The rise of medical robotics in China

A decent article appeared recently on RoboHub about the potential of the Chinese medical robotics industry. It is amended by a detailed PRNewswire article,   Some domestic and international development results are already used in rehabilitation, drug delivery, hospital logistics and patient transport.

"The overall development of Chinese medical robotics, in particular surgical robots, is relatively backward. In recent years, China has been dependent on da Vinci products imported from the United States-based Intuitive Surgical. As of the end of December 2015, more than 40 Chinese hospitals had installed over 50 surgical robots for fulfilling 11,445 cases of surgery in 2015 and 22,917 cases over the years cumulatively. According to diseases, Da Vinci surgical system finds main application in urology and general surgical disciplines (hepatobiliary, pancreatic, gastrointestinal, colorectal and thyroid surgery, etc.) in China, and have implemented 9,313 and 7,220 cases so far respectively, occupying 40.6% and 31.5% of the total separately."

"According to a report by GCiS in 2016, the Chinese medical robots market is valued at RMB 791million, up 34.4% from 2015. By 2021, the medical robot sector is projected to grow to at least RMB 2.2billion. From surgical to rehabilitation and homecare, robots look set to transform parts of the nation’s healthcare industry. Robots will reshape secondary care, tertiary care, even primary, home and community care. Already, surgical robots are assisting the nation’s surgeons in some high-end hospitals, and accomplishing more precise, less invasive procedures. And the sales of rehabilitation robots have boomed as hospitals improve their rehabilitation units (in keeping with government policy). But the medical robots industry in China is still emerging, with many domestic players still in the product development and clinical testing stage.

According to GCiS’ research, there are fewer than 20 active manufacturers of medical robots in China currently. But there are, at minimum, half a dozen emerging companies still at the product development or clinical testing stage, and many with a clinically tested products pending China’s Food and Drug Administration’s (CFDA) approval."

Chongqing Jinshan Science and Technology is a private Chinese company founded in 1998, with manufacturing capabilities in a range of gastrointestinal medical devices. Based in Chongqing, the company is traditionally a manufacturer of capsule endoscopes. Capsule endoscopes are pill sized cameras that records images of the digestive tract, particularly in hard to reach areas like the small intestines. In 2004, Chongqing Jinshan launched its first capsule endoscope product and, later in 2008, the capsule received US FDA approval and the CE mark."

The company is also developing a complete master-slave teleoperational system:

"It is reported that Jinshan Science and Technology has developed a minimally invasive surgery machine death, near the point of view. "The surgical system is a complete MIS system for cholecystectomy, nephrectomy, radical prostatectomy and other surgeries. Xiangdong Li said that the  mechanical arm has seven degrees of freedom, and a special equipment for manipulating the device, with a maximum load capacity of up to 2 kg, and with 3D image system. As for the medical experience, it can make the same as the real operation, while increasing the accuracy. It may be very useful for blood vessel suture surgery, where it is difficult to perform 1 mm vascular closure, while the robot can do less than 0.1 mm accuracy." 

"Beijing Tinavi is a company listed on China’s National Equities Exchange Quotation (NEEQ). Backed by China’s Ministry of Science, the Beijing Government and the Chinese Academy of Science, Tinavi is a manufacturer of robotic guided systems designed for orthopedic surgeries. In 2010, it was the first Chinese company to be awarded the CFDA permit to manufacture its first generation orthopedic robot. Tinavi’s orthopedic robots have been installed in more than 10 Chinese hospitals, and have completed around 2000 surgeries since 2010. Tinavi’s GD-2000 model is now selling at RMB 5.4 Mn. According to GCiS, the company is growing at a rate of 150%. Its newest medical robot, Phecda (designed for minimally invasive spinal surgeries) is still pending CFDA’s approval in 2016." It targets spine and trauma applications. "In July 2016, CFDA received Beijing TINAVI's registration application for its third-generation "Tianji" orthopedic surgery robot, which is expected to be formally commercialized at the end of 2016 or in early 2017. At present, TINAVI's orthopedic surgery robots have been applied to more than 10 hospitals such as Beijing Jishuitan Hospital, and have completed beyond 2,000 cases cumulatively."

