[China Tech] Local medical experts provide boost for robotic surgery

China Tech is a column dedicated to the innovations reshaping China – and, inevitably, the world. From cutting-edge AI labs and next-gen robotics to homegrown apps that redefine daily life, we explore the breakthroughs that emerge from the country's relentless drive for technological dominance. Some are game-changers, others cautionary tales, but all offer a glimpse into the future as it's being built, at breakneck speed, in China.

Robotic surgery has better outcome

Doctors in Shanghai are the first in the world to use solid evidence and long-term research to confirm that robotic surgery has better effects than human surgery on patients with middle and low rectal cancer.

Dr Xu Jianmin's team from Zhongshan Hospital launched a research covering 1,240 rectal cancer patients from 11 leading hospitals in eight Chinese provinces and municipalities.

The three-year follow-up confirms that patients after robotic surgery had lower relapse and complications, better urinary and sexual function as well as higher life quality.

Their research findings were published by the world-leading The Journal of the American Medical Association, drawing wide attention from the international medical industry.

"Our research has been included in the latest National Comprehensive Cancer Network Guidelines Version on Rectal Cancer. It is the most influential guideline on oncology treatment in the world, and it is the first time that Chinese research was included in its rectal cancer section," Xu noted. "It is an international recognition of China's achievement in clinical practice and research."

Colorectal cancer is one of the most prevalent cancers in the world. China has the highest incidence of colorectal cancer, which is the second most common cancer in the nation, with the fourth leading mortality among all cancers. There are over 200,000 new cases each year. Both incidence and mortality are rising.

Surgery is the major treatment for rectal cancer. Minimally invasive surgery under laparoscopy is the mainstream surgery method. However, such surgery for patients with middle and low rectal cancer is a very challenging task for doctors, as the limited surgery space causes poor vision while there is a high operation difficulty, a high risk of injuring nearby organs and the likely inability to completely remove the cancer.

"Robotic surgery, which means the leading doctor operates several robotic arms to conduct the surgery, can ensure better flexibility and a more precise operation. But there was not enough clinical evidence to testify that robotic surgery is good enough to take the place of laparoscopic surgery," Xu said. "So we launched this large-scale research to boost technology updates and benefit the patients."

Due to Zhongshan Hospital's efforts, robotic surgery on rectal cancer has been included in Shanghai's government-run medical insurance, patients only need to pay 20 percent of the cost by themselves.

"We are also involved in the development of a domestic robotic surgery system to help further reduce the medical cost," Xu added.

Self-developed robotic system in supermicro surgery

Doctors from Shanghai Ninth People's Hospital, meanwhile, have teamed up with local engineers to develop the nation's first robotic microsurgery system, which has been put into clinical trial.

Microsurgery is a very delicate procedure, as it is always used for tiny blood vessel operations, having an extremely high requirement on precision, stability and persistence. It is also an important field for the expanded application of the clinical surgical robot system.

The development and clinical use of the robotic microsurgery system is an important leap from traditional manual operation to human-robot cooperation, according to Dr Zhang Yixin, director of the hospital's microsurgery center.

In a recent trial, Zhang's team launched a 0.5-millimeter blood vessel connection through the robotic system, successfully demonstrating the domestically made system's credibility and safety.

"It is the first time the system was used in a 0.5-millimeter supermicro blood vessel operation. It shows that the China-made system is in line with international level," Zhang pointed out.

"This system can greatly improve the safety, standardization and replicability of reconstructive surgery. By combining with AI and other data systems, the technology is expected to be used in more scenarios like remote surgery and automatic surgery to deeply upgrade surgical treatment."