Breakthrough Achieved: China's First Natural Orifice Transluminal Flexible Gynecological Surgical Robot Completes Initial Live Animal Trial

Natural Orifice Surgery, also known as NOTES, refers to surgical procedures performed via natural body orifices—such as the mouth, vagina, and anus—using platforms like endoscopes. Incisions are a critical factor influencing postoperative recovery. Compared with the trauma inflicted on the body surface by traditional open surgery, NOTES accesses the internal organs through natural orifices, significantly minimizing external trauma. This approach effectively alleviates postoperative pain, reduces the risk of infection, helps shorten the recovery period, lessens the burden on both patients and healthcare providers, enhances patient satisfaction, and delivers greater therapeutic benefits to patients.

In recent years, numerous manufacturers worldwide have actively explored this field. For instance, Momentis Surgical’s Anovo™ surgical system, Medrobotics’ Flex™ robotic system, and Endomaster’s EASE System have all demonstrated the advantages and broad prospects of natural orifice surgery. Currently, no natural orifice surgical robots have been approved in China, where the technology remains in its early research stages. The series of breakthrough advancements achieved by Shitong Medical in flexible gynecological surgical robotics mark a new level in the company’s overall capabilities.

Shitong Medical's flexible gynecological robot offers the following advantages:

（1）Offers dual access options: transumbilical and transvaginal.。Compared with traditional laparoscopy and other surgical robots, Shitong Medical’s flexible gynecological surgical robot not only enables umbilical minimally invasive surgery but also allows for transvaginal natural orifice surgery, achieving scarless abdominal outcomes. This approach results in smaller and more aesthetically pleasing surgical wounds, faster postoperative recovery, and improved patient comfort, providing patients with a more advanced and human-centered surgical treatment option.

（2）The 7-degree-of-freedom flexible instrument arm has a broader range of applications, enabling access to areas unreachable by traditional surgery.Shitong Medical’s structural design, featuring three 7-degree-of-freedom flexible arms with multi-segment coupling, significantly reduces the “chopstick effect” between instruments, minimizes interference with surrounding tissues, and enhances surgical safety. This enables the robotic system to navigate complex anatomical structures with greater flexibility, thereby broadening its range of indications.Design of the flexible arm with 180° rotation,Simulates the forward-facing perspective of transabdominal surgery, shortening the learning curve for surgeons and enhancing surgical precision.Each robotic arm is equipped with monopolar, bipolar, and tissue-grasping capabilities, allowing surgeons to freely switch between operational modes during the procedure based on the complexity of the surgery.Complete more refined and complex surgical procedures.

(3) Equipped with a bedside mobile platform, it has a small footprint and is easy to operate.Shitong Medical has optimized the structural design of its physician and patient platforms through multiple iterations, resulting in a more compact footprint that delivers excellent performance even in confined operating room environments. Compatible with existing operating rooms in Chinese hospitals, it enhances space utilization. Its flexible and compact chassis allows for easy installation, effectively reducing robot preparation time and facilitating rapid deployment across different departments.

(4) The cost advantage facilitates wider adoption in hospitals across second- and third-tier cities, promoting inclusive healthcare.Shitong Medical’s independently developed core technology modules, which include the robotic unit itself and disposable flexible robotic arm consumables, have effectively reduced manufacturing costs. The end-user price of the robotic arm consumables is comparable to that of traditional surgical supplies. Meanwhile, the robotic system boasts strong compatibility, seamlessly integrating with existing hospital medical infrastructure. It features a short learning curve for physicians and is simple to operate. Suitable not only for large medical institutions, it holds promise for future deployment in resource-limited healthcare settings. By promoting its adoption in hospitals across second- and third-tier cities, Shitong Medical ensures that patients can access advanced medical technologies regardless of geographic location.

The Vitong Medical team, in collaboration with gynecological experts from a renowned tertiary Grade-A hospital in Shanghai, successfully completed the first-ever in vivo animal trial of a natural orifice gynecological robot, includingTransvaginal posterior fornix puncture, tubal ligation, and oophorectomy...and a series of other surgical procedures. The female sheep animal model, serving as the study subject, encompasses key structures of the female reproductive system, including the vagina, uterus, and ovaries.

AtPuncture Approach ProcedureinThe procedure utilized a proprietary puncture kit developed by Shitong Medical, which integrates functions such as dilation, puncture, guidance, and wound protection to ensure smooth access to the pelvic cavity via the posterior fornix approach. Shitong Medical’s ingeniously designed flexible arm significantly reduces the risk of puncture and compression of intestinal tissues, fully leveraging its unique advantages in anatomical access.

The flexible arm, via the transvaginal approach, demonstrates a flipping capability exceeding 180°. By adjusting the surgical view and instrument positioning, it simulates the visual field of traditional laparoscopic surgery within confined operative spaces, thereby providing a broader workspace for surgical procedures.

InTubal Ligation Surgeryin China,Shitong Medical Robot Demonstrates Superior Electrosurgical Performance. Through precise robotic arm manipulation, the sheep’s fallopian tubes were successfully located and the mesosalpinx was exposed. Utilizing electrosurgical cutting and coagulation technology, the procedure was completed while minimizing thermal injury to surrounding tissues, thereby ensuring safe protection for pelvic organs.

InOophorectomyin China,The flexible arm design of the natural orifice robot plays a pivotal role, providing surgeons with greater operational flexibility and enabling effective tissue retraction. Coordinated manipulation of the robotic arms exposes the ovarian ligament, rendering vascular and neural structures clearly visible. Through localized traction and dissection of tissue planes, the ovarian artery and vein are effectively exposed and occluded using electrocoagulation, thereby achieving a bloodless surgical field.

Shitong Medical adheres to independent innovation, focusing on the identification of clinical pain points and the translation of needs into solutions. During the early stages of research and development, it engaged in medical-engineering collaborations with gynecology teams at several top-tier (Grade 3A) general hospitals in Shanghai, laying a solid clinical foundation for the subsequent commercial application of its products. The company has achieved original technological breakthroughs in modules such as multi-degree-of-freedom robotic arm development, underlying control algorithms, motor servo drive, and high-precision real-time master-slave control, thereby establishing a technological development platform for surgical robots.

Suzhou Shitong Medical Technology Co., Ltd., established in August 2022, subsequently secured tens of millions of RMB in angel financing led by Proxima Ventures. As an enterprise integrating the research and development, production, and sales of natural-orifice flexible robots and high-value consumables, it has filled the gap in China’s high-end flexible robot technology.

Shitong Medical leverages platform-based technologies to develop flexible, miniaturized, and low-cost surgical robots. The company currently has multiple products under development. In addition to its gynecological surgical robot system,Digestive Surgical Robotic Systems, Neurosurgical Robotic Systems...will be launched successively, and animal experimental studies will be carried out in the near future.

Shitong Medical Digestive Surgical Robotic System: Transoral or Transrectal AccessUp、Lower gastrointestinal tract,Both the access channel and the flexible instrument arm are controlled via a master-slave system from the physician’s console, enabling precise manipulation through the flexible instrument arm to achieveSurgicalization of Endoscopic Surgery。This system canCompatible with Mainstream Endoscopic ImagingSystem,Broad range of indications,In terms of implementation、Comprehensive Coverage of Lower Gastrointestinal Surgical Procedures, not only suitable for common digestive system surgeries, but also capable of handling more complex and delicate procedures. The 7-degree-of-freedom multi-segment coupled flexible instrument arm has a minimum diameter of only 5 mm, enablingImplementation of Suturing Function，Greatly improves surgical efficiency, with potential for future expansion into otolaryngology and bariatric surgery.Digestive Notes surgery and other application departments.

Shitong Medical's neurosurgical robotic system features high-precision flexible instrument arms, with a theoretical manipulation accuracy of 0.05 mm,Capable of treating tumors and blood clots in the deep regions of the brain.possessingTransnasal or Transcranial 10-mm Single-Port Approachcharacteristics, completely replacing existing craniotomy procedures, reducing head trauma, alleviating postoperative recovery pain, and facilitating accelerated postoperative recovery. Furthermore, the system offers the advantage of preoperative planning compatibility with CT and MRI imaging systems, enabling physicians to plan surgeries based on these imaging data. During the procedure, the system achieves platform registration through binocular sensor alignment.Automated Operation, which can greatly improve surgical precision and achieve precise resection of lesions.PostoperativePatientNo CT/MRI examination required, providing patients with more convenient and safer medical services. It can be further expanded to multiple clinical departments, such as thoracic surgery and spinal surgery, as well as to procedures like biopsies.Multiple application scenarios.

Currently, Shutong Medical has established collaborations with multiple leading hospitals both domestically and internationally. Its products are widely applied in clinical departments such as gynecology, gastroenterology, neurosurgery, and general surgery, and are gradually expanding to other specialties including urology, otolaryngology, pulmonology, and thoracic surgery, thereby achieving comprehensive coverage across all clinical departments.

The Shitong Medical team currently comprises approximately forty members, with its core personnel hailing from renowned medical device and diagnostic equipment companies. These experts possess extensive industrialization experience in the design, research and development, manufacturing, and commercialization of surgical robots. Leveraging robust technical problem-solving capabilities and sustained innovation, the company has achieved significant breakthroughs in the field of natural orifice flexible surgical robots.

Wang Zhen, the company’s founder, stated that Shitong Medical’s achievement of this major breakthrough within less than a year of its establishment was made possible by the team’s relentless pursuit of excellence and by the trust and support of market-oriented investment institutions such as Proxima Ventures. Shitong Medical is committed to breaking down professional barriers in the field of flexible robotics through original technologies, thereby accelerating research and development in natural-orifice flexible surgical robots. In the future, the company will continue to be guided by clinical needs to drive product development and provide more solutions for surgical departments.

It is expected that in the second half of 2023, Shutong Medical will conduct a Pre-A round of financing to prepare for clinical trials following the finalization of its surgical robot system product design, as well as subsequent commercial promotion.。We believe that more patients will benefit from the intelligent and precise treatment solutions offered by Shitong Medical’s surgical robots in the future.