maybe we had a question over here.
Hi. Carl-Erik Forsstad, private investor.
A newcomer to a company, which is lucky, so I'm a happy investor. AI is the new animal in the room. What potentials or risks do you see? Would it be easy to use AI to do what you have done in a number of years here?
Yeah, so as Ariel spoke about in his video, we use AI both in our product development to actually build better products, and Niclas spoke a little bit about what type of features and functionality that you can get from AI. You can get more insights from the actual output of the simulator so that the AI or the software can guide you better through your proficiency journey or your learning journey, right?
And then we also use AI, of course, as many other companies do, as an internal efficiency tool in all the work that we do, both in R&D, but also in other parts. And then your question about, okay, perhaps AI then, could it replace the procedural simulation that we're doing today with taking a data set or even taking clinical imagery and then making simulation out of that? We still think that that is quite far away, given that the foundational models that are needed to do so, they have to be very, very big. And there's a very big effort going into that. And you also then have to do a simulation that is not yet like 60% or 70% good. It needs to be clinically accurate and valid, right? That's what we spoke about as one of the key parts of our Surgical Science advantage.
So in order to get to that level, we think that we're quite far away. But of course, as a leader in this space, this is something that we are monitoring very, very closely and actually try to make advantage of and build on because we know this space better than many other companies or, yeah, a lot of the ecosystem. So that's how we think around it. We're actually trying to utilize this as much as we can and try to have a high innovation base.
Thank you.
At the back.
Thank you, Ulrik Trattner here again from DNB Carnegie. A question on Educational Products. My impression, and based on the history of Surgical Science, the profitability of the educational segment is largely volume-driven. So it's volume-dependent.
We had a discussion a year ago where you stated that you did see improvement in the procurement and tender activity of the industry. What's the state of the industry right now?
When it comes to your statement about that it's volume-dependent, I'm not sure I agree, actually, with all due respect. I think that we have opportunities both to become more efficient in our production, but definitely also in our sourcing activities. With the initiatives that we're doing on the platform side, there is lots of profitability improvements that we can do on our production cost in general for Educational Products. Then, of course, as you say, with increasing volumes, we can distribute the work over more units if we are efficient. That will definitely help.
Then your second question, I think, was more around the kind of state of the business in general for Educational Products. And here we, I think, see a mixed picture, I would say. Certain markets are growing very strongly, as we recorded 45% or 46% growth in EMEA last quarter, for example. And other markets, such as our important U.S. market, have more of a sluggish development. And here, what we are trying to do is, of course, to have specific plans for each and every one of these markets. But of course, we cannot expect the same kind of growth rates right now from where U.S. is today in the type of development that they have up to EMEA.
One of the things that have really worked well, even in economic difficulties, if I look back at my experience, is that if you launch new products, even if it's a sluggish budget situation or sluggish economy, there can be a very high new product pickup also in tough markets. So that's why we believe a lot in launching new products as a vehicle to drive sales, both in markets that are doing great and markets that are doing not so great.
And just what about forward integration? It looked like your acquisition of Intelligent Ultrasound was a bit of sort of portfolio acquisition, but it was also you're buying a market space in the U.K. Are there more markets that you're open up to taking over from distributors? What's your take on it?
No, I think that on the industry side, we have a very clear key account direct strategy, and we will keep that because it's fewer customers, fewer accounts, and they require quite a high professional and sort of relation with many different counterparts of Surgical Science interacting with the customer. We strongly believe in the distributor model for educational because it's a model that we can get a large coverage, as Niclas said, more than 90 distributors globally. And we can also use this model as we have five different market segments, so we can create separate subdivision, subsegments of distributors depending on the different segments that we target because the customer groups are fairly different. So it's definitely so that we want to keep on working with the distributor model.
We do think that with some of the efficiency methods or projects that we're running, we will actually become quite profitable in doing so as well.
Carl Armfelt, TIN Fonder. You mentioned you want to scale on software. Historically, you kept the physics engine separate after the acquisitions and kind of had a last meter integration in the software. Is that changing? You want to scale more? Can you just add some more detail on that?
Yeah. We have, because of the acquisitions that you point out, we've sort of come with different tech stacks on the software side and on the hardware side, of course, into the company. And then there has been some integration being done, as you point out, but not kind of to the full extent possible.
I think one of the key parts of this plan now, as you could see on the OpEx slide with platform, is to consolidate the number of physics engines even further. The main reason for that is to be able to handle more customer projects concurrently and use more of the software assets that we have. Also, the entire team is trained on one specific engine so that all the different improvements and work goes into the same bucket, so to say, and benefits all of our customers. It's definitely the ambition, and this is a work that has been ongoing for the last, I would say, nine to 12 months. It's accelerated now with a new strategy to try to reduce the number of engines, for sure.
