Hangzhou, China – After rigorous and sufficient technical justification, animal experiment and the scientific ethics justification, on August 18^th, the first 5G ultra remote robot-assisted radical nephrectomy for left renal tumor in Southwestern China achieved a total success. With the assistance of the China-made Toumai^® Surgical Robot, this surgery was jointly performed by Prof. Dahong Zhang, Vice President of Zhejiang Provincial People’s Hospital (the “General Hospital”) and urology academic leader, together with the surgical team from Zhejiang Provincial People’s Hospital Bijie Hospital (the “Bijie Hospital”), who were 1800 KM apart. As a Level 4 surgery, this surgery is of high risk with complex process and huge challenges. Moreover, it places rigorous requirements on the 5G signal and the performance of the surgical robot. The total success of this surgery not only signifies that the General Hospital, together with Bijie Hospital, has created a new milestone for the telemedicine in Southwestern China, reaching another breakthrough on the path of jointly building a national regional medical center, but it also means that Toumai^® robot-assisted urologic surgeries have been conducted on a regular basis, while the 5G technology could help to improve the medical quality and service level of grassroots hospitals.

Pre-operation Overview

This surgery was performed on a merely 17-year-old patient Xiao Liu, who was found a space-occupying lesion of the left kidney during a recent physical exam. The renal enhanced CT showed the larger section of the tumor reaching 6.5 cm, which occupied almost half of the left kidney. Malignancy was considered in imaging diagnosis.

The surgery was urgently needed. However, it would be a highly difficult one as many vessel branches existed in the left kidney of the patient, and laparotomy may cause severe damage to the patient, while traditional laparoscopic surgery may lead to significant bleeding risk, thus requiring highly skillful surgeon to take the job. The attending surgeon wanted to complete the surgery with the help of robot, as robot has the significant advantages of minimal invasiveness, precision, flexibility, and anti-jittering, but it places higher demand of the operating surgeon, who must be of deeper clinical experience.

Therefore, the Urology Department of Bijie Hospital reported the case to the Urology Department of the General Hospital. After discussion and assessment by the medical teams of the General Hospital and Bijie Hospital, and upon the consent of the patient and his family, they decided to perform 5G ultra remote China-made Toumai^® robot-assisted radical nephrectomy for left renal tumor. Prof. Dahong Zhang, who is far away in Zhejiang province, conducted the surgery remotely, while Xiao Liu received the treatment right at the place where he was.

Before surgery, Mi Zhou, an expert dispatched by the General Hospital and the Director of Urology at Bijie Hospital, told the patient’s family that “Please be rest assured, this surgery is destined to be successful, as it will be jointly conducted by our General Hospital, together with Bijie Hospital, and it will be in the skillful hand of our top expert and assisted by the matured China-made surgical robot.”

As this was the first 5G remote urologic surgery performed jointly by the General Hospital and Bijie Hospital, both hospitals hosted together a “Launch Ceremony of 5G Ultra Remote Robotic Surgery Demo by Zhejiang Province People’s Hospital”. Prof. Dahong Zhang from the General Hospital stated in an interview that “5G remote surgery can effectively narrow the gap between the grassroots hospitals and those tertiary hospitals, thus promoting down-spreading of high-quality medical resources. With the trend of the General Hospital taking the lead and coordinated development of multiple hospitals, the introduction of surgical robots can make up for the lack of experts accessible on site and enable patients in remote areas to enjoy high-end minimally invasive robotic surgery resources.”

On the pre-operation ceremony, Minghua Ge, President of the General Hospital, announced that “Let’s start the first 5G remote China-made robot-assisted radical nephrectomy for left renal tumor in Zhejiang Province People’s Hospital Bijie Hospital!” On the same day at 8:58 AM, all preparations were completed at the patient end in Bijie Hospital OR, and the surgery began.

Surgical Process

Prof. Dahong Zhang, who is 1,800 kilometers away, was proficiently operating the China-made Toumai^® robot at the Robotic Surgery Center of the General Hospital. The robotic arm in Bijie Hospital OR was controlled remotely via 5G network to complete each surgery step. The robotic surgery team dispatched by the General Hospital and the urological surgery team of Bijie Hospital closely cooperated remotely to successfully complete the radical nephrectomy for left kidney tumor for the patient. (The tumor size is approximately 63 × 65 mm).

Assisted by the highly accurate, multi-dimensional vision system, the flexible robotic arm and the precise control system of Toumai^® robot, the entire surgery was completed in less than 2 hours, without significant intra-operative bleeding, and the patient was in good condition after surgery.

The success of the surgery depends not only on the superb medical skills, sense of responsibility and mission from both Prof. Dahong Zhang and the surgical team, but also on the reliable performance of Toumai^® robot and the assurance of 5G surgical technique. Before surgery, the General Hospital sent out to Bijie Hospital a team consisted of Feng Liu, Deputy Director of Urologic Endoscopy and Oncology Department, Haibin Wei, Director Assistant of Urology Department, Xiaofen Yu, OR Chief Nurse, Mangmang He, OR Nurse-in-Charge, to coordinate with urological surgery team of Bijie Hospital. They worked together for the basic preparation of the robotic surgery for the patient, including patient anesthesia, reasonable positioning, disinfection, punching, and installation of robot instruments, to ensure the safety of the patient during surgery.

Prof. Dahong Zhang from Zhejiang Provincial People’s Hospital stated that the whole surgery went smoothly. This is not only the first 5G ultra remote robotic surgery by Zhejiang Provincial People’s Hospital, but also the first 5G ultra remote China-made robot-assisted radical laparoscopic nephrectomy for left renal tumor in Southwestern China. Though the surgery was difficult due to larger tumor mass of the patient, Toumai^® robot could make extremely fine dissection to the kidney and well handle the lymph and vessels around the kidneys, especially the fine processing of renal vessels, which enabled a smooth surgery with little intra-operative bleeding. As to the surgical quality, there is not much difference compared to performing (robot-assisted) minimally invasive surgery by the side of the patient, and no sense of latency. We can perform surgery for patient in Bijie when we are physically in Hangzhou.

Mr. Yu Liu, Executive Vice President and Chief Commercial Officer of the MicroPort^® MedBot^® stated that, he is very grateful of the support to China-made Toumai^® robot by Zhejiang Province People’s Hospital and Bijie Hospital. Thanks to the proficient surgical skills of Prof. Dahong Zhang and the surgical team, the first 5G ultra remote robot-assisted radical nephrectomy for left renal tumor in Southwestern China made a breakthrough. This is not only a new milestone for the hospital and Toumai^® robot, but also an important starting point to benefit patients across Southwestern China. With a firm base of 5G remote surgical technique, the patients may enjoy high-quality and developed medical resources and technology across China, yet without leaving their city and receive surgery nearby. This is beneficial for patients living in remote areas, and it also reflects the original intention of Toumai^® robot – to get rid of difficult surgeries in the world.