From newcomers to global challengers: how Chinese surgical robotic companies are competing head-on with da Vinci

Among them, MicroPort MedBot's Toumai® Endoscopic Surgical Robot has achieved a cumulative global commercial order volume of over 100 units to date, with more than 60 commercial installations worldwide. In the first half of 2025, Toumai® secured 18 overseas orders and completed 16 commercial installations and sales.

Following its breakthrough in the Indian market, Sagebot's Kangduo® Robot has entered the batch delivery phase for orders in countries including Ecuador, Indonesia, and Azerbaijan.

Another Chinese surgical robot company, Edge Medical, initiated its global expansion in 2025. Within just over six months, it has secured 25 commercial orders in nearly 20 countries, cumulatively exceeding 30 units. Recently, Edge Medical's Edge® Single-Port Robot SP1000 and Edge® Multi-Port Robotic Surgical System MSP2000, officially received EU CE MDR certification. This marks another milestone in the company's international journey, following the CE certification of its multi-port robot in March this year. In addition, Edge Medical has entered into a strategic partnership with AMICO, a leading Middle Eastern healthcare group, to accelerate the deployment of its surgical robotic technology in the region's medical institutions and jointly build a sustainable localized ecosystem.

Tuodao Medical places significant emphasis on the ASEAN market and plans to complete the registration and certification for its MA2000 Endoscopic Surgical System in key ASEAN countries in the near future. Simultaneously, as a pivotal component of its global strategy, the company's Singapore R&D center, established in 2021, has been dedicated to advancing breakthroughs and translation in medical robotic technologies. Through in-depth collaboration with the Institute of Microelectronics (IME) under ASTAR, Tuodao has achieved notable progress in MEMS sensors and micro-nano manufacturing technologies.

Surgical robots represent a high-end segment of medical equipment, characterized by high complexity, significant technical challenges, and difficulties in market promotion. The da Vinci system has long maintained a dominant position in the global market. Starting relatively late, Chinese surgical robots—particularly endoscopic surgical robots—have taken only three years to progress from regulatory approval to scaled global expansion. What key initiatives have enabled Chinese surgical robots to gain recognition in operating rooms worldwide?

The first step in the global expansion of surgical robots is the selection of target markets. The surgical robotics segment varies significantly across regions, with differences in market penetration rates and primary surgical applications.

Strategically, Chinese surgical robot companies typically begin their overseas expansion by entering emerging markets before focusing on mature markets. MicroPort MedBot initially concentrated on emerging markets such as Africa, Central Asia, and the Balkans, later expanding to Southeast Asia and Latin America. Starting in 2025, the company will intensify its efforts in major markets including Europe and Brazil. Meanwhile, Edge Medical has primarily focused on Central-Eastern Europe, Southern Europe, and Belt and Road markets, with plans to prioritize Latin American expansion in 2025.

Chinese surgical robot companies have encountered distinct characteristics in various overseas markets:

The European market continues to exhibit dual features of "high growth and high potential." Overall, Europe faces challenges such as staff shortages and reduced government healthcare funding, yet the adoption of surgical robots is expanding rapidly. Robotic penetration remains relatively low in Europe, with endoscopic surgical robots reaching approximately 2% penetration—compared to about 15% in the United States—indicating significant room for growth in the region.

Western Europe serves as a key growth stronghold for da Vinci surgical robots. In terms of da Vinci's performance in Europe, 309 new da Vinci systems (including Xi/5/SP models) were installed in 2024, accounting for 20% of global new installations, bringing the total installed base to approximately 1,900 units. Germany, the United Kingdom, and Italy are the primary markets driving procedure volume for da Vinci, making market entry particularly challenging for Chinese surgical robot competitors.

Central and Eastern Europe have emerged as a strategic breakthrough. Chinese companies have successfully installed systems in Italy, Belgium, and Poland. These Central and Eastern European countries—characterized by low robotic penetration rates and rapid growth—serve as key entry points, representing long-overlooked potential markets. Taking Poland as an example, the country currently has approximately 80 endoscopic surgical robots installed nationwide. In 2023, about 10,000 robot-assisted procedures were performed—a 108.71% increase compared to 2022. Edge Medical has established a strategic partnership with Meden-Inmed, a established Polish healthcare group, to jointly promote the deep market penetration of Chinese high-end medical equipment in Central and Eastern Europe.

The Asia-Pacific market also remains a key focus for Chinese companies. In terms of da Vinci's commercial presence, Japan was one of the earliest Asian markets entered by Intuitive, demonstrating high system utilization and stable installation growth. South Korea shows rapid growth in single-port robotic adoption, while India experienced the fastest procedure volume growth in the Asia-Pacific region last year, accompanied by accelerating installation rates.

Chinese companies are strategically focusing on Central Asia and Southeast Asia within the Asia-Pacific region, having completed installations in Pakistan, Indonesia, Georgia, India, and Thailand.

The Latin American market is also poised to become a key growth driver for Chinese companies. Within the region, Brazil stands as the primary target for Chinese surgical robot expansion. The country's per capita GDP is comparable to China's, and it boasts a well-developed minimally invasive surgery landscape that actively adopts robotic surgery. Over 100 robotic systems have been installed in Brazil, primarily concentrated in its prosperous southeastern region. Meanwhile, the Brazilian market maintains high standards for product quality, service capability, and academic support. In 2025, both MicroPort MedBot and Edge Medical obtained regulatory approval for their surgical robots in Brazil, indicating that the market is expected to be a strategic focus going forward.

Chinese surgical robot companies have adopted distinct strategies for different markets. In emerging markets, they primarily focus on supporting the upgrade of local healthcare capabilities. In mature markets, they leverage emerging technologies like remote surgery to establish market recognition.

Overall, the global expansion of Chinese surgical robots has progressed from initial experimentation to scaled deployment, with the development of mature markets becoming the next strategic priority.

The global endoscopic surgical robot industry has long been dominated by the da Vinci system. What, then, constitutes the core competitive strength of Chinese surgical robot companies?

There is no doubt that Chinese endoscopic surgical robots offer significant advantages in cost-effectiveness compared to the da Vinci systems.

Taking the Surgerii Robotics' SHURUI Endoscopic Surgical System as an example, its price is estimated to be only about two-thirds that of the da Vinci SP. Furthermore, by achieving multiple world-first surgical procedures in general surgery and thoracic surgery, it demonstrates the potential to surpass da Vinci SP in terms of procedure adaptation.

Edge Medical has integrated its multi-port, single-port, and remote surgery systems into a unified platform, pioneering a "three-in-one" surgical solution within the industry. A single control system can adapt to both multi-port and single-port robots, maximizing the ability to meet diverse clinical needs with lower overall configuration costs.

The cost advantages established by Chinese manufacturers—through breakthroughs in core technologies and algorithms, coupled with a well-developed local supply chain—will enable rapid expansion in countries with limited healthcare budgets.

Of course, relying solely on cost advantages is insufficient to build a sustainable competitive edge. Enhancing product strength is crucial for gaining recognition from global clinical experts for Chinese surgical robots. Based on existing corporate explorations, Chinese surgical robot companies are pursuing distinct product development pathways:

First, breaking the monopoly requires products with greater innovative attributes. In the surgical robotics field, remote surgery technology has become a core strategy for Chinese companies to overcome international competition barriers. Through forward-looking planning and technological breakthroughs, Chinese firms have established a unique advantage in remote surgery. Transforming this technological capability into recognition from the international medical community has created a critical breakthrough point for brand elevation.

The Toumai® Robotic System received approval from China's National Medical Products Administration (NMPA) in January 2022, becoming the first domestically developed four-arm endoscopic surgical robot approved for clinical application in China. Subsequently, Toumai® achieved a breakthrough in remote surgery by leveraging 5G technology as a key enabler. Through developing underlying core technologies—including specialized algorithms, low-latency image compression, and multi-dimensional encrypted data transmission—the system mitigates challenges like signal instability and transmission delays. In April of this year, it became the world's first endoscopic surgical robot approved for remote surgery across all clinical departments.

The Edge® surgical robot, utilizing 5G technology, has successfully supported a team of local medical experts in Paraná, Brazil, in performing Latin America's first cross-city remote animal surgery. The procedure connected Cascavel's CEONC Cancer Hospital with the Scolla Surgical Training Center in Campo Largo, spanning a distance of 500 kilometers, to successfully complete a cholecystectomy on a porcine model. The bidirectional communication distance exceeded 1,000 kilometers, with a network latency of only 10 milliseconds, ensuring a smooth and uninterrupted surgical process.

In late September, the Edge® surgical robot achieved a Guinness World Record for the "longest distance remote robotic surgery." This milestone procedure was a bidirectional remote robotic transabdominal preperitoneal (TAPP) inguinal hernia repair, jointly performed by surgical teams in Brazil and Kuwait over a certified distance of 12,034.92 kilometers.

In July 2025, the Sagebot's Kangduo® Robot SR2000 successfully performed the world's first multinational dual-console, transcontinental, triple-console multi-point collaborative robot-assisted remote surgery. The procedure was live-streamed globally during the SRS 2025 Annual Meeting of robotic surgery held in Strasbourg, France.

Haptic feedback technology, which enables surgeons to perceive interaction forces between instruments and tissue—thereby assisting in precise force control during delicate operations—has garnered significant attention. While the da Vinci 5 has already incorporated this technology, Chinese companies are rapidly catching up and developing differentiated advantages.

MicroPort MedBot's Toumai® Four-Arm Endoscopic Surgical Robot pioneered a haptic perception and feedback module named "Force Presentation," which offers a significantly lower cost than Western counterparts, providing a more cost-effective solution. The Surgerii Robotics' SHURUI Robot is developing innovative Native Sensing technology that achieves haptic feedback without additional hardware through proprietary force-sensing algorithms. Tuodao Medical's haptic sensing and feedback technology delivers highly realistic tactile feedback, helping surgeons shorten the learning curve.

Furthermore, beyond urology, general surgery, thoracic surgery, and gynecology, Chinese companies still have ground to cover in high-complexity procedures such as cardiac and pediatric surgery.

Currently, Chinese manufacturers are achieving progress through technological innovation. For example, the SHURUI Single-Port Robot has expanded its clinical applications to include pediatric surgery and is actively exploring new indications such as head & neck surgery and thyroid & breast surgery. It has pioneered over 40 globally first-of-their-kind surgical procedures worldwide. Additionally, the company is collaborating with multiple hospitals and leading a national key R&D project in China to develop a single-port robot for cardiac surgery.

It is anticipated that breakthroughs in high-risk and high-complexity procedures will present a significant opportunity for Chinese endoscopic surgical robots to penetrate premium markets in Europe and the United States.

Secondly, differentiated product strategy. In terms of product portfolio, Edge Medical has adopted a dual-platform approach, advancing both multi-port and single-port robotic systems. This strategy enables coverage of diverse clinical needs in laparoscopic surgery. Multi-port systems are better suited for large-scale operations and instrument coordination, while single-port systems offer distinct advantages in minimizing invasiveness and meeting cosmetic expectations. By providing tailored solutions based on specific customer requirements, the company maintains flexible positioning in international tenders and partnership negotiations.

As an industry insider noted, in the highly specialized field of surgical robotics, a company's global competitiveness is ultimately anchored in the strength of its products. To genuinely gain ground in international markets, sustained recognition must be earned through demonstrated excellence in product performance.

Beyond product capabilities, academic promotion and training represent a critical competitive factor in global expansion and the most challenging aspect of international sales. Unlike other medical devices, even after regulatory approval is obtained, the adoption of surgical robots heavily depends on training, academic engagement, and service support. Surgeons require systematic training to achieve proficiency before they can effectively utilize the systems.

Academic influence forms a vital part of surgical robot brand building. Chinese companies are actively building international academic recognition primarily by engaging with top-tier conferences and networks, supporting clinical experts in publishing research based on their systems, and presenting breakthrough clinical outcomes at leading industry forums.

For instance, during the 2025 Society of Robotic Surgery (SRS) annual meeting held in France, multiple Chinese companies participated. Among them, the Toumai® Robot successfully performed the world’s first transcontinental ultra-remote liver cancer resection—remotely operating on a patient located in Hangzhou, Zhejiang, to complete a robot-assisted left lobe hepatectomy.

This year, the 22nd European Urology Robotic Section Annual Meeting (ERUS25) was held in London, UK. Edge Medical showcased its flagship multi-port endoscopic surgical robot at this premier global academic event. Through a live ultra-long-distance surgical demonstration spanning 8,200 kilometers, the company once again demonstrated China's world-class breakthroughs in remote surgery to an international audience of experts at the heart of European medical innovation.

In early August, the first Edge® surgical robot introduced to Brazil was officially installed at the Scolla Surgical Training Center, one of Latin America's largest surgical training bases, marking its successful commercial deployment in the region.

In reports about the Toumai® and Edge® robotic systems, the crucial role of Key Opinion Leaders (KOLs) in product promotion is consistently evident.

At Georgia's MMT Hospital, a nerve-sparing radical prostatectomy was successfully performed using the Toumai® robot. The procedure was led by Prof. Karazanashvili, a renowned urologist and recipient of Georgia’s highest honor, the National Prize, and marked the hospital's 100th robotic surgery.

In another case, Dr. Youness Ahallal, a prominent urologist from Nice University Hospital in France, performed a radical prostatectomy on a patient in Morocco from the MicroPort® MedBot™ global remote command center located at its Zhangjiang headquarters in Shanghai.

The Guinness World Record for the "Longest Distance Remote Robotic Surgery," achieved using the Edge® system, was jointly completed by Brazilian robotic surgery pioneer Dr. Leandro Totti and Kuwaiti distinguished surgeon Dr. Humoud Alrasheedi.

Endorsement and adoption by such KOLs have directly facilitated the acceptance and dissemination of Chinese surgical robots in hospitals across these regions.

Collaborating with established distributors enables rapid development of sales networks, reduces localization costs and risks, and enhances brand trust and recognition. Distributors for surgical robots must commit resources across teams, training, academic support, and after-sales service—a long-term investment with relatively low short-term returns.

A case in point is Edge Medical's entry into the European market. The company formed major strategic partnerships with Dornier MedTech, a global leader in urological medical devices, and the long-standing Polish healthcare group Meden-Inmed, jointly establishing surgical robotics training centers. Leveraging their mature channel networks and support systems, Edge Medical has adopted a dual-core strategy focused on Southern and Central-Eastern Europe, progressively building a strategic network that spans the continent.

Overall, the global surgical robot market remains an oligopoly, leaving substantial room for growth among Chinese companies. The focus of competition has shifted from singular technological breakthroughs to vying for leadership in the global second tier, where Medtronic and Chinese companys now compete in parallel. With surgical robot penetration still low worldwide and high costs remaining a major barrier to broader adoption, the global expansion of Chinese surgical robots holds promise for addressing the challenge of accessibility.