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Lanzhou, China — On July 13^th, after rigorous and sufficient technical justification, animal experiment plus the scientific research ethics evaluation, the first robot-assisted 5G remote unilateral nephrectomy (Level 4) in Western China was completed successfully by the team of Fenghai Zhou, Director of Urology Department of Gansu Provincial Hospital, under the assistance of Toumai^® Laparoscopic Surgical Robot, a product of Shanghai MicroPort MedBot (Group) Co., Ltd. (hereinafter referred to as “MicroPort^® MedBot^®”). This is another breakthrough in the practice of 5G remote robot urology surgery achieved by the team of Director Fenghai Zhou, following their completion of the first 5G remote robotic urologic surgery in Western China on May 24^th. It also means that the Toumai^® robot-assisted 5G remote urologic surgery is getting more and more matured. As Toumai^® is progressively deployed in multiple departments of various hospitals across China for 5G remote robot surgery, 5G telemedicine is breaking the time and geographical constraints of resource allocation to benefit more patients.

▲ Surgery performed by Director Fenghai Zhou

Patient Information:

The patient is a 67-year-old female, who has undergone extracorporeal and ureteroscopic lithotripsy in another hospital for the past decade due to recurrent left ureteral stones. Two months ago, she visited Gansu Provincial Hospital due to worsening back pain. CT revealed severe hydronephrosis and cortical atrophy in the left kidney, while ECT revealed a filtration rate of 12ml/min in the left glomerulus, with a low and flat elongated curve. Assuming the left kidney was not functional, left nephrostomy was performed for two months of observation, during which 50 mL of urine every day was observed and left kidney dysfunction was confirmed.

Considering the senility and overall poor conditions, history of repeated surgeries leading to possible perirenal adhesions and structural disorders of the hydronephrotic kidneys, it was quite difficult to perform surgery for this patient. To guarantee a safe and smooth procedure, Director Fenghai Zhou organized the departmental robotic team to conduct detailed pre-operative justification and labor division, and finally decided to perform Toumai^® robot-assisted laparoscopic nephrostomy of the dysfunctional left kidney, based on Toumai^® robot’s extensive experience in 5G remote urologic surgery.

▲ Screen of remote monitoring from multiple locations

This surgery was conducted with two primary operators on both master and slave ends, where Director Fenghai Zhou served as the operator at master end and Vice Chief Physician Xiaofeng Zhang as the participant. They sent surgical instructions to the robotic arm at remote patient's end (slave end) through Toumai^® robot’s doctor console; while inside the OR of the slave end, Chief Physician Bohong Guo, Attending Physician Haidi Lu, and Attending Physician Xinping Wang cooperated to finish the surgery.

Intra-operation:

During surgery, difficulties such as dilation and hydronephrosis of the renal pelvis and calyx, obvious perirenal adhesions, disordered adhesions of the renal hilum, and significant thickening of the ureter were observed. Thanks to Director Fenghai Zhou’s outstanding skills and accurate positioning and flexible assistance of Toumai^® robot, the surgery was successfully completed within 1 hour.

▲Screen of multi-site interconnection by Toumai^® robot and intra-operation images

With 5G transmission system, movements of Director Fenghai Zhou were accurately reproduced in a real-time manner at the slave end of Toumai^® robot. The surgery was performed with almost no bleeding, together with clear surgical FOV and clear images transmission. Guaranteed by the interconnection technology team of the MicroPort^® MedBot^® Group, the high-speed, large bandwidth, and low latency of the 5G network achieve a smooth and seamless surgical process without any noticeable delay.

▲ Robotic 5G Remote Surgery Center of Gansu Provincial Hospital

Director Fenghai Zhou from Gansu Provincial Hospital stated that, with the high-precision and multi-dimensional visual system, precise surgical arm and control system of the Toumai^® robot, surgery can be conducted accurately and safely, with less intra-operative bleeding, lower incidence of postoperative complications and faster recovery. Toumai^® Laparoscopic Surgical Robot comes with 5G technology, allowing surgeries to be performed in standard surgical operating rooms thousands of kilometers apart without the need of patients and surgeons to meet in person. It reflects the focus of Chinese-made robots on frontline clinical practice and embracing medical needs, also marks that our urological robotic surgery has reached international leading level. This is another milestone in the development path of the Urology Department of Gansu Provincial Hospital to “focus on cutting-edge technology and create a first-class discipline”. With the popularity of surgical robots, the skillful surgical technique of the Urology Department of Gansu Provincial Hospital will benefit more patients in and surrounding the province through 5G technology.

Mr. Yu Liu, Executive Vice President and Chief Commercial Officer of the MicroPort^® MedBot^® Group, stated that: Following the completion of the first 5G remote laparoscopic robotic surgery in western region, Gansu Provincial Hospital has once again completed the “first 5G remote robot-assisted nephrectomy in Western China”. It reflects the excellent surgical skills of the team led by Director Fenghai Zhou at Gansu Provincial Hospital, also that the spirit of the hospital in focusing on the forefront and attaching great importance to innovation. This is also a new achievement by Toumai^® on 5G remote assisted surgery. “Starting from the clinical needs and ending with patient satisfaction” is the original intention of MicroPort^® MedBot^® to widely benefit the patients. In the future, we will continue to stay close to the clinical practice and listen to the frontline voices and feedback, in order to better promote continuous optimization of the surgical experience and bring convenience for healthcare professionals and patients as a whole.