The surgical robot gives the doctor "super power"

In a human body space of two or three centimeters square, the robotic arm can be operated as delicately as an embroidery. Today, surgical robots are making many surgical scenarios that were previously unimaginable a reality. Among them, the Da Vinci Surgical Robot System (hereinafter referred to as "Da Vinci Surgical Robot") represents the cutting-edge level in this field.

Since the introduction of the first Da Vinci surgical robot in China in 2006, more than 40,000 robotic operations have been carried out in China, covering various operations such as urology, hepatobiliary and pancreatic surgery, gastrointestinal surgery, and obstetrics and gynaecology. On February 26th, the first Da Vinci surgical robot basic training base was opened in Shanghai, providing international training services for doctors at home and abroad. In the future, the application of Da Vinci surgical robots will be even broader.

What is the magic of surgical robots? Why has the Da Vinci surgical robot been the leader for many years?

Brighter "eyes" and more flexible "hands"

As early as last year, a video was on the Internet. The video is displayed in a small glass bottle. A grape is sutured by a robotic skin. This robot is a Da Vinci surgical robot. Grape skins are less than 2.5 cm in length, less than 1 mm thick, and very fragile. After the last shot of the Da Vinci surgical robot, the grape is basically in perfect condition. The entire procedure was fast and precise, and many people were amazed at the Da Vinci surgical robot. But in fact, for the medical community, it is not new.

The surgical robot represented by the Da Vinci system is one of the medical robots.

"Medical robots are a big concept. According to international standard terminology, robots or robotic equipment that can be used in the medical field in terms of potential capabilities can be called medical robots." Deputy Director of Robotics Research Institute, Harbin Institute of Technology Zhijiang said that medical robots can be divided into surgical robots, rehabilitation robots, medical service robots (that is, service robots used in medical fields) and robotic Medical Equipment.

In Du Zhijiang's view, the role of medical robots is not only to assist doctors, to expand the doctor's ability, to continuously improve the level of intelligence, but also to have safe and effective medical properties, otherwise it is impossible to go to the clinic, and at the same time be flexible and flexible. The clinical applicability and good interactivity to achieve a harmonious coexistence between doctors, patients and machines.

It is undeniable that the emergence of surgical robots has benefited from the background of minimally invasive surgery in the surgical field. "Compared with traditional open surgery, laparoscopic surgery has many advantages, and it has been widely carried out now. However, the operation of laparoscopic surgical instruments requires very high doctor skills. At the same time, doctors who perform surgery for a long time can cause fatigue and hand. Trembling affects the accuracy and quality of surgery. The freedom of laparoscopic instruments is still limited. Therefore, in order to further improve the level of minimally invasive surgery, surgical robots have emerged." Du Zhijiang said that there are several surgical robots. Advantages: First, surgical instruments with multiple degrees of freedom make the operation more dexterous; second, it can provide doctors with magnified three-dimensional images to make the surgery more precise; third is to change the mode of previous surgery, it is the doctor standing in the patient Next surgery, now sitting in front of the console surgery, relieved the fatigue of the doctor; Fourth, remote surgery can be achieved, we can put the robot in remote areas, remote control by doctors, so that more patients enjoy the benefits of high-end equipment .

Why do you monopolize?

The world's exploration of surgical robots began in the 1980s. In 1985, American researchers tried to use bio-assisted brain biopsy, which is also the prototype of surgical robots. Since then, in the late 1980s and early 1990s, surgical machines dedicated to surgery were born, more typically the RoboDoc surgical robot. In 1994, Aesop's mirrored robot developed by Computer Motion of the United States achieved a more precise and consistent lens movement than humans. It took a crucial step in the development of a minimally invasive surgery system for robots, but it was not able to execute instructions alone. The operation is just a "mirror" electronic manipulator. In 1996, Computer Motion developed the Zeus robotic surgical system for minimally invasive surgery.

In 1999, Intuitive Surgical of the United States released the Da Vinci surgical robot, which opened a new situation for the development and application of surgical robots. The Da Vinci surgical robot consists of a surgeon's console, a bedside robotic arm system, and an imaging system. Compared with the human hand, its artificial wrist device has 7 degrees of freedom, which is more flexible and precise, and can also automatically filter the tremor, which is more stable than the human hand. In addition, its imaging technology is more realistic, and the naked-eye 3D stereo image can magnify the image by 10 times. Since its release, the Da Vinci surgical robot has been out of control and has been rapidly applied worldwide, almost monopolizing the global surgical robot market and continues to this day.

