SS Innovations: Indian NASDAQ-Listed Surgical Robotics Firm Reports 251.5% Revenue Surge Amid Breakthroughs in Cardiothoracic Robotic Surgery

July 19, 2025,Dr. Sudhir Srivastava, an Indian surgeon and founder of SS Innovations, manipulated robotic arms via a screen to perform the world’s first intercontinental remote robot-assisted cardiac surgery from thousands of miles away., drawing global attention. How did this seemingly obscure Indian company manage to break through the technical barriers in cardiac and thoracic surgical robotics?

Three months ago, SS Innovations listed on the Nasdaq with its laparoscopic surgical robot, SSi Mantra. Leveraging a tripartite architecture of “hardware platform + ecosystem synergy + mixed reality,” the company aims not only to establish a presence in tens of thousands of hospitals across India but also to deliver advanced medical equipment to underserved regions in Africa, South America, and other areas with scarce healthcare resources.

In 2024, SS Innovations saw its revenue surge by 251.5%, yet its net loss still exceeded $19 million. With R&D spending, equity incentives, and capacity expansion continuously burning through cash, how does this newly Nasdaq-listed company balance “high growth” with “persistent cash burn”? And can it survive the critical challenge of maintaining liquidity?

Currently,Laparoscopic Surgical Robot SystemWidely recognized globally for its ability to enhance efficiency, improve clinical outcomes, and reduce healthcare costs, but itsMarket penetration remains very limited in less developed countries and regions.Due to high system costs, significant technical barriers, complex and evolving regulatory approval mechanisms in developing countries, companies’ natural preference for prioritizing markets in Europe and the United States, and insufficient market ecosystem maturity in less developed regions, the use of surgical robot systems remains largely confined to developed countries and regions such as the United States, Europe, and Japan.

SS Innovations’ 2024 Form 10-K annual report reveals that India has 70,000 hospitals and performs approximately 21 million major surgeries annually. However, only 10,000 to 12,000 robotic surgeries are conducted in India each year, accounting for less than 0.1% of the global total. Furthermore, laparoscopic surgery is well-established in India, which will help accelerate the transition from laparoscopic to robotic procedures. There is a significant unmet demand in India for surgical robotic systems that are affordably priced, readily accessible, and backed by after-sales support.

Based on this, SS Innovations’ initial strategy focuses on emerging markets with very low penetration rates of surgical robots. Currently, the company has built a product portfolio around its laparoscopic surgical robot system, including surgical instruments, a mixed reality platform, an integrated surgical multimedia platform, and ecosystem solutions, to accelerate the commercial deployment of this equipment in emerging markets.

SS Innovations’ core product is its third-generation multi-functional surgical robot, the SSi Mantra 3, which was launched in June 2024 and will be applied in cardiac surgery, urology, gynecology, general surgery, thoracic surgery, and head and neck surgery. The SSi Mantra system has received approval from India’s Central Drugs Standard Control Organization (CDSCO) and has undergone clinical validation for more than 100 types of surgical procedures in India.

This system is a modular, multi-arm remote-assisted surgical platform that supports the coordinated operation of 3–5 robotic arms and features a flexible patient-side docking solution adaptable to diverse clinical scenarios. Its patient surgical platform is equipped with a touch panel integrating digital operational guidelines to streamline workflows, and it supports robotic arm application modes customized for specific surgical procedures to precisely meet operative requirements. The SSi Mantra 3 imaging cart features a wide-field 3D 4K imaging system and integrates preoperative guidance applications to assist in surgical planning.

Furthermore, the system is equipped with virtual real-time imaging of the robotic patient-side cart, displaying the position and motion trajectory of the robotic arms in real time. This feature helps avoid collisions during multi-arm coordination and precisely controls the distance between instruments and tissues in confined surgical spaces, thereby enhancing operational coordination. The 3D diagnostic image overlay function superimposes preoperative 3D anatomical models derived from CT and MRI scans onto the intraoperative field of view in real time, facilitating rapid lesion localization and path optimization. It also provides guidance for novice surgeons to shorten the learning curve, collectively improving surgical precision and safety.

Furthermore, SS Innovations is deeply committed to innovation in laparoscopic surgical robotic instruments, offering more than 40 surgical tools compatible with the SSi Mantra robotic surgical system, ranging from basic electrosurgical instruments to advanced specialized instruments for cardiac surgery.It possesses unique advantages, particularly in the design and development of robotic surgical instruments for cardiothoracic surgery, and has already developed specialized cardiac devices such as bipolar forceps, short-valve retractors, and long-valve retractors.

