Surgery robots are secretly revealed: price, profit, application department, full player resolution!

Release date: 2015-07-13

Intelligentization is a new direction for the development of the medical hardware equipment industry. We propose the theme of “smart medical hardware” investment, and believe that this theme will be an important investment opportunity for the next three to five years in the domestic first- and second-tier market in the pharmaceutical industry after “individualized medical/precise medical”. We define "smart medical hardware" as a new generation of medical applications that are based on advanced software technology and big data with new generation hardware technology to innovate or upgrade traditional medical equipment.

We will screen and integrate industry information on the theme of “smart medical hardware” according to the development of the Chinese market, and launch a series of research reports in the field of medical equipment segmentation. The subject of this study is one of the smart medical hardware that best represents the latest developments in medical development.

The application of robots in the medical field has received extensive attention. At present, research on the application of robots in the medical field mainly focuses on surgical robots, rehabilitation robots, nursing robots and service robots. Among them, surgical robots are currently the most widely used and most promising, and their powerful functions overcome the problems of poor precision, long operation time, fatigue of doctors, and lack of three-dimensional precision vision in traditional surgery.

Surgical robots will change the traditional medical landscape. Minimally invasive surgery is the theme that the medical profession has been pursuing for nearly 30 years. Minimally invasive endoscopic surgery has seen a bright future for minimally invasive surgery. The da Vinci surgical robot (da Vinci) system, which was introduced in 2000, has an excellent clinical effect and has laid an important tone for the future development of medical intelligence, minimally invasive and precise. With the upgrading and continuous improvement of surgical robots, major reforms in the medical system will be promoted in the near future.

US IntuitiveSurgical Corporation monopolizes the global market. The launch of the company's Da Vinci surgical robot system caused a sensation in the overseas primary and secondary markets. IntuitiveSurgical's share price also rose from $10 at the time of listing to a high of $588 in May 2012, an increase of 58.8 times. As of the end of 2014, there were 3,266 Da Vinci robots in the world, and the domestic introduction price was as high as 20 million yuan. The surgical robot system not only has a large sales market, but also has the potential to change the rules of the medical industry. It is an important strategic weapon for the future medical field layout.

China will usher in important development opportunities in the surge of surgical robots. China's current market reaches 850 million, and by 2018 it will be 1.57 billion. With the domestic policy of encouraging high-tech medical device research and development in recent years, and the continuous improvement of the domestic research institute's efficient independent research and development, China will have the hope to break the monopoly of surgical robot import. The industrial chain of surgical robots will also bring opportunities to domestic related companies, and have the potential to enter the market from dealers, consumables and maintenance, robotic operation training services, and even surgical outsourcing services.

Research logic

1. What is a surgical robot?

The robot has high assembly motion accuracy and can operate stably and accurately process data. In the medical field, robots can better replace some doctors with computer control technology to complete some tasks. At present, research on the application of robots in the medical field mainly focuses on surgical robots, rehabilitation robots, nursing robots and service robots. Among them, surgical robots are currently the most widely used and most promising, and their powerful functions overcome the problems of poor precision, long operation time, fatigue of doctors, and lack of three-dimensional precision vision in traditional surgery. Surgical robots are a new type of research field that integrates many disciplines such as medicine, mechanics, biomechanics, computer vision, and artificial intelligence.

1.1 History of surgical robot development

In 1985, robots were used for surgery for the first time in medical treatment. The robot used at the time was the PUMA560 industrial robot. The doctors used it to complete the guided probe brain biopsy, and then improved the transurethral resection of the prostate. However, due to security risks, the robot has not been further promoted.

In 1987, after the first successful laparoscopic minimally invasive surgery, the public began to increase the demand for Minimal Invasive Surgery, and more and more surgical fields have used minimally invasive surgery to replace traditional surgery. However, laparoscopic surgery has obvious defects, such as the need for surgeons to assist surgery, loss of three-dimensional vision and touch, excessive instrument length and fulcrum effect leading to poor flexibility.

