For Brian Miller, his appointment to CEO of robotic surgery company Sovato in April 2026 was a culmination of a journey up the ranks in health tech. From work on the first transatlantic remote surgery between the U.S. and France, called the Lindbergh Operation, to the first FDA-cleared robotic systems at Computer Motion in 1996, Miller has had an impressive career of more than 25 years in surgical robotics and digital innovation.
Before Sovato, Miller was head of digital and AI strategy and chief digital officer at Intuitive, maker of the da Vinci robotic surgery system. Miller joined Sovato because its cofounder and executive chairman, Yulun Wang, is also the founder of Computer Motion, where Miller used to work.
Close to one-third of people in the U.S. lack access to interventional radiologists in their county, according to a 2023 study in the Journal of Vascular and Interventional Radiology. That shows a need for surgical robotics, according to Miller.
“We've now come to a point in time where you are starting to see a real need for physicians to be able to perform procedures across distances,” he says.
Miller shared with Dice some highlights from his career in surgical robotics and provides advice to tech professionals interested in health IT and surgical robotics on what skills they need to succeed.
The First FDA-Cleared Robotic System at Computer Motion
Back at Computer Motion, Miller developed specifications for groundbreaking robots.
“It was an exciting time because we were inventing things that never existed before, and so [we were] trying to work with physicians to understand what the spec is for the product,” Miller says.
Computer Motion looked to Miller to get the first robotic system FDA-approved. The company also wanted Miller to oversee a remote procedure that would take place from New York to Strasbourg, France, about a year later, in 2001, in which a patient’s gall bladder was removed.
“As a young engineer, that really made an impression on me,” Miller recalled. “Robots at that point in time weren't even for surgery, weren't even proven out, and so they were early on.” Today, robotic surgery clearly delivers outcomes that are better than ‘open surgery’ and what’s conducted in the lab.
In 2003, Computer Motion and Intuitive Robotics merged, and that’s how Miller landed at Intuitive.
Miller led robotic development for Intuitive and oversaw a shift in robotic systems from simply communicating via the internet to actual telepresence sessions for remote surgery. The robotic systems at Intuitive provided both an endoscopic view of procedures and also guided experts through the procedures visually.
Robotic surgery has evolved from relying on fiber across the ocean in 2000 to now using existing infrastructure to guarantee performance, according to Miller.
“It's leveraging infrastructure that exists, but we're able to do it in a way where we can guarantee the performance that's needed, we can guarantee bandwidth, and we can guarantee latency and jitter, things where you need a controlled environment if you're going to be doing surgery,” Miller says.
Essential Skills for Surgical Robotics
At Intuitive, Miller and his team built a virtual reality simulator to help surgeons and care teams learn how to use the robotic surgery system. Intuitive also provides hands-on training in labs.
Miller describes the skill set needed in surgical robotics as multidisciplinary. That includes mechanical engineers, electrical engineers and computer scientists that program robotic systems.
“Even if you're an expert in a deep area, say mechanical engineering, you also need to make sure that you understand how all the other pieces fit together from all the other disciplines, and you need to understand the clinical application that you're trying to solve for,” Miller explains.
The best engineers are “system thinkers,” he says. That means they can understand the broad picture and the goals of what they’re trying to accomplish.
“You need really deep thinkers, really deeply talented engineers in all these different areas, but they're always much more successful if they've got a little bit of a breadth and depth in their knowledge,” Miller says.
Another key area for robotic systems that’s “table stakes” is network connectivity, he stresses. That means networking skills are needed to build high-performance networks to connect the robotic systems.
Miller described how the da Vinci robots worked before they had network connectivity and AI intelligence.
“You had a bunch of different instruments you could use, but it had no clue what procedure was being performed, and so it had no context to be able to help guide the surgeon in a way that they could add some value,” Miller says. “You start adding network. You start adding AI. Now, all of a sudden, you can have the physician and the robot doing the surgery together.”
The robotic system provides context to ensure that physicians performing a procedure such as a colectomy know what needs to be done in a particular phase, he explains.
Meanwhile, AI engineers are needed to train models used for clinical-decision tools and integrated in physical AI, where the algorithms enable autonomic robotic motion. Surgeons are the professionals that interact most directly with robotic systems, and an operating room (OR) team sets up the robot as well as changes instruments during a procedure.
Advice for Tech Professionals Considering a Career in Surgical Robotics
Today, surgical robotics has taken off, and the skills to operate these platforms are in demand.
Tech professionals entering surgical robotics should have a “risk-based mindset” given the medical risks from operating these systems, Miller says.
“It’s a way to think through how you design a system,” Miller says. Risk-based planning includes redundancy, or a failover system. A potential danger of the failover system failing is patient harm.
“You have to put yourself in that mindset, and then you use the technical skills and tools that you have, but you have to think about it in terms of a risk-based framework,” he says.
The failover system also includes dual sensors. If they detect a problem, robotic systems can shut down into a safe state and then physicians can revert back to surgery without the robotic system.
“That's ingrained in how the system is designed, how the system is tested, and an extremely important part of making sure that that you're building a safe device that can detect if something's not right, shut it down into a safe space, and allow the surgical team to do what they need to do and convert to a different modality,” Miller says.
Miller had a strong technical background before becoming a tech CEO, which is helpful in understanding how systems work.
“It does help — because you know the engineers and people they can't pull one over on me,” Miller jokes.
“To be a good leader, you've got to help your teams bridge that gap and explain it in that way because otherwise, you're going to build technology for the sake of technology, and it's going to miss the mark, and then you're in trouble,” Miller says.
Still, for up-and-coming tech professionals looking to become a leader in health IT, a user-centered design will be important, according to Miller. A trap for people undertaking a career in tech is to get too involved in the technology and not understand the system they are enabling, Miller explains.
If there are four or five clicks that allow surgeons to operate a robotic surgery system, health IT leaders must understand how it works, according to Miller.
“You go in the operating room and you have somebody that's supposed to be paying attention to the patient. They're trying to help over there. They're trying to make a change,” Miller explains. “Those four clicks do take time, and it takes focus away from the patient.”
Once the products hit the market, surgical robotics leaders will need to adapt the product to users’ needs, he says. In addition, iteration will be important to address problems in the robotic systems as you go along.
Another strategy that’s important for tech leaders going forward is, of course, relationship building. As Miller takes Sovato’s surgical robotics system from early market development to an early 2027 launch with health systems followed by broader commercialization, he will draw on his relationships across the industry as well as with health systems and clinical leaders. Bringing together AI engineers as well as clinical leaders will be key.
“It's kind of morphed as the capabilities have started to grow to a point where you really have skill sets across the board, at least in my experience,” he says, “between the telecom industry and networking, AI, and then kind of the hardcore mechanical, electrical, computer, and programming for the robot itself.”
