How Can Domestic Surgical Robots Break Through? Shanghai Jiao Tong University's Zheng Guoyan Reveals the Path of Technological Innovation

Surgical robots represent a key direction for innovation in the medical field and have become a focal point of intense investment by numerous enterprises and research institutions both in China and abroad. However, the development of domestically produced surgical robots has not been smooth sailing; it faces multiple challenges, including technical hurdles, market barriers, and regulatory policies. Critical questions remain to be addressed, such as how Chinese manufacturers can break through in this sector, achieve technological innovation and breakthroughs, and enhance product competitiveness and market share.

Recently, VCBeat held a dialogue with Zheng Guoyan, Deputy Director of the Medical Robot Research Institute at Shanghai Jiao Tong University, to delve into the current technological landscape, development trends, and innovation pathways of surgical robots, offering valuable insights for the advancement of domestically produced surgical robots in China.

Zheng Guoyan has conducted in-depth research in computer-assisted surgery, multimodal image segmentation, registration and reconstruction, computer-aided diagnosis, machine learning, and deep learning. He repeatedly received the Best Technical Paper Award at the International Conference on Computer Assisted Orthopaedic Surgery (CAOS) in 2006 and 2018. In 2018, he was awarded the Springer Best Paper Award at the International Conference on Image Analysis and Recognition (ICIAR), as well as the Best Paper Award at the MICCAI Workshop on Computational Methods and Clinical Applications for Spine Imaging. In 2017, he received the Best Paper Award at the MICCAI Workshop on Machine Learning in Medical Imaging.

As a university-level multidisciplinary research platform at Shanghai Jiao Tong University, the Institute of Medical Robotics aligns with the national scientific and technological development direction of “prioritizing people’s lives and health.” Focusing on major national medical needs and serving the development of the broader health industry, the Institute has conducted core basic research, engineering technology development, applied research, and translation in various medical application fields, including minimally invasive surgery, rehabilitation therapy, and assistive devices for daily living. It supports Shanghai’s establishment of a key technology translation platform for the medical robotics industry, promotes innovative research on medical robotics technologies in China, and has achieved a series of positive advances and significant outcomes in technological research and promotion within the medical field.

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Developing a surgical robot that truly addresses clinical pain points, is adopted by hospitals, and is accepted by patients is no easy feat. It must achieve technological breakthroughs that disrupt traditional surgical methods, improve surgical outcomes and safety, and alleviate the burden on surgeons. These technologies must not only be highly innovative but also possess robustness to adapt to diverse cases and environments.

For instance, the application of laparoscopic robots in urology serves as a successful example. This technology enables physicians to perform precise resections for conditions such as prostate cancer via remote operation, while preserving critical structures like nerves and blood vessels, thereby minimizing bleeding and complications. Such advancements not only enhance surgical outcomes but also reduce intraoperative fatigue for surgeons and improve overall procedural efficiency.

Unfortunately, spinal and joint robots have not yet identified technologies that can fully address clinical pain points, necessitating continuous research and optimization. Currently, surgical robots in this field remain at the navigation and positioning stage, primarily providing location information rather than directly participating in surgical procedures. Moreover, due to the complexity and variability of human anatomy, such positional data may not always be accurate or stable. Therefore, orthopedic surgical robots must adopt technologies that enable true intelligence, automation, and personalization to meet market demands and expectations, thereby assisting surgeons in performing precise, minimally invasive, and intelligent operations.

Furthermore, it is worth noting that the core competitiveness of surgical robots lies not only in hardware technologies such as robotic arms and sensors but also significantly in software technology. While hardware technologies often suffer from severe homogenization, software technology can leverage algorithmic advantages to integrate surgeons’ experience into the product, thereby optimizing or even revolutionizing surgical workflows. It can be said that, given the high degree of hardware homogenization, software is the soul that determines a product’s quality and usability. Currently, the surgical robots most needed in clinical practice must use software technology to embed surgeons’ experience into the product and optimize it through algorithms, making it user-friendly, easy to operate, and durable. The goal is to provide essential support where it is most needed, rather than merely adding superficial enhancements.

Surgical robotics is a high-barrier field that demands continuous innovation and breakthroughs. Merely developing generic technologies will lead to intense, homogeneous competition, as such technologies are easily imitated and substituted. To stand out in the surgical robotics sector, companies must avoid over-generalization, focus on core technologies, address the critical pain points of enterprises and hospitals, and integrate physicians’ expertise and clinical workflows into their products. Only in this way can they enhance product competitiveness and added value, thereby meeting market demands and expectations. Core technologies for surgical robots include registration, image segmentation, intelligent diagnosis, and force control. These technologies require in-depth research and optimization to ensure the safety, accuracy, and stability of surgical robotic systems.

Multimodal perception technology is crucial for surgical robots, requiring the integration of various sensors such as visual, tactile, and force sensors to enhance the precision and safety of surgical procedures. This involves a wide array of technologies, and breakthroughs in these core areas cannot be achieved merely through relentless refinement; they also require continuous application and iteration in clinical settings. Moreover, technological advancements in this field are not necessarily driven by the medical sector itself but may instead be propelled by other industries, such as entertainment and gaming, which have greater demand for sensor technologies and thus accelerate their development and cost reduction. Therefore, the surgical robotics field must closely monitor technological progress in other sectors and seize opportunities for breakthroughs to achieve genuine innovation and advancement.

Currently, medical imaging technology in China is experiencing robust growth, characterized by a diverse and flourishing landscape. It covers a wide spectrum of diseases, and in terms of technological sophistication, some applications have even integrated technologies such as virtual reality (VR). Meanwhile, surgical robots have undergone four generations of development, with each generation possessing its own distinct characteristics and advantages.

The earliest first-generation robots were adapted from industrial robots, primarily addressing issues related to cutting navigation. Second-generation robots, such as the Da Vinci and Zeus systems, mainly resolved challenges in hand-eye coordination, three-dimensional vision, and physiological tremor. These systems effectively addressed significant clinical pain points and demonstrated strong application outcomes in fields such as urology. Third-generation robots, including spine and joint surgery robots, primarily tackled problems of precise positioning and force feedback. Fourth-generation robots, such as endoscopic surgical robots, achieved breakthroughs in minimally invasive procedures, mainly resolving issues related to operational flexibility and clear visualization.

Currently, the development of surgical robots is focused on enhancing intraoperative imaging resolution and diagnostic capabilities, implementing multimodal perception technologies to address the challenges of visibility, clarity, and penetration. This enables surgeons to detect smaller lesions, perform more precise operations, and facilitate earlier interventions. Intraoperative imaging allows physicians to visualize surface structures, microscopes provide magnified details, and augmented reality (AR) technology offers a fused view of internal anatomical structures by integrating virtual and real-world data. These technologies must not only demonstrate high levels of innovation and robustness to adapt to diverse cases and environments but also incorporate diagnostic functionalities capable of automatically identifying tissue types and the severity of lesions, thereby enabling timely detection and treatment of diseases.

Therefore, fifth-generation surgical robots must incorporate endoscopic microscopy technology to achieve micron-level precision and diagnostic capabilities. By leveraging fiber-optic technology, multi-sensor technology, and other advanced methods, these systems enable microscopic observation and identification of tissues, allowing physicians to detect smaller lesions, perform more precise operations, and facilitate earlier interventions. This represents the future direction for surgical robots as well as a key avenue for innovation in the medical field.

Compared with overseas markets, the development of surgical robots in China is still relatively lagging. Domestic manufacturers of surgical robots are facing competitive pressure from overseas giants. To achieve breakthroughs in this field, they cannot merely imitate and follow; instead, they must pursue independent innovation and develop distinctive features.

On one hand, we must strive to catch up in established fields by learning from and drawing on the technological expertise of overseas industry giants, thereby enhancing product quality and performance to address the needs and pain points of the domestic market.

On the other hand, it is essential to seek opportunities in new arenas by exploring and developing emerging technological directions, such as endomicroscopy and multimodal sensing technologies. By capitalizing on technological advancements to achieve leadership and differentiation, companies can stand out in the competitive landscape and earn market recognition and trust.

Of course, such innovation and breakthroughs cannot be achieved overnight; they require government support, the efforts of researchers, and independent core technologies. The government should provide greater policy support and financial subsidies to domestic surgical robot manufacturers, encouraging them to engage in technological R&D and market promotion. Researchers must possess foresight and courage, continuously exploring and innovating without fear of failure or challenges. Most importantly, domestic surgical robot manufacturers must master their own core technologies, avoiding reliance on external supply chains and patents, in order to truly achieve autonomy, controllability, and sustainable development.

As a key area of innovation in the medical field, surgical robots require continuous exploration and breakthroughs in technical challenges to meet market demands and expectations. For domestically produced surgical robots to break through in this sector, they must identify and genuinely address clinical pain points. Meanwhile, they should disrupt traditional surgical procedures, deliver tangible clinical value, and further increase clinical adoption rates, thereby providing essential support (“adding charcoal in snowy weather”) rather than merely incremental improvements (“adding flowers to brocade”). In this way, significant market opportunities will naturally emerge.

As one of the leading authorities in the field of surgical robotics in China, Zheng Guoyan possesses extensive experience and insights in technological research and application. His perspectives and recommendations hold significant guiding value for the development of domestically produced surgical robots. We have every reason to believe that, with concerted efforts from all parties, a thriving future for China-made surgical robots may be just around the corner.