That is also one of the reasons to why we'll be able to keep an even higher innovation pace here going forward. Both that and kind of focus on five different areas, is that like a reorg starting today or something you already initiated? No, we are quite happy with the organization that we have right now. We haven't spoken about that specifically here, but we have a functional organization with a head of each of the departments. So we have the finance department, the sales department, the R&D, the product marketing, and so on. For the company with the size that we are in, around 300-350 people as we are today, we feel that this is the adequate and most efficient organization.
Then, of course, as you grow, especially on the business segment side, these five segments that we have noted, you could over time see that these become more divisions or business areas within the company. It's very, very critical that you do that at the right timing so that you don't introduce a lot of inefficiencies organizationally, but rather do it when the time is right. We don't think that the time is right for now. Now we have a great organization, and I think that the main challenge for us now is to manage these cross-functional projects across these functions that we have. That is something that we put a lot of emphasis on, and we think we are handling it pretty okay.
Thank you. Viktor Westman from Rede ye Capital.
I was happy to see the decision to change the listing to the main market, and then I was equally disappointed when you told us that the reason was changing the listing just for the sake of it. I would have thought that share buybacks would be a no-brainer on today's valuation. So my question would be, what would it take for stock buybacks to be the top priority on the agenda?
Anna?
It was on the list, so it's definitely there and a tool, again, that we would like to have. And then, of course, you need the AGM's approval, and it's a board decision. But it's definitely a tool that we would like to have.
Shall we take a question from the chat?
Yes. Let me see.
Maybe a bit in line with your questions, Simon, but still, in which market segment do you see the highest growth potential, and which segment do you expect to be the primary driver in achieving the overall growth target for the company?
I think that the smallest market segments are, of course, the ones where we will have the highest growth rate just because of the simple mechanics of it, right? So emergency medical simulation and also ultrasound. We're starting from very low levels there. But then I think that when it comes to the segments that will have the highest impact on kind of reaching our overall sales growth target, it will definitely be minimally invasive surgery simulation, medical device simulation, and robotics simulation because they are the biggest ones. And both robotics and med device, we have this stronger growth rate.
I do think that if we are successful with the strategy of expanding the market, there is a very big upside also in minimally invasive surgery simulation just because of the fact that we still have a very low penetration in this segment. But I think the proof is in the pudding here, and it will take some time before we can see those kind of revenue growth accelerate to a different level than they are today. On top, we have some macroeconomic factors that are working that we have to take into consideration.
We have a question. Should we expect a scenario in which hospitals decide to only go with one RAS provider, meaning robotic surgery provider, given the complexity of training on several different robot simulations?
I can start here, and perhaps you can chime in, Niclas.
But what we see in the market is that there is a clear need for alternatives to the incumbent robotic surgery supplier and that hospital management and also surgeons welcome the newcomers that come in, not perhaps only because it provides more competition and better price points, but we definitely think that the OR of the future will have several different robotics platforms, two, perhaps in some cases even three different robotics suppliers. And the third one will be for specific applications that the two general robotics suppliers cannot handle. So we believe that that is what's going to happen. I don't know, Niclas, do you want to comment further on that or?
Yeah, I mean, in the markets where there is public tender, in the markets where it's public tendering, the hospitals can't choose. And we see that across Europe and in some other spaces as well.
When you look into the current alternative and the options that will come, it's going to be a drive for having multiple platforms. I just want to take the opportunity while standing up here to respond to the question about fidelity or haptic feedback. It's on the market, actually, a non-issue because from the robotic platform suppliers, they don't want the training device to be so similar to the real thing, so to speak. It causes a problem with muscle memory and that the trainees believe that they can fly the real plane, so to speak. We have a number of projects with the industry with this platform when we will configure it with, as Tom said, new grips, etc. Fidelity or haptic feedback has never been an issue.
Great.
Thanks.
Yes, we've gotten here again.
We have a ton of moving parts here, two operating segments, but a ton of products. You talk about improved profitability for Educational Products coming from different angles or sources. Wouldn't it make sense for you to get a bit more transparent and start sort of reporting a contribution margin per segment for us, enabling sort of to track the development going forward?
Yeah, you're absolutely right that this is the first time we actually actively started speaking about the different profitability levels, relative profitability levels of our different segments. We haven't done that before, right, on one of the early slides that we had here in the presentation. And we think that it's important right now to say these are the areas where we have profitability improvements. But then, of course, as these grow, I spoke about divisions and larger business units as this company grows.
Then, of course, we will also start tracking these financially. But it doesn't make sense with a small P&L that we have today and the number of shared resources that we have across these segments to do it. The most important thing that we should do for the segments right now is to make sure that we can have great and amazing products for each of the different segments, and we can make sure we have strong sales activities and marketing activities for each of the different segments. And then, of course, internally, yes, we will monitor this and make sure that we have this ambition, as I said, to work towards this ambition to have each of the segments profitable and contributing to the profitability. And then at some point, I don't know, we will probably open up and divulge a bit more.
But rest assured that this is an internal very, very strong focus.
Definitely. We add more details as we go.
And to your point, I think also just we think that it's important to show the complexity or show the different parts of our business and go deeper and explain the different segments because it is actually five different businesses within the business, as you can understand, instead of trying to hide it on a higher level because then it's possible for you to actually understand the company. Even if there's a lot of moving parts, you can do your own reasoning in a better way than not being transparent.
Erik Sprinchorn, TIN Fonder, going to the smallest business area then, Emergency Services.
I guess just to get a feel for the ultimate risk scenario, right, is that you have this fantastic order, which you complete with success or not, but then there's nothing more because we don't know. We haven't seen it, and the upside is, of course, that every rescue worker in the world has to perform some kind of training like this, so since you bring it up as a business segment, is it even feasible that this would just fizzle out and become nothing? Or what's your feel?
It's a very good point, and you know, as we said, that it's less than 5% of the company turnover, so it represents a very, very small part, right, and as we were also very clear about, we started this when we got this order from the Southeast Asian company.
And then we had a strategic goal, a strategic objective to bring up new businesses because we think that our technology is applicable and valuable in broader segments than just this one. But to your point, it is a different discipline to bring up small businesses rather than to work on improving existing businesses, right? So you have to do it right. Both you have to set the expectations right, and we have been very clear that this is an incubation and we need to take it to the next step. And in terms of financial forecast, we have not kind of allotted a lot of revenue upside internally when, for example, devising these targets into that segment. And then it's about making sure that you have a dedicated team, making them work individually, making sure that you reach product-market fit, making the customer super happy.
But of course, at the same time, having a strategic perspective of this is the market, as you could see, it was very, very big, right? And it starts with one happy customer and one customer who is returning and comes back and perhaps even sells it to another department within the same country and so on. So that's how it starts. So as I said, we have a huge pipeline or a big pipeline already with similar customers. So we feel pretty positive about this, but we are also very careful of not kind of making this into a too big thing. But we think it's important for you to understand that this is one of the areas that could have a very big potential here going forward, but also speaking transparently about the time it will take until this gets significant. Does that answer your question?
Yes, it warms my heart since I'm one of the few people who have actually tried out the product before it was launched and critically failed at doing so.
Yeah. Yeah, and in order for us to get into the bigger part of the pyramid and go deeper in the market, then you can't launch half-mature products. Then you have to really nail it in all the different aspects. It becomes more of like a consumer product, for example. This looks like an Xbox. It should behave like an Xbox when I open it. Same thing with this one. So we are definitely aware of the ambition level that we have to have internally to reach these markets.
Okay, let's just take one more question from the people joining us online. How far along are your customers today in adopting continuous learning workflows?
Are you seeing tangible commercial demand for continuous learning modules today, or is this primarily a forward-looking opportunity you are investing ahead of?
So our customers today are adopting continuous learning workflows in that sense that certain associations and societies are asking their surgeons to certify us on a specific procedure. In that case, you could say that they have to do this continuously, but it's still very few associations and societies that are doing it like that. And in many cases, sort of our customers are hindered by the fact that what's available to them is what is available in the software modules that we provide to them. There is no kind of infrastructure or process around.
That's why it's so important to work on the medical affairs, to work even deeper with these associations and societies to build these continuous learning workflows out and also to really improve on our LMS and our cloud solutions so we can provide that kind of learning journey ourselves, right? And that is something that is a big focus for us. So you don't do this kind of one-type training, but rather revisit the simulator and revisit the LMS again and again and again. And the utopia or the dream is, of course, when you merge these two together. And our learning journeys coincide with the mandated certification processes of the societies and associations. So you can actually learn and perhaps also get accreditation and certification with the LMS of Surgical Science.
So I think you're pointing to one of the most strategic topics that we have internally in the company, which we are both pushing, taking a lot of action on. Thank you.
Thank you. And with that, I think we will conclude our Capital Markets Day 2025. Thank you to the team behind the scenes, all of you who joined us here today, and those of you who followed us online. We truly appreciate your commitment. Thank you and goodbye.
Thank you.