■ This is the first radical prostatectomy through extraperitoneal approach completed by Toumai^® Laparoscopic Surgical Robot. It is another important expansion of the System in clinical application in urology after Professor Guo's team completed the first partial nephrectomy through retroperitoneal approach with domestic robot in China.

■ The successful completion of the first case of radical prostatectomy through extraperitoneal approach fully demonstrates the technical strength and clinical application value of Toumai^® Endoscopic Robot in the complex and difficult surgical application of urology.

Shanghai, China --- With Toumai^® Laparoscopic Surgical Robot (hereinafter referred to as “Toumai^®") independently developed by MicroPort^® (Shanghai) Medbot Co., Ltd. (Hereinafter referred to as "Microport^®Medbot”), a robotics-specialized subsidiary of Shanghai MicroPort^® Medical (Group) Co., Ltd. (hereinafter referred to as "Microport^®"), the team led by Director Guo Jianming, Prof. Jiang Shuai and Prof. Xu Zhibing of Urology Department of Zhongshan Hospital affiliated to Fudan University completed the radical prostatectomy through extraperitoneal approach successfully on December 23, 2020. This is the first radical prostatectomy through extraperitoneal approach completed by Toumai^® Laparoscopic Surgical Robot. It is another important expansion of the System in clinical application in urology after Professor Guo's team completed the first partial nephrectomy through retroperitoneal approach with domestic robot in China.

The patient, a 79-year-old male, received prostate puncture two weeks before, and suffered from pathological prostate acinar adenocarcinoma after surgery. He was treated in the Department of Urology, Zhongshan Hospital affiliated to Fudan University. The team of Dr. Guo Jianming, Professor Jiang Shuai and Professor Xu Zhibing of Urology discussed about the patient's situations carefully before surgery, and finally decided to use the domestic Toumai^® Endoscopic Robot to perform the robot-assisted radical prostatectomy on the patient. The operation was conducted by Professor Jiang Shuai. A severe adhesion was discovered between prostate and rectum during the operation. With the help of the high-definition 3D eyepiece of Toumai^® Endoscopic Robot and surgical instruments of 7 degrees of freedom (DOF), Professor Jiang Shuai dissociated and resected the prostate successfully and cleaned the lymph nodes on both sides. The bleeding during operation was 50ml, the operation lasted 1.5 hours, and the patient could get out of bed and take food the next day after operation.

After surgery, Professor Jiang Shuai made the comment that: "Toumai^® can provide broad 3D operation view field and accurate and flexible control ability, which can clearly show the anatomical structure of tissues and organs and the course of neurovascular bundles. Fine separation is beneficial to lymph node dissection and can help operators to best identify the tumor boundaries. Wrist surgical instruments of 7 DOF are flexible and smooth to operate and can help complete complicated and fine operations. Accurate suture ensures the high-quality anastomosis and the successful completion of radical prostatectomy for high-risk prostate cancer through extraperitoneal approach."

The case is a high-risk prostate cancer. Compared with conventional radical prostatectomy through abdominal cavity by endoscopic robot, the radical prostatectomy through extraperitoneal approach is more challenging. As the operation is performed outside the abdominal cavity, it can avoid interference to the intestinal tract, beneficial to the recovery of postoperative intestinal functions and reducing the occurrence of postoperative intestinal adhesion, intestinal obstruction and incision hernia; even if urine extravasation occurs after operation, the urine will not flow into the abdominal cavity and leads to peritonitis. Meanwhile, it is helpful to dispose the important structures in the deep pelvic floor carefully and accurately, and reduce the damage to urethral sphincter and cavernous neurovascular bundle. Since there is no adhesion in gastrointestinal tract, the postoperative adjuvant radiotherapy can reduce the radiation injury. Thanks to the small surgical incision and small trauma, the patient can recover faster after operation.

Dr. He Chao, President of MicroPort^®MedBot, expressed that: “the successful completion of the first case of radical prostatectomy through extraperitoneal approach fully demonstrates the technical strength and clinical application value of Toumai^® Endoscopic Robot in the complex and difficult surgical application of urology. MicroPort^®MedBot will continue to work with clinical experts to provide universal and intelligent surgical solutions that can save the lives of patients or reshape their quality of life."