The origins of the Phecda dates back to 2005, as a Bi-plane orthopedic robot: "Zhihang  Bi-plane orthopedic robot is a robotic system developed by Beijing University of Aeronautics and Astronautics and Beijing Jishuitan Hospital. It is mainly applied to the internal fixation of femoral neck screw and internal fixation of pelvic sacroiliac joint. It can solve the problems of traditional X Ray fluoroscopy, positioning difficulties and lack of stability and other issues.  In the process of screw fixation for patients with complex fractures such as pelvic fractures and long bone fractures, the robot can help determine the position and direction of the distal screw hole after inserting the intramedullary nail into the long bone marrow cavity, thus improving the accuracy of operation." 

"Beijing Bohuiweikang Technology was founded in August 2010 by Professor Liu Da to commercialize the Remebot system. Remebot is a stereotactic neurosurgery robot system comprising of a six axis robotic arms, and a CT/MRI compatible visual imaging system which will enable surgeons to perform more accurate and less invasive neurosurgical procedures. Remebot was developed by Professor Wang Tianmiao and his team at Beihang University in 1998. Even though Remebot completed its clinical testing and the first telesurgery in early 2000s, the technology did not reach the commercialization stage earlier due to a lack of funding and disputed IP issues."

"In addition, Tianjin University has put its minimally invasive surgical robot system "Smart S" into clinical application and prototyped three models of "Smart S2" which are expected to be mass-produced at the end of 2016 or in 2017. Neurosurgical robot Remebot, the 6th-generation product co-developed by Navy General Hospital and Beihang University (Remebot responsible for industrialization) came out and was specially accepted for approval by CFDA in 2015 and is expected to be granted approval certificate at the end of 2016. It targets neurosurgical procedures, including SEEG for Parkinson treatment. "In December 2015, Remebot Medical Robot (for frameless brain stereotactic surgery system) announced the green light for its "innovative medical device special examination and approval of the results of the examination results announcement (2015 8)", having passed the expert review." 

Remebot had been preceded by many earlier experiments and prototypes:

"The earliest operation of the robot to try to start from 1997, by the People's Liberation Army Navy General Hospital of neurosurgery expert Dr. Tian Zengmin and Beijing University of Aeronautics and Astronautics robot expert Professor Wang Tianmiao led. The neurosurgical robot using PUMA 262 passive five joint manipulator, in 1998 into the national 863 project. The latest generation, called Remebot, is currently in clinical use." 

"Moreover, Remebot has started CE certification. The Laboratory of Robotics and System of Harbin Institute of Technology (affiliated companies: Boshi Automation and Harbin Sizherui Intelligent Medical Equipment Co., Ltd.) is expected to apply for product registration for its minimally invasive celiac surgical robot system at the end of 2017. Jinshan Science & Technology announced in Sept 2016 that the "minimally invasive thoracic & celiac surgical robot" co-developed with Tianjin University, Suzhou University, Harbin Institute of Technology, Chongqing University, and Southwest Hospital will go into clinical stage soon." 

"Midea-Yaskawa, is a joint venture company by Midea (one of China’s leading appliance companies) and Yaskawa (Japanese industrial robot company). In August 2015, these two companies announced that they will be setting up a joint venture in China to produce a range of nursing care and rehabilitation robots for the domestic market. In March 2016, this joint venture was officially set up in Guangdong Shunde. This JV will oversee the product development, manufacturing and sales of Midea/Yaskawa’s robots in China. In the initial stages, it is likely that this company will front the sale of Yaskawa’s existing product lines like the LR2 Lower Limb Physical Therapy robot launched by Yaskawa earlier in 2014. Other possible products could also include Yaskawa’s Rewalk exoskeleton suit and ankle walking assistive device. Depending on the approval of China’s FDA, some reports estimate that these products might be available sometime in 2017."

"Shenzhen Sanggu  is a subsidiary of the Chinese company Silver Star Group. Founded in 2003, Sanggu develops and supplies intravenous infusion monitoring systems and intravenous robots. Its IV robots were launched in China in mid 2016 and, within just 6 months, around 50 units were sold. Sanggu’s IV robots are used by pharmacy nurses in the preparation of medication meant for intravenous infusion, including the medication for oncology and chemotherapy. With such IV robots, medical staff no longer have to be exposed to the dangerous concoction of chemotherapy medications. They can now operate this IV robot system remotely and work outcomes can be completed with better efficiency and less wastage. The company is now rapidly ramping up its plant capacity to deal with the growing demand."

And let us not forget about Tianjin University's Micro Hand S robot, which is already in clinical use.

Source: RoboHub, PRNewsWire, Remebot