Mixed Reality (MR) Robotic Surgery Platform SSI Maya, focusing on the vision of “The Future of Digital Healthcare,” and integrating cutting-edge technologies such as Web3, artificial intelligence, and holographic imaging, it provides innovative solutions including 3D holographic DICOM imaging, immersive preoperative training, AI-based anatomical segmentation, virtual surgery, and remote surgery, covering the entire workflow of surgical training, preoperative planning, and remote collaboration.

SSi Yantra Integrated Multimedia Surgical PlatformFocusing on the four core scenarios of “surgical video management + system collaboration + training simulation + telemedicine,” it builds a full-process digital support system for the SSi Mantra surgical robot and surgical teams, with the core goal of breaking down spatial and procedural barriers to enhance the efficiency of surgical education, collaboration, and planning. In addition, the SSi Yantra is equipped with preoperative guidance applications that provide preoperative data empowerment to optimize surgical planning for the SSi Mantra system.

SSI Sutra Robotic Surgery Ecosystem SolutionCentered on “Connectivity + Collaboration,” the platform is built around the SSI Mantra surgical robot and encompasses all key stakeholders—including surgeons, surgical teams, supervising experts, hospitals, and clinical engineers—to break down procedural barriers and optimize lifecycle management of robotic surgery.

A comprehensive overview of its full product line makes it evident that,SS Innovations is not limited to hardware performance upgrades and functional iterations. Instead, through its tripartite architecture of “Mantra (hardware platform) + Sutra (ecosystem synergy) + Maya (mixed reality technology),” it has built a comprehensive closed-loop system covering surgical procedures, workflow management, remote collaboration, and training empowerment. This approach profoundly reflects its long-term strategy of “inclusive healthcare,” ensuring that advanced technologies transcend the realm of sophisticated equipment to become accessible, easily implementable, and complete medical solutions, thereby breaking down barriers to technological adoption.

Notably, in March 2025, SS Innovations launched the mobile remote surgery unit “SSi MantraM,” aiming to provide such medical services to regions lacking access to remote robot-assisted surgery.

As of December 31, 2024, SS Innovations had installed 62 systems in hospitals, with 58 located in India and 4 overseas. According to disclosures by SS Innovations, the SSi Mantra surgical robotic system, commercially deployed in the Indian market, has performed over 3,500 surgical procedures, including those in cardiovascular surgery, thoracic surgery, head and neck surgery, gynecology, urology, oncologic surgery, and general surgery. Its latest-generation product, the SSi Mantra 3, has also received regulatory approval in Guatemala, Nepal, Ecuador, and Indonesia.

Outside India, SS Innovations’ distributor network covers Colombia, Ecuador, Guatemala, Indonesia, the Philippines, the United Arab Emirates, the Commonwealth of Independent States (CIS), the Baltic region, Greece, Cyprus, Sri Lanka, Bangladesh, Nepal, Oman, and Australia.

The SSi Mantra system features a fifth-arm capability, a unique advantage that enables it to perform complex cardiac surgeries. As the first remote surgical robot system in India to receive CDSCO approval, the SSi Mantra has successfully completed a robotic cardiac telesurgery across a distance of over 2,000 kilometers. On July 19, 2025, Dr. Sudhir Srivastava, founder of SS Innovations, successfully performed the world’s first intercontinental robotic cardiac telesurgery using the SSi Mantra 3 surgical robot system.

The founder of SS Innovations is Dr. Sudhir Srivastava, a globally renowned robotic cardiac surgeon.He performed the world’s first single-vessel off-pump endoscopic coronary artery bypass grafting (TECAB) surgery, and subsequently carried out the world’s first double-vessel and triple-vessel off-pump TECAB procedures., and he is the first physician in the world to perform a four-vessel beating-heart TECAB procedure at the University of Chicago. Meanwhile, he is also a roboticWorld Record Holder for the Most “Totally Endoscopic Coronary Artery Bypass (TECAB) on a Beating Heart” Procedures。

According to the official website of SS Innovations, SDr. Rivastava Has Performed the Highest Number of Robotic Cardiac Surgeries Worldwide. Its forward-thinking innovation and extensive accumulation of surgical expertise drove the creation of the SSi Mantra system. Empowered by the clinical experience of cardiac surgeons, the SSi Mantra excels in identifying clinical pain points, aligning with surgeons’ operational habits, and enhancing clinical adaptability.

