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On November 5, 2022 - The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU) completed the first radical nephrectomy via retroperitoneal approach assisted by Toumai^® Four-arm Laparoscopic Surgical Robot. According to the published information, Toumai^® is the first Chinese-developed surgical robot that has successfully completed this kind of operation. This surgery was operated by the team led by Professor Dan Xia and Professor Shuo Wang of the Urology Surgery Surgery Department of FAHZU, which was the 9^th highly challenging urology surgery assisted by Toumai^® completed by FAHZU within two weeks. Though few such surgeries were previously completed in the field of urology surgery, Toumai^® once again created a new record in the history of Chinese-developed  surgical robots in the field of urology surgery by completing this procedure successfully with high stability and accuracy.

The patient is a male. According to the preoperative examination, the tumor is located between the upper poles of the right kidney and the renal hilus area. Affected by the tumor, the artery and vein blood vessels in the renal hilus area feature abnormal and complicated structure. Since the right renal hilus area is very close to the inferior vena cava, any mis-operation may cause damage to the large vessels in this area. So the surgery is very difficult, and may even threaten the life of the patient. The complex conditions had imposed extremely high requirement on the stability of robotic performance, the skill of the head surgeon and the collaboration of the team.

The traditional four-arm surgical robot requires a large operation space. However, the space around the patient’s waist is rather limited. The operation via the retroperitoneal approach has the advantages of small injury to the abdominal cavity and no abdominal adhesion. However, to achieve these, both the surgeon and the surgical robot shall be excellent and be able to overcome the challenge of limited space. To ensure the optimal coordination among the four robotic arms, the team led by Director Shuo Wang carefully planned the surgical approach, drilling and position, and successfully placed the four robotic arms around the narrow waist space.

During the surgery, the enlarged high-resolution 3D image offered by Toumai^® helped the surgeon with accurate anatomical orientation, and provided significant convenience to the assistant for real-time traction for exposure, suction and blocking in coordination with the head surgeon. By controlling the highly flexible mechanical simulation wrist from the surgeon’s console, Director Shuo Wang exposed the tissue layer by layer within the narrow extraperitoneal space and gradually advanced to the anatomical position in the kidney. The kidney is wrapped up by complicated artery and vein blood vessels and other tissues, and the blood supply is abundant. So the head surgeon has to be very accurate and fine in dissection and excision. The 3D immersive image and the hand shaking elimination function of Toumai^® increased the accuracy, convenience and safety of the surgery, and enabled to head surgeon to perform dissociation, dissection and transection in a safer and more minimally invasive manner, maximizing the safety of the patient.

It is not the first time that the urology surgery team of FAHZU has completed highly challenging surgeries assisted by Toumai^®. Previously, Toumai^® has assisted with 8 highly challenging urology surgeries including one live surgery during an important academic conference in China.

On November 5, during the opening ceremony of the 2022 Robot and Minimally Invasive Urological Surgery Forum, professor Shuo Wang completed the first live broadcasting of Toumai® in operating the radical prostatectomy via extraperitoneal approach, and demonstrated the whole surgery process to the onsite audiences with textbook-like operation. The success of this surgery indicated the outstanding skills of professor Shuo Wang’s team, and also verified the clinical adaptability and accurate assistance function of Toumai^®.

Based on the successful experience of this surgery, Director Dan Xia and Director Shuo Wang will continue to promote the routine and normalized operation of this type of surgery. Through continuous repetition of highly challenging surgeries, the clinical operation level of the team and the post-operative experience of the patients may be improved, thus enabling more patients to enjoy the benefits brought by the Chinese-developed surgical robots.

Professor Shuo Wang said, “Despite huge challenges, the radical nephrectomy via retroperitoneal approach assisted by the surgical robot has minimizes trauma to the abdominal cavity of the patient, and represents the direction for our improvement of operation skills. Therefore, our target extends beyond this one success. We will continue to challenge this kind of difficult procedures, and popularize it as one of the routine procedures through continuous exploration and practice, thus bringing benefits to more patients. However, this target is very challenging. So we need the support and coordination of stable and accurate robots like Toumai^®

Thanks to the combination of medical resources and clinical technologies between MicroPort^® MedBot^® and FAHZU, Toumai^® has made a number of breakthroughs in the field of challenging procedures in the Urology Surgery Department of FAHZU. By continually challenging new procedures, Toumai^® has grown increasingly mature in clinical adaptability. It is expected that the product performance and its clinical assistance capability of MicroPort^® MedBot^® will continue to improve through communication, and cooperation with the surgeons and practicing the concept of medical-engineering cooperation.

Mr. Yu Liu, Executive Vice President and Chief Commercial Officer of MicroPort^® MedBot^®, said: “The successful completion of radical nephrectomy via retroperitoneal approach assisted by Toumai^®four-arm surgical robot is a new achievement of Toumai^® and even the whole domesticrobot industry. This success attributes to the sophisticated skills of Director Shuo Wang. And I would like to extend my sincere thanks to the support from Director Dan Xia and Director Shuo Wang for Toumai^®. With the continuous advancement of MicroPort^® MedBot^® in the clinical application, Toumai^® has made a number of breakthroughs in handling challenging procedures. Through the continuous improvement in clinical assistance, it has become a convenient assistant of more and more surgeons, thus bringing benefits to more patients and realizing the original aspiration of "Make Surgery Easier, Safer and Less Invasive”.