In 2000, the Da Vinci surgical robot was officially approved by the US Food and Drug Administration for use as the first surgical robot that can be used in abdominal surgery. The 301 hospital introduced the first Da Vinci surgical robot in mainland China at the end of 2006 and completed the first operation in 2007. In 2014, the Da Vinci surgical robot updated the fourth generation system.

In Du Zhijiang's view, the Da Vinci surgical robot is able to take the lead, and its emphasis on the close integration of engineering technology and medical needs is indispensable. "When I visited Intuitive Surgical, I saw that one of the important tasks of the company's engineers and technicians every day is to fully communicate with doctors to make the robots meet the needs of doctors to the greatest extent." Du Zhijiang concluded, "Da Vinci surgery robot There are a number of robotic arms that perform the operation in a multi-arm coordinated manner; it relaxes the requirements for the position of the human incision. During the operation, the mechanical arm enters from the incision of the human body. If the incision is too strict, some procedures In addition, the Da Vinci surgical robot facilitates quick positioning and reduces the preparation time of the operation. Especially when the accident occurs during the operation from the minimally invasive surgery to the open surgery, the surgical robot is needed. The device is removed in a very short time; the interface of the Da Vinci surgical robot is unified, which reduces the time for surgical replacement of the instrument; in addition, it can also be pre-set according to the operation, and continuously improve the intelligence level of the robot. Over the years, The development of the Finch surgical robot has been moving in these directions."

Medical work is the focus

In the 1990s, the country began to study the operation of surgical robots. Typical systems such as the brain surgery robot jointly developed by Beijing University of Aeronautics and Astronautics and the Navy General Hospital, and the orthopedic surgery robot developed by Beijing University of Aeronautics and Astronautics have all been certified by the State Food and Drug Administration.

In addition, Harbin Institute of Technology has conducted research in the fields of laparoscopic, orthopedics, and interventional surgery. The Institute of Automation of the Chinese Academy of Sciences has conducted research in the fields of vascular intervention and orthopedics. Tianjin University has conducted research in the fields of laparoscopic and microsurgery, Beijing. The University of Science and Technology has conducted research in the fields of soft tissue puncture and cranio-maxillofacial surgery. Fudan University and Zhejiang University have also carried out research on medical robots and achieved results.

Du Zhijiang believes that in order to do a good job in the research and development of surgical robots, we must first pay attention to the combination of medical and labor. "Doctors should make clear the surgical procedures, the use of surgical robots and medical application taboos, and can present some subjective content. Engineering and technical personnel need to listen, understand, determine design input, plan implementation, and then use The language of engineering is expressed, and the prototype is used to communicate with the doctor repeatedly. Doctors and engineers must interact, and this interaction may be long-term."

In Du Zhijiang's view, the current development of medical robots has good prospects. At present, the global market for medical robots is continuing to grow at a high speed. Domestically, a number of strategic planning and support policies have been introduced to promote the healthy and rapid development of the robot industry, including "Made in China 2025" and "Robot Industry Development Plan (2016-2020). 》etc, where medical robots are an important part. "As a kind of robot, surgical robots have unlimited innovation space in technology, sensing, control, interaction, Internet and other technologies," Du Zhijiang said.

At the same time, the development of surgical robots also faces challenges from technology, talent, capital, market, and policy. "Surgical robots are highly technically intensive robotic systems with high technical thresholds and require talents in robotics, medical devices, medicine, etc., especially cross-border composite talents. The development cycle of surgical robots is also long, generally 6~ In the past 10 years, the investment is big, the risk is high, and continuous investment is needed." Du Zhijiang said, "To achieve outstanding progress in the field of surgical robot research and development, it is necessary to establish a long-term mechanism of combining politics, production, learning, research and medicine. Forming a government guidance, capital support, corporate efforts, R&D team competition, doctors dare to try, and open up a chain of R&D, registration, production, and sales. This requires more efforts."