The research boom of minimally invasive surgery robots kicked off in the 1990s. In 1994, the first computerized surgery robot Aesop (AESOP) from Computer Motion of the United States appeared. Aesop has a virtual joint (7 degrees of freedom) that can receive the surgeon's voice command or foot control to adjust the position of the laparoscope, but cannot perform the operation independently. By the end of 1999, AESOP had completed 80,000 operations.

In 1996, ComputerMotion's upgraded version of the second-generation robot Zeus (ZEUS) was introduced in a hand-operated mode consisting of three robot arms, a coefficient console and a computer controller. The doctor can control the laparoscope arm by voice control and operate the other two surgical robots by hand. Zeus was awarded the European CE market certification in 1999 and completed a remote cholecystectomy in 2001.

In 1999, IntuitiveSurgical's first Da Vinci Standard robot was successfully developed. Based on the basic model of Zeus, its excellent ergonomic design, high-performance vision system and unique internal wrist technology complete the initial setting of the surgical robot. In July 2000, the Da Vinci system was approved by the US FDA as the first legally commercial surgical robot allowed for clinical use. The company was listed on NASDAQ in June 2000. In 2003, Intuitive Surgical completed the acquisition of Computer Motion, which began to monopolize the surgical robot market, and its global robot market share has reached more than 50%.

In 2006, the second-generation DaVinciS system (daVinciS) appeared with four robotic arms and HD 3D HD endoscopes. In 2009, the third-generation da Vinci Si system was further upgraded, with a two-master-doctoral doctor's console, which facilitated surgical guidance and advanced visual HD technology with a magnification of 10 times.

The latest generation of the fourth generation Da Vinci Xi was approved for use by the US Food and Drug Administration on April 1, 2014. In addition to the robotic accuracy and operating range upgrades, the new DaVinci system also features laser positioning and a new design for rotating brackets that make the four minimally invasive scalpels more flexible. The new system is scalable and seamlessly connects a range of imaging systems and instrumentation technologies. The University of Miami's Sylvester Cancer Center officially launched the fourth-generation DaVinci system, but the third-generation DaVinci system still dominates the market.

Figure 1: Schematic diagram of the fourth generation Da Vinci system (da Vinci Xi)

This article is based on the most mature technology, the world's most widely used auxiliary surgical robot system Da Vinci as the main reference, the analysis of the minimally invasive surgical robot investment market.

1.2 Da Vinci Surgical Robot System

The Da Vinci Surgical Robot System is an auxiliary surgical robot system developed by the global medical robot giant Intuitive Surgical. It is also the only robotic surgery system in the world that can be officially used in hospital surgery.

The Da Vinci surgical robot system consists of three main parts: 1. Doctor's console, 2. 3D imaging video imaging system, 3. Multiple robotic arms, camera arm and surgical instrument. The doctor can sit in front of the console away from the operating table, directly acquire the three-dimensional stereoscopic field around the surgical target position in the patient through the three-dimensional imaging video imaging system, and perform the operation through the hand motion sensory manipulation of the mechanical arm.

The latest generation of "Da Vinci" surgical robots have 4 arms, one for the camera arm, and the other three can be used to convert the separator, tweezers, and ultrasonic scalpel. The imaging system's built-in robot's core processor and image processing equipment, combined with the 3D camera arm, can display high-definition 3D images of the patient's body for the surgeon to accurately complete the operation through the robotic arm. The Da Vinci surgical robot system breaks through the limitations of the traditional surgical field of view and the surgical operation angle of the patient, and achieves the degree of miniaturization and precision that cannot be achieved by traditional surgery. At present, the Da Vinci surgical system has been adopted by hospitals all over the world, and has been successfully applied to general surgery, thoracic surgery, urology, obstetrics and gynecology, head and neck surgery and cardiac surgery for adults and children.

Figure 2: Schematic diagram of Da Vinci system operation

For surgeons, the advantages of the Da Vinci surgical robot system are:

(1) Provide a stereoscopic field of vision and clearly prepare the position of the surgical target.

(2) The joint wrist on the surgical instrument has multiple degrees of freedom of movement, which is more flexible, expands the operation ability of the operator, improves the accuracy of the operation, and can eliminate unnecessary vibration and break the limitation of the operation space.

(3) The surgeon can personally complete the work of a TV laparoscopic surgery team to optimize human resources.

(4) The surgeon is in a sitting position for system operation, which is conducive to long and complicated surgery.

For patients, the advantages of the Da Vinci surgical robot system are:

(1) Minimally invasive surgery minimizes wounds (single wound diameter is 25px),

(2) The amount of blood loss or blood transfusion is reduced;

(3) reduce the demand for anesthesia and the risk of infection;

(4) The recovery time is shortened and the number of hospital stays is reduced.

Therefore, the surgical robot system is absolutely revolutionary innovation for minimally invasive surgery, which not only reduces the surgical trauma to a greater extent, but also improves the efficiency of the doctor. More importantly, it improves the surgical effect and promotes minimally invasive surgery. Advances in surgery offer more possibilities.

1.3 surgical robot industrialization bottleneck

The constraints of the industrialization of surgical robots are mainly experienced in three aspects: technical defects, management applications and high cost of use.

Technical defect

Loss of touch leads to the inability to distinguish between tissue toughness and vascular pulsation, and the lack of temperature sensation leads to the inability to discern differences in tissue temperature.

Lack of grip and pressure feedback systems for fine movements.

Management application

Robotic surgery systems are not yet available for all surgical procedures, especially complex and difficult surgical procedures.

The robotic surgery system requires a surgeon with some surgical clinical experience and operational training.

The quality control system is imperfect, and the quality control of the equipment requires the third-party testing and certification body to regulate.

At present, robotic surgery can not be included in the medical security system, which has a small economic burden on patients.

High cost of use

Maintenance costs are high, and surgical robots usually need to be maintained and maintained every 3-4 months.

The equipment is expensive, and its price in China is as high as 20 million yuan.

Consumables are expensive, and the surgical instruments that are equipped with the equipment are consumables. Each use is limited to 10 times, and each operation requires 3 to 4 pieces. The price of each consumable device is as high as 3.6-4.2 million yuan, which means that each robotic surgery consumables will cost about 10,000 yuan.

Surgery is expensive, and its cost is 20,000-30,000 yuan more than ordinary surgery.

1.4 The future development direction of surgical robots: personalized, remote, intelligent

The development direction of minimally invasive surgical robot technology can be mainly reflected in the following three technical branches: workspace analysis and path planning system, virtual reality surgery system and human-computer interaction system.

Workspace Analysis and Path Planning System: Personalization

In the use of robotic surgery, the speed of the instrument in the patient's body, the range of movement needs to be more accurately calculated. When multiple robotic arms are operated together, it is especially important that the coordination path does not interfere with each other in a small space. Therefore, improving workspace analysis and path planning can improve surgical efficiency and safety. The future technical goal is to combine pre-operative information with the in-situ navigation system so that the surgical procedure can automatically determine the workspace and path automatically. Future surgery will tend to be personalized. The doctor will edit the surgical procedure according to the image of the patient's body, and then only need to monitor the completion of the operation after issuing the surgical operation instructions.

Virtual reality surgery system: remote

The integration of virtual reality technology, such as medicine, is of great significance. Future virtual reality technology can enable the surgeon to complete the operation with remote control. As early as 2001, the United States and France had completed the world's first remote cholecystectomy surgery across the ocean. In 2003, China’s Beijing Navy General Hospital and Shenyang Hospital cooperated to complete the first remote remote robot operation in China. The development of future surgical robots will make communication and cooperation between surgeons unhelpful, and the global medical technology will be rapidly improved.

Human-computer interaction system: intelligent

The research and development of dynamic feedback can further improve the human-computer interaction system. The dynamic feedback of adding fine movements not only enhances the precision of the surgeon's operation, but also provides surgical tips and alarms for the doctor through software settings, making the surgical robot more intelligent.

2, the global market for surgical robots

2.1 Global medical device market scale and R&D investment grow steadily

According to EvaluateMedTech, the global medical device market grew from $272 billion in 2007 to $380 billion in 2014. According to forecasts, the compound annual growth rate will be 5% between 2013 and 2020, and the global market will reach 514 billion US dollars by 2020. Among them, global medical device R&D investment will reach US$30.5 billion in 2020 from US$23.8 billion in 2014, with a compound annual growth rate of 4.2%. The market size of global medical devices and steady growth in R&D investment will continue to improve existing medical standards. As the future direction of medical device evolution, surgical robots will also face challenges and opportunities.

2.2 Global medical robots will reach $3.764 billion in 2018

According to MarketsandMarkets' 2014 research report, the global medical robot market was $1.781 billion in 2013 and is expected to reach $3.764 billion in 2018, with a compound growth rate of 16.1%. Among them, surgical robots account for about 60% of the market share. The report indicates that the current North American market is currently the largest market, and due to increased government medical investment, medical system restructuring and people's awareness of minimally invasive surgery, the future market focus will gradually shift to the Asian market.

2.3 US Intuitive Surgical Company Monopolizes Global Market

The emergence of the Da Vinci surgical system has changed the landscape of traditional surgery and reshaped the US surgical market. The figure below shows the scale of surgery types in obstetrics and gynecology and urology. It can be seen that the Da Vinci surgical system has changed the pattern of traditional surgery during the 10-year period, and its status in the medical field is becoming more and more important.

Figure 3: Evolution of Da Vinci's surgery in obstetrics and urology

Intuitive Surgical was founded in 1995 and went public in 2000. It began to make profits in 2004. The stock price also rose from 10 dollars at the time of listing to the highest price of 588 dollars in May 2012, an increase of 58.8 times. As of June 22, 2015, Intuition Surgery Company's share price was 499.45 US dollars, the total share capital was 36,599,800, and the market value reached 18.28 billion US dollars, equivalent to 113.33 billion.

Intuitive Surgical's financial performance over the past decade has been amazing. The compound revenue growth rate of the company reached 41%, the net profit growth rate was higher, and the gross profit margin was in an upward trend. From 2008, the gross profit margin exceeded 70%. According to IFR statistics, the global sales of medical robots in 2013 was about 1.45 billion US dollars, about 8.7 billion yuan, of which Da Vinci system accounted for more than 50% of the entire medical robot market.

According to the official INTUITIVESURGICAL 2014 report, the Da Vinci system performed approximately 570,000 surgeries, compared to 523,000 in 2013 and 450,000 in 2012. The major increase in the volume of surgery in 2014 came from general surgery in the United States and urological surgery worldwide. In 2014, the total number of operations except the United States was 121,000, a year-on-year increase of 19.8%, much higher than the 9.0% increase in total surgery. Figure 4: Da Vinci system surgery total 2009-2015 data.

The Da Vinci system is generally priced between 3.72 million yuan and 15.5 million yuan. IntuitiveSurgical's turnover also comes from consumables and maintenance, with contracted maintenance costs ranging from RMB 62 to 1.05 million per year depending on the model. In 2014, the annual turnover reached more than RMB 13 billion. The revenue from consumables and maintenance costs is growing faster than the Da Vinci system sales revenue.

The Da Vinci system sold a total of 431 units in 2014, compared with 546 units in 2013. As of December 31, 2014, the global DaVinci system reached 3,266 units, of which 2223 were distributed in the United States, 549 in Europe, 193 in Japan, and 301 in the rest. System sales have declined in Japan. In China, INTUITIVE SURGICAL's 2014 annual report is optimistic and believes that sales will continue to rise steadily in previous years.

Figure 5: Global sales of the Da Vinci system in the four quarters of 2013 and 2014

By the end of 2014, there were 3,266 Da Vinci robots in the world, including 2,223 in the US, 549 in Europe, and 350 in Asia. There are 29 in China, 9 of which are in Beijing. According to incomplete statistics, there are currently about 34 Da Vinci surgical robots imported from 30 medical institutions in China, and 8 Da Vinci surgical robots in Hong Kong.

2.4 Other surgical robot companies

Intuitive Surgical's DaVinci system currently has a huge advantage, basically completing the rule of the surgical robot market. The Da Vinci surgical system has been used in general surgery, thoracic surgery, urology, gynecology, head and neck surgery, and cardiac surgery, and its superiority makes it impossible to replace in these areas.

Figure 6: Current FDA approved surgery that can be operated by the Da Vinci robotic system

At present, most robots developed by other companies or institutions have turned their attention to the surgical fields that are temporarily unoccupied by the Finch system, such as ophthalmology, neurosurgery, and orthopedics. In 2007, Johns Hopkins University developed Steady-Hand for the vitreoretinal minimally invasive robot. ZTH Zurich is currently developing a wireless micro-robot system for eye surgery. ImperialCollege London recently studied a new type of robotic probe for craniotomy for neurosurgery. The ROBODOC robotic system developed by the IBM Research Center and the University of California research team was approved by the FDA for total orthopedic surgery for orthopedics in 2008 and is constantly being updated. However, the above-mentioned surgical robots have a small market, expensive equipment and technical defects, which have made them unable to receive special attention in the market.

The SPORT system being developed by Canada's TitanMedical Company is trying to challenge the dominance of the Daphne system with its small equipment, low price and independent research and development patents. Targeted in general surgery, gynaecology and urology, the SPORT system has a patented design for single-hole devices and is marketed with a flexible platform, small footprint and low cost (less than $1 million). Titan Medical plans to be FDA-approved in 2017 and sold in the United States. Then the factors such as insufficient funds and time-consuming research and development will leave no room for delays in equipment approval or other emergencies. The prospects remain to be seen. Its share price has fallen from $2.19 on September 30, 2014 to $1.34 (June 23, 2015).

3. Why do domestic and foreign surgical robots cross the threshold at this time?

3.1 Smart medical hardware is the global medical trend

When "Internet +" and "Big Data" flourished in China, the United States has gradually begun the "smart hardware era." With strong software technology and big data foundation, the Internet and software technology giants have already begun to deploy smart hardware.

Amazon invested in the development of unmanned aerial vehicles following the e-reader. Google is committed to building Google glasses and driverless cars. Facebook plans to launch a series of "virtual world" experience devices. In order to consolidate its position in smart hardware, Apple launched Apple's smart watch. The intelligent hardware represents 3D printers, intelligent robots, and Tesla pure electric vehicles, etc., which are familiar to everyone.

"Intelligent medical hardware" is bound to be the future trend of medical device development. Many domestic and foreign giant companies have laid out the smart medical hardware business. Throughout history, the advancement of emerging technologies will inevitably be reflected in the development of the medical industry. The arrival of the "smart hardware era" driven by the development of artificial intelligence technology will not only improve and improve people's lifestyle, but will also create more far-reaching value on the medical side.

Many foreign giant companies have stuck in smart medical hardware. Apple is making every effort to create medical hardware products and actively develop sensor technology that can predict heart disease. Ethicon, a medical device company of Google and Johnson & Johnson, announced a strategic cooperation agreement in March this year to jointly promote a new robot-assisted surgical platform. Intel entered the chip field of medical monitoring equipment by acquiring new technology company Basis Surgical Science.

Domestic Internet BAT (Baidu, Alibaba, Tencent) