The world's first robot-assisted bile duct stent placement clinical surgery was successfully performed

SHANGHAI, Oct.
31, 2022 /PRNewswire/ -- On October 29, 2022, ERCP (Endoscopic Retrograde Cholangiopancreatography) ushered in a historic breakthrough, and the natural orifice ERCP soft mirror surgical robot developed by Apeng Medical and Hangzhou First People's Hospital affiliated to Zhejiang University School of Medicine successfully completed the world's first case in a hospital in Hangzhou Robotic-assisted bile duct stent placement for human clinical surgery
.

The operation was performed
by the team of Professor Zhang Xiaofeng, Vice President of Hangzhou First People's Hospital and Director of the Digestive Endoscopy Center.
After perfect preoperative preparation and planning, Professor Zhang Xiaofeng realized the entire surgical process of precise control of the end direction of the endoscope, precise delivery of the catheter guidewire and convenient and accurate instrument exchange by operating the Open surgical robot on the operating table outside the operating room (no need to wear lead clothing), and successfully completed the whole surgical process of nipple cutting, balloon stone removal, and accurate placement of bile duct stents, and successfully completed the operation, with good
feedback from patients after surgery.

Professor Zhang Xiaofeng fully affirmed the role of surgical robots in surgery, and at the same time, the operation coincided with the 15th Hangzhou International Symposium on the Diagnosis and Treatment of Biliary and Pancreatic Diseases in 2022, which was hosted by a hospital in Hangzhou, and the whole process of surgery was broadcast live at the conference, which was affirmed and praised
by many experts attending the meeting.

The successful completion of this operation means that the application of surgical robots in the field of natural orifice ERCP endoscopic surgery has been clinically verified, officially entering a new era of
robotic surgery.

The ERCP market is huge

Surgical robots have obvious advantages

Endoscopic retrograde cholangiopancreatography (ERCP) refers to the general term
of the technique of inserting an endoscope into the duodenum through the mouth, esophagus and stomach, introducing special instruments into the bile duct or pancreatic duct through the duodenal papilla, injecting contrast agent angiography under X-ray or photography, introducing endoscopic observation, completing the diagnosis of biliary and pancreatic diseases, and implementing corresponding interventional treatment on the basis of diagnosis.
Nowadays, ERCP has developed from a diagnostic technology to an endoscopic minimally invasive interventional technology with the main purpose of treatment, and has been widely used in the minimally invasive treatment
of hepatobiliary and pancreatic lesions.

According to the "2021-2025 China Disposable Cholangioscopy Industry Market Supply and Demand Status and Development Trend Forecast Report" released by Xinsijie Industry Research Center, the number of ERCP surgeries in China will be 300,000 units in 2020, and the market penetration rate is still at a low level, and it is expected that the number of ERCP surgeries will reach 650,000 units by 2028, with huge
room for future growth.

Although ERCP surgery is huge and promising, the pain points of manual surgery since its emergence in the 60s of the last century are still a great challenge
that medical staff have to face.

ERCP is an endoscopic minimally invasive interventional technology, and its guidewire-based instrument exchange process needs to be performed under X-rays, so the doctor needs to wear a 30-pound lead suit, hold the endoscope handle, and complete the operation
with the assistance of a nurse's assistant.
Long-term radiation exposure and weight-bearing surgery not only seriously affect the body of medical staff, but also accumulate fatigue, affecting the efficiency and effect of
surgery.

In addition, the position of the duodenal nipple towards and the opening varies a lot, the accuracy of manual surgery cannot be quantified, the difficulty of surgical operation is very high, the doctor's movement control and stability, and the tacit understanding with the nurse's assistant require long-term experience
.
Therefore, training a stable and qualified ERCP doctor and an excellent ERCP team requires the accumulation of time and the inheritance
of experience.

The pain points that manual surgery has never been able to solve are easy
for surgical robots.
ERCP surgery using surgical robots allows doctors to operate remotely from the X-ray environment by operating the console behind the lead glass, avoiding the health risks
caused by radiation and weight.
At the same time, the inherent stability, accuracy and flexibility of the robot can effectively reduce the difficulty and learning curve
of ERCP surgery.
And it can bring better treatment efficiency
to patients.

The future of natural orifice surgical robots can be expected

Opun took the lead in layout

Minimally invasive or even non-invasive surgery is the future development direction of surgery, and non-invasive surgery through the natural orifice of surgical instruments is a hot spot
in the research and development of surgical robots.
As a leading robot platform company in Shanghai Zhangjiang Science City, Aobeng Medical has applied for 65 invention patents
through close medical-engineering integration mode, deep insight into clinical needs, and nearly 10 years of forward-looking basic technology research, in the field of surgical robot research and development, covering robot architecture design, robotic arm and execution hand process design, force feedback mechanism, software algorithm and automated surgery, system integration and other fields.

In recent years, Aopeng Medical vascular interventional surgical robot ALLVAS^® has successively completed the world's first operation of robot-assisted endovascular interventional surgery such as aortic covering stent intervention, peripheral vascular stent intervention, etc.
, and has received extensive attention from the international community, and has also gained insight into the future development trend of surgical robots, and the advantages of surgical robots in the field of ERCP surgery, taking the lead in layout, and collaborating with clinical experts such as Professor Zhang Xiaofeng.
It has created a leading natural orifice ERCP flexible surgical robot
in the world.

The ERCP flexible surgical robot through the natural orifice is designed as a split modular structure from the structure of imitating the doctor + assistant to ensure that it can replace the composite role of "doctor + assistant" anywhere in the operating room, and is small in size, easy to move, and convenient for flexible deployment
.
The robot adopts the principle of master-slave operation, and the operation of the master hand of the operating table is completely consistent with the operation mode of manual surgery, which greatly shortens the learning time
.
The doctor can complete the operation of the size knob of the endoscope handle, the lifting forceps, the water and gas button, the pumping button, the guidewire guide tube pushing, withdrawal, instrument exchange and other operations
through the simultaneous operation of the left and right main hands.
At the same time, the robot also contains a closed-loop mechanism for the movement of the guidewire device, which overcomes the risk of slippage or blockage during the transmission of the guidewire device, and the push of the guidewire instrument has the function of force perception, which reproduces the resistance in real time in the hands of the operator, so that the doctor has an actual feel
.