Tuge Medical: A 100% Domestically Developed 4K Endoscopy System Challenging Global Leaders

Endoscope: A slender tube equipped with a lens and a light source, it can be inserted into the human body through natural orifices or surgical incisions to perform various diagnostic examinations or minimally invasive surgeries. Compared with traditional open surgery, endoscopic minimally invasive surgery is highly favored by both physicians and patients due to its advantages, including smaller incisions, less blood loss, and faster recovery. It has become one of the fastest-growing segments in China’s medical device industry in recent years.

According to the "2019-2025 Comprehensive Survey and Development Prospect Forecast Report on China's Endoscope Market" released by Zhiyan Consulting, the endoscopy sector features high technical barriers and a highly concentrated market. Foreign brands dominate the mainstream market, particularly in flexible endoscopes, where Olympus of Japan has established a global monopoly through its image processing technology, capturing over 65% of the market share. The rigid endoscope market is four to five times the size of the flexible endoscope market, with the majority of its share held by companies from Germany and Japan.

According to data from the China Association of Medical Device Industry, in 2018, China’s endoscope market reached RMB 27.8 billion, while the market for endoscope accessories was even larger, at RMB 50 billion. However, domestically produced endoscopes held a very low market share, accounting for only about 10% of sales volume. Imported products dominated the market, making endoscopes the medical devices with the lowest domestic production rate among mainstream medical equipment in China.

In this context, TUGE Healthcare has broken through the competition by introducing a fully self-developed 4K medical endoscopy system, thereby disrupting the domestic market landscape previously dominated by imported products.

TUGE’s 4K Ultra-HD Medical Endoscopy Imaging System is benchmarked against the latest products from leading international brands, offering imaging clarity that is four times the resolution of existing mainstream products.

TUGE, established in February 2018, is a company dedicated to the research and development and industrialization of ultra-high-definition medical endoscopy systems. Just three months after its inception, the company secured tens of millions of RMB in angel financing led by ZKCX Star, the proposer of the “hard tech” concept. To gain deeper insights into the company, VCBeat conducted an exclusive interview with Dr. Wang Yangang, Founder and CEO of TUGE.

When discussing 4K endoscopy products, Wang Yangang exudes confidence, a assurance rooted in the professional expertise of him and his founding team.

Wang Yangang graduated from the Institute of Automation, Chinese Academy of Sciences, with a Ph.D. in Pattern Recognition and Intelligent Systems. Since 2005, he has been dedicated to research on image processing algorithms and their hardware architectures. In 2010, Wang developed a high-resolution medical display solution for a medical imaging company in Nanjing. The medical display products he led in development achieved sales exceeding RMB 800 million, enabling his company to capture a 60% market share in this sector and reducing the market price from over RMB 100,000 to RMB 30,000.

This marked Wang Yangang’s first foray into the healthcare sector, in which he subsequently took root. Originally engaged in manufacturing accessories for endoscopes, he discovered that many domestic manufacturers were unable to clearly articulate the specific specifications and compatibility requirements of their products when communicating with the Chinese branches of foreign endoscope brands. Consequently, Wang Yangang decided to conduct his own in-depth research on endoscopes.

Wang Yangang believes that the lackluster performance of domestic medical endoscope brands is due to the high technical complexity and development risks associated with endoscopy, but the fundamental cause is a scarcity of R&D talent. Therefore, Wang Yangang placed particular emphasis on professional expertise when assembling his core team. To date, the key members of TUGE Healthcare’s founding team all come from front-line roles in the R&D and marketing of medical imaging equipment. The company has built a specialized team comprising masters and doctoral graduates from prestigious universities both in China and abroad, bringing extensive R&D experience and channel management capabilities.

Wang Yangang discovered that the mainstream endoscopes at the time were all 1080P products, while the imaging and display components required for 4K imaging technology had already matured and begun to gain widespread adoption in other fields. He keenly identified this breakthrough opportunity and, combining it with frontline clinical needs, initiated product definition and research and development. Wang Yangang stated that image quality, particularly clarity represented by high resolution, is a core demand of physicians, as well as a significant pain point and challenge within the industry.

Currently, the unit price of imported medical endoscopes exceeds one million yuan, a prohibitive cost that restricts the widespread adoption of minimally invasive surgery. As a result, endoscope-assisted minimally invasive procedures are predominantly concentrated in major cities and large hospitals.Popularizing medical endoscopes, breaking the monopoly of foreign products, and achieving high-quality import substitution have become the goals of TUGE.

The imaging component, which accounts for more than 70% of the total value of medical endoscopy systems, is one of the key R&D focuses of the TUGE team. After three years of dedicated research and development, TUGE completed the product development of its 4K medical endoscopic imaging system and submitted it for medical device registration on April 3, 2018. Wang Yangang stated: “"We have compared it with international leading brands using the same quantitative indicators. Key performance metrics such as resolution, color reproduction, and safety have reached world-class levels, with some specifications surpassing those of certain international leading brands."

