Foreign academician of the Chinese Academy of Sciences, selected in the Thousand Talents Program, and recipient of the Chinese Government Friendship Award, Toshino Fukuda is running for the 2019 IEEE President. This is the first time an Asian is running for the IEEE presidency. Professor Fukuda has made significant contributions to academic exchanges and cooperation between China and the world over many years, and IEEE members and colleagues in the robotics industry can vote to support him, expanding Asia’s influence in IEEE.
IEEE website:ieee.org/elections
Voting:Directvote.net/ieee
Voting period:2018.8.15-2018.10.1 EDT USA time 1 PM, UTC time 5 PM
Researchers at the Medical Robot Research Institute of Shanghai Jiao Tong University demonstrate a laparoscopic minimally invasive surgical robotPhoto by Liu Ying/This journal
“Finding deep blood vessels is difficult; doctors mainly rely on experience to puncture patients. Now, with our ultrasound navigation puncture-assisted medical robot system, we can see the location of blood vessels on the real-time ultrasound image screen, and based on the puncture path planning and navigation system, assist medical staff in easily completing precise punctures and guidewire placement for blood vessels 1-3cm deep.”At the World Robot Conference, Zhang Bo, an associate researcher at Beijing Institute of Technology, introduced the research team’s achievement—ultrasound navigation puncture-assisted medical robot.
The neurosurgical navigation robot incubated by Beihang University and the Da Vinci surgical robot from Intuitive Surgical in the USA also attracted many eyes.
One of the important pioneers in the field of medical robots, Professor Taylor Watson from Johns Hopkins University believes that the collaboration between human clinical doctors and computer technology will fundamentally change the way surgery and interventional medicine operate in the 21st century, just as computer technology changed manufacturing in the 20th century.
Medical robots can provide more precise, non-invasive services and have become a research hotspot of concern in various countries.Compared to developed countries like Europe and the USA, the development of medical robots in China is still in its infancy, and commercial applications need to overcome multiple obstacles.
The medical robot industry is catching up
According to a research report by the International Federation of Robotics (IFR), in 2016, the European medical robot market accounted for 52% of the global total market, followed by North America, with a share of 46%.The US medical robot industry is leading globally, with more than 30 companies developed, possessing excellent R&D teams, original core technologies, and has transitioned from early research to product development and market promotion.Most of China’s medical robots are still in the R&D or clinical trial stage, and have not formed a scaled industry.The penetration rate of medical robots in major hospitals is also relatively low, with a significant gap compared to developed countries. However, in some areas, Chinese scientists have already made substantial technological accumulations.The Da Vinci robot from the USA is the leader in laparoscopic surgical assisting robots.Currently, there are 72 Da Vinci surgical robots performing surgeries in China. Due to high technical barriers, long medical device certification cycles, and intellectual property protection, there have been no products launched in this field in China yet. Bian Guibin told the Outlook Weekly reporter that in the field of ophthalmic surgical robots, domestic and foreign developments are basically synchronized. “In 2016, at the Cambridge University Hospital, foreign experts performed a surgery to remove the epiretinal membrane using a robotic arm under the microscope. Our development is for four types of ophthalmic surgeries such as glaucoma, cataracts, and retinal diseases, with a three-dimensional imaging system and independent intellectual property rights.” In 2015, Liu Da quit his job at Beihang University to start a business, focusing on the industrialization of neurosurgical navigation systems. He told reporters that the technology for developing neurosurgical robots in China is not behind that of foreign countries; as early as 1997, the teams from Beihang University and the Navy General Hospital of the PLA jointly developed a brain surgery robot-assisted positioning system and conducted the first clinical experiment. “In 2014, foreign neurosurgical robots were launched. Although the proportion of hospitals and departments using surgical robots in the domestic neurosurgery field is not large, the product has been deeply integrated into the domestic clinical environment since the early R&D stage, incorporating much feedback from doctors during the product iteration process,” Liu Da said.