To date,SSi Mantra has successfully completed over 5,000 surgeries without any device-related adverse events. This includes 250 cardiac surgeries and 35 remote surgeries.(including 10 cardiac surgery cases), it demonstrates excellence in telesurgery and complex soft-tissue procedures, and is expected to accumulate proprietary data in cardiac surgical techniques.

As of2024Year12Month31Day,SSi MantraNumber of Surgeries Performed

According to ResearchAndMarkets, the global market for cardiac surgery devices was valued at $17.1 billion in 2023 and is projected to grow at a rate of 5.5%, reaching $24.9 billion by 2030. The global surgical robotics market was valued at $78.8 billion in 2022 and is expected to reach $188.8 billion by 2032, with a compound annual growth rate (CAGR) of 9.1% from 2023 to 2032.

Currently, cardiac surgery indications represent a key challenge that laparoscopic surgical robots are striving to overcome, characterized by high technical barriers and substantial market potential. If SS Innovations can achieve breakthroughs in this field, it will establish significant differentiated competitive advantages for its products. Meanwhile, cardiac surgery has long been recognized as the “high ground” of medical technology; such a breakthrough could help SS Innovations reduce its reliance on the domestic Indian market, enter high-end markets and top-tier global medical centers, and even export its technology to regions with abundant medical resources but high cost sensitivity.

In its 2024 Annual Report on Form 10-K, SS Innovations stated that the Company is still in the early stages of generating revenue through product sales and has not yet established a stable stream of operating cash flows to cover all fixed operating costs; therefore, it may continue to incur losses for the foreseeable future.

Comparison of the Annual Financial Position as of December 31, 2024, with That as of December 31, 2023

In 2024, the company’s revenue reached US$20.6495 million, representing a 251.5% increase from US$5.8753 million in 2023, marking explosive growth.

Comparison of Revenue Breakdown by Source: 2024 vs. 2023

Furthermore, compared with 2023, the company’s core revenue streams all demonstrated significant growth in 2024. System sales increased from USD 5.2258 million in 2023 to USD 19.4578 million in 2024, representing a year-over-year increase of approximately 272.34%; surgical consumables sales rose from USD 647,800 in 2023 to USD 942,500 in 2024, an increase of approximately 45.50%. As the primary revenue source, system sales maintained triple-digit growth, reflecting the rapid advancement of the company’s product market penetration.

Notably, compared with 2023, “lease income” was added to the total revenue in 2024, amounting to $71,700, indicating that SS Innovations’ business model has become more diversified, which will further lower the customer entry barrier.

SS Innovations’ R&D expenses amounted to $2.4918 million in 2024, compared with $1.0587 million in 2023, representing a year-over-year increase of 135.36%. This aligns with the company’s ongoing commitment to enhancing the design and technical capabilities of its existing SSi Mantra system and further expanding its product offerings.

For the year ended December 31, 2024, the Company recorded a net loss of $19.1512 million, representing a narrowing compared to the net loss of $20.8783 million for the year ended December 31, 2023. The primary driver for the reduction in net loss from 2023 to 2024 was a $7.7268 million increase in gross profit, which was partially offset by a $4.6193 million increase in stock-based compensation expense. Meanwhile, net interest expense decreased by $429,100, declining from $604,300 to $175,200.

In the surgical robotics sector, characterized by high R&D barriers and long return cycles, SS Innovations is in a “market breakthrough phase.” Its rapid revenue growth validates product potential, but sustained investments in R&D, talent (equity incentives), and production expansion have made it difficult to curb losses, necessitating long-term capital support.

Currently, the installed base of the SSi Mantra surgical robot system has surpassed 100 units in India and other regions. In terms of market strategy, SS Innovations has adopted a strategic logic of “first solidifying its domestic stronghold,” with over 90% of its revenue derived from the local market.

For the years ended December 31, 2024, and December 31, 2023, revenue generated from within India accounted for 92% and 91% of SS Innovations’ total revenue, respectively. In India, a country with one of the largest populations globally, the company is well-positioned to gain a first-mover advantage by leveraging its early entry through R&D and cost advantages.

Revenue by Geographic Region (Based on Customer Location)

Secondly, SS Innovations has expanded its market to populous countries, neighboring nations with urgent needs for healthcare upgrades or similar medical systems, focusing on “low-barrier, high-synergy” markets. By leveraging reusable certifications, channels, and service systems from India, along with the core advantages of “low price + basic functionality adaptation,” it has entered cost-sensitive markets.

Overall, overseas revenue accounts for less than 10%, underscoring the challenges SS Innovations faces in its international expansion and globalization efforts. Moreover, entering emerging markets solely through a “low-price” strategy risks trapping the company in a vicious cycle of “price wars–margin compression–insufficient R&D investment–technological lag,” leaving it unable to withstand the “asymmetric competitive pressure” exerted by global giants.

As disclosed, the company expects to submit a De Novo classification request for the SSi Mantra to the U.S. Food and Drug Administration (FDA) by the end of July 2025, covering multiple indications, and plans to initiate the application process for European Union CE marking as early as possible in the second half of 2025. However, Intuitive Surgical holds an absolute advantage in the European and American markets, with deep integration into hospitals across these regions.To achieve a breakthrough, SS Innovations must continue to exert effort in the areas of technological differentiation, clinical credibility, regulatory barriers, and localized ecosystem partnerships.

SS Innovations Announces Unaudited Financial Results for the Three Months Ended March 31, 2025

Q1 2025 Revenue Breakdown and Summary of Installation/Surgical Volumes

As disclosed, revenue in the first quarter of 2025 increased by 40.77%, rising from $3.6377 million in the first quarter of 2024 to $5.1206 million. This revenue growth was primarily driven by increased sales of the SSi Mantra 3 surgical robot system in leading healthcare institutions in India and overseas. The gross profit margin expanded by 121 basis points, increasing from 20.02% in the first quarter of 2024 to 21.23%, mainly due to a decline in raw material prices. Gross profit grew by 49.3%, rising from $700,000 in the first quarter of 2024 to $1.1 million. The net loss was $5.7 million, with a diluted loss per share of $0.03; in comparison, the net loss in the first quarter of 2024 was $9.8 million, with a diluted loss per share of $0.06. The installed base of the SSi Mantra surgical robot system reached 15 units, representing a 66.7% increase from the 9 units recorded in the first quarter of 2024.

As of March 31, 2025, the cumulative number of SSi Mantra procedures reached 3,568.The positive trends in installed base, revenue, and gross margin have preliminarily validated the feasibility of SS Innovations’ business model for its surgical robots in emerging markets. However, substantial losses and tight cash flow persist, while an overly high proportion of equipment sales and insufficient contribution from recurring revenue streams, such as consumables, have failed to effectively support the optimization of the overall profitability structure.

From a business model perspective, the revenue of surgical robots primarily comes from equipment sales in the short term, while it relies on consumables and services in the medium to long term. Taking the da Vinci system as an example, its consumables revenue exceeded equipment revenue as early as 2013, with the gap widening thereafter, establishing consumables as the dominant revenue source over the long term. In Q1 2025, consumables accounted for as high as 61% of its revenue. Service revenue, which is correlated with the installed base of instruments, remains relatively stable, consistently accounting for 15–20%.

In contrast, for SS Innovations, system sales accounted for as high as 96.07% of total revenue in the first quarter of 2024, while consumables sales and warranty service sales represented only 3.26% and 0.26%, respectively. In the first quarter of 2025, system sales accounted for approximately 87.93%, consumables sales for 9.32%, and warranty service sales for approximately 2.39%. Although the revenue structure has improved compared to the previous year,Compared with the mature business model of surgical robots represented by da Vinci, there is still a huge gap. It will take a long time to establish the “razor-and-blades” business model and achieve economies of scale.。

Currently, SS Innovations is focused on developing the following innovative solutions to provide more advanced minimally invasive surgical solutions;

● Intraoperative Holographic Anatomy for Enhanced Visualization

● 5G-based remote surgical communication for telesurgery

● Single-arm robotic system to enhance surgical efficiency and flexibility

● Integration of remote ultrasound and biopsy to enhance intraoperative diagnostic capabilities

● Voice-controlled endoscopic assistance for laparoscopic surgery

● Intraoperative AI Assistant to Support Surgical Decision-Making

● Targeted Ablation Therapy for Precision Treatment

●Automated surgical robots to enhance surgical precision

● Visceral Microrobots for Minimally Invasive Interventions

In addition, the company is developing novel surgical instruments, such as an automatic coronary anastomotic connector for joining two arteries during coronary artery bypass grafting (CABG), the SSi multi-fire clip applier for vascular hemostasis, and the SSi robotic stapler for use in general surgery, thoracic surgery, and oncologic surgery.

Can SS Innovations turn a profit and gain a firm foothold in the international market for laparoscopic surgical robots? Time will tell.