In 2016, TUGE’s core team was established, focusing on the research of image algorithms. Three years later, the team completed product development and subsequently initiated registration and marketing plans. In April 2019, its 4K medical endoscopy system passed all technical tests. “By the end of September, our product will obtain the registration certificate from the National Medical Products Administration (NMPA), becoming the first 4K endoscopy product in China that is fully independently developed and compliant with the new endoscopy standards implemented in 2019.”

TUGE AIENDO 4K Ultra-High-Definition Endoscopy System features a full 4K imaging chain, with every component meeting 4K imaging standards, laying a solid foundation for image quality. The system primarily consists of a 4K camera, 4K camera control unit, cold light source, and 4K monitor.The application of 4K technology enables physicians to clearly visualize microvascular, neural, and lymphatic structures within the human body, providing reliable imaging for precision surgery.

AIENDO 4K Ultra-High-Definition Endoscopy System (Image provided by the interviewee)

After the physician activates the light source, the 4K optical lens is inserted into the human body through an incision. The illumination is delivered into the body via the light guide, while intraoperative images are transmitted in real time from the distal lens to the handle. The handle houses three circuit boards that rapidly convert optical signals into digital signals, achieving a link bandwidth of 12 Gb/s (whereas typical household broadband is 100 Mb/s, making 12 Gb/s 120 times faster). Finally, a 4K monitor employing 12G-SDI technology synchronously displays ultra-high-definition imagery, supporting transmission over a single cable for up to 100 meters. This offers a distinct advantage over foreign brands, which require four 3G-SDI links for equivalent transmission.

This system employs TUGE’s proprietary ACRe color reproduction technology to clearly and authentically distinguish the details and color variations of various tissues, achieving a color deviation (ΔE) of less than 1.5, which far exceeds industry standards. Built upon a comprehensive image processing algorithm pipeline, the system ensures precise eye-hand coordination for surgeons during procedures. It utilizes FPGA-based parallel processing to guarantee minimal system latency. Furthermore, the system complies with high-standard medical safety and EMC regulations, such as CE and BF ratings. It effectively resists interference from high-energy, high-frequency devices like electrosurgical units on signal transmission and processing, while ensuring surgical safety through extremely low radiation and leakage current specifications, thereby maintaining stable and safe operation in complex operating room environments.

“This serves as another pair of ‘keen eyes’ for physicians, enabling clear visualization of various human tissues and lesions, thereby enhancing surgical precision, minimizing tissue damage, and improving therapeutic outcomes,” said Wang Yangang. The TUGE AIENDO 4K Ultra-High-Definition Endoscopy System is independently developed by the TUGE Healthcare team. Compared with imported products, it offers significantly reduced costs while maintaining top-tier performance, resulting in a substantial price advantage.

In addition to providing medical endoscopic imaging systems for minimally invasive surgery,TUGE has also developed 3D endoscopes, 4K medical video recording and broadcasting equipment, full-link 4K integrated operating room solutions, and their supporting components.TUGE’s proprietary LLIP (Low-Latency Lossless IP) transmission technology leverages FPGA-based hardware for real-time encoding of ultra-high-definition video signals (3840x2160@60Hz), achieving a latency of less than 0.8 ms. Meanwhile, the video signals can be transmitted over networks with lossless image quality, providing a valuable technical solution for operating room renovations and surgical demonstrations.

Furthermore, TUGE has embedded AI hardware modules into its latest models. Leveraging state-of-the-art deep learning algorithms and the processing power of FPGA/SoC chips, the company is collaborating with research institutions such as the Institute of Automation of the Chinese Academy of Sciences and Southeast University, as well as multiple hospitals, to develop new functionalities. These innovations are designed to address practical frontline clinical needs by providing superior image quality and auxiliary information for minimally invasive surgeries.

Wang Yangang stated that improving endoscopic image quality and increasing the penetration rate of minimally invasive surgeries have always been TUGE’s goals. TUGE will continue to invest in research and development to consistently enhance the quality of its endoscopic imaging equipment.

Unlike many companies with strong R&D capabilities, the TUGE medical team also boasts extensive experience in sales, branding, and management.All members of TUGE’s marketing team possess hands-on hospital experience and team management expertise. Core team members have previously held positions at renowned enterprises in China and Europe, having led marketing teams to propel multiple products from zero market share to the No. 1 position in China.

Currently, TUGE’s rigid endoscope products have rapidly established strong relationships of mutual trust with the gastrointestinal surgery, hepatobiliary surgery, urology, and gynecology departments at more than ten top-tier hospitals in China. Meanwhile, its flexible endoscopes have developed mature sales solutions in collaboration with leading domestic manufacturers. The company also possesses comprehensive information on the majority of endoscopy and imaging equipment distributors across China, having previously maintained strong cooperative relationships with a significant portion of them. This has laid a solid foundation for launching comprehensive marketing and sales activities nationwide.

Meanwhile, TUGE has also initiated applications for CE and FDA certifications, aiming to enter the international market and compete with top-tier global brands. Wang Yangang revealed to VCBeat that TUGE is currently undergoing Series A financing to strengthen new product development and marketing efforts. Recognizing that superior technology requires strong market acceptance, the company also intends to attract more professional talent to bolster its team.