Industrialization must be built on technological accumulation
Medical robots encompass subfields such as surgical robots, diagnostic and therapeutic (diagnosis, intervention, radiotherapy, capsule) robots, rehabilitation robots, and transport care robots.Surgical robots are the cutting-edge products in the robotics field, with very high technical barriers and R&D manufacturing costs. Bian Guibin has been developing robotic systems for puncture, vascular intervention, and other surgeries since 2007, with over ten years of technological accumulation. “The ocular microscopic surgical robot system we are currently working on is based on previous technological research; we have made a prototype and hope to produce an experimental prototype in the next two years, complete animal experiments, clinical experiments, and develop a clinical product in the next 3-5 years.”There is no shortcut to overcoming core technical challenges; the Da Vinci robot took 14 years from laboratory to product and industrialization.“Applying robots to the human body is a very complex process; it requires a lot of time from laboratory to human trial, and must be done step by step.” Brad Nelson mentioned that developing robots requires significant public investment, so they are very focused on future commercial potential, considering how many people can benefit from it, the patent holdings in the field, and integrating all factors to formulate a feasible business plan.
CFDA is the certification for Class III medical devices by the National Medical Products Administration, obtaining the CFDA registration certificate means the product can officially enter the market for sale. “From 1998, when the Beihang University Medical Surgical Robot Research Team undertook the national ‘863’ program project for original technology accumulation, to 2018, when it passed the CFDA review and became the first officially approved neurosurgical robot in China, we took 20 years. During this period, countless industrialization challenges were encountered,” Liu Da said.
“To ensure the camera inside the capsule takes clear photos, we must ensure that the transparent cover of the capsule head is not contaminated by gastric mucus. To solve this problem, we experimented with hundreds of coatings. To prevent the capsule robot’s outer wall from being corroded by gastric acid, we continuously experimented and ultimately chose high molecular medical materials to make the surface smooth and strong.” The main developer of this robot, Xuandan, told the Outlook Weekly reporter that to ensure safety, the capsule endoscope robot must be tested by a third-party testing agency, undergoing a series of rigorous tests for corrosion resistance and pressure resistance in environments worse than gastric acid. Xuandan and Liu Da are both researchers who transitioned from the laboratory to industrialization; in their view, the mindset for research and product development is different. In developing surgical robots, the safety requirements are higher; otherwise, they cannot become products. “In scientific research, we continually apply for projects; if one direction doesn’t work, we can change to another; it’s not life or death. In business, there is only one way: you must survive,” Liu Da lamented.
How to make patients able to use and afford them
Using domestic neurosurgical robots incurs an additional cost of about 8000 yuan per surgery, Liu Da frankly stated, that their products are currently being promoted clinically in 14 top-tier hospitals, but the first problem encountered during promotion is the medical insurance and charging issue; without insurance reimbursement, the clinical application of surgical robots is very limited.How to make ordinary patients able to use and afford medical robot products has become a bottleneck restricting the development of medical robots in China.Incorporating medical robots into medical insurance, Shanghai has already begun to explore—after incorporating the 3760 yuan “magnetic control capsule endoscope” robot into medical insurance, patients only need to pay about 1000 yuan out of pocket.Combining medical insurance with commercial insurance, in Xuandan’s view, is a feasible way to reduce the cost of using medical robots. “We are currently cooperating with insurance companies to explore gastrointestinal insurance types, setting the capsule robot inspection cost plus insurance to over 5000 yuan; if the capsule robot detects malignant tumors in secondary hospitals or above, there will be a reimbursement of up to 200,000 yuan.” Xuandan said that national policies need to encourage innovation, and medical insurance should support commercial insurance as a supplement to further address medical needs.Experts believe that national policies still need to be refined, and support for emerging industries, especially those with independent intellectual property rights, should be implemented.The “Robot Industry Development Plan (2016-2020)” proposed supporting the promotion of robots included in the “Guidance Directory for the Promotion and Application of Major Technical Equipment” through the insurance compensation mechanism for the first major technical equipment. However, due to the lack of detailed rules for practical operation, policies are often difficult to implement.
☞Article source: Outlook Weekly reporter He Yongshun
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