Updates on MicroHand S
"The development of Micro Hand S took a patient-centred approach. It closely follows protocols for evidence-based medicine to complete in vitro studies, animal experiments, and clinical trials.
First, in vitro studies were conducted based on real-time movement tracking data for safety evaluation. Mapping of the robot motion was analysed to see how well it coordinates movement of the multiple instruments by the robotic arm. The study results suggest that the movement of the instruments at the slave end of Micro Hand S closely follows that of the surgeon’s operation at the master end, with minimal superfluous movement. Both ends operate smoothly and efficiently, showing great coordination. Compared with traditional laparoscopic surgery, the surgical robot uses less operating space, and the surgical knot it ties is firmer and tighter, showing higher efficiency and precision. Its greater flexibility and stability confer advantages over laparoscopic surgery3.
In studies, Micro Hand S was used to perform 200 surgeries on pigs, including gallbladder removal, liver lobectomy, gastroenterostomy, which makes a new connection between the stomach and the duodenum, as well as intestinal anastomosis. Using 5G technology, the project team also experimented with telemanipulation. In these animal experiments, the Chinese-designed surgical robot proved capable of performing clamping, separation, cutting, electrocautery, stitching, and knot tying, completing all the complicated procedures required for minimally invasive surgeries.
In 2014, with accreditation from the Association for the Accreditation of Human Research Protection Program, a phase-I clinical trial was conducted to test the safety and efficacy of Micro Hand S. By January 2019, 103 robotic procedures were performed in gastrointestinal, hepato-pancreato-biliary, thoracic, urologic, and gynaecological surgery. From simple surgeries, or those aimed for single disease treatment, the robot was gradually used in more complicated procedures requiring greater dexterity, such as gastrectomy plus D2 lymphadenectomy, which combines lymph node removal and gastric resection for treating advanced gastric cancer.
In a few cases when complications occurred, the surgical robot was able to perform repair procedures. These robotic surgeries take reduced installation time (a median of 20 minutes) and shorter operative time (a median of 245 minutes)4,5.
Based on animal studies and phase-I clinical trials, phase II trials were launched in late 2019, with approval from China’s National Medical Products Administration. These are prospective, randomized, single-blind trials with paralleled intervention and control groups for comparing safety and effectiveness. A total of 84 gallbladder surgeries were performed, half by Micro Hand S, and half by the da Vinci system. The main indicator for success was the rate of change into non-robotic surgeries during the operation. Operative time, bleeding levels during operation, post-operative pain, bowel function recovery time, length of hospitalization, an index for complications, and rating for robot performance by the operating surgeon, were also considered in the study. The two groups appeared to show similar results in the comparison study.
Next, the project team is planning for multi-centre, prospective, randomised trials to collect more evidence for safety and effectiveness of the domestically developed surgical robot. It looks to push forward manufacturing of the surgical robot, boosting China’s industry.
The project team plans to build a national training base to educate surgeons about the use of the surgical robot, promoting its broad use. Plans are also made to establish a clinical data centre, by collecting big data on the use of surgical robots, and using AI algorithms for analysis, to guide further upgrade of China’s surgical robot, optimizing its performance, and making it globally competitive.
The development of medical robots will also extend to systems for prosthesis, rehabilitation, psychological rehabilitation, personal care, and health monitoring, which, along with surgical robots will be the emphasis of future research focuses"
"In the past, limited by the lack of technological innovation capabilities and the inadequate integration of production, education, research and application, the technical competitiveness of China's high-end surgical robots for diagnosis and treatment equipment was weak. In order to solve this problem, the team of Professor Zhu Shahong of the Third Xiangya Hospital of Central South University and the team of Professor Wang Shuxin of Tianjin University have developed the domestic surgical robot "Miaoshou S", which can help doctors perform various operations, especially for difficult operations.
Professor Zhang Guogang, dean of the Third Xiangya Hospital of Central South University, told reporters that the biggest feature of robotic surgery is its precision. Because there is a stabilizer on the robotic arm, it can help doctors perform operations more stably and avoid surgical accidents. At the same time, patients have small postoperative wounds and quick recovery."
"On March 5, 2018, the country’s first domestic robot-assisted laparoscopic radical resection of colon cancer was successfully completed in the Third Xiangya Hospital of Central South University. The operation lasted 1 hour and 30 minutes. The patient's intraoperative blood loss was only 50ml, and he returned to the general ward after the operation. , Recovered well, and recovered and was discharged from the hospital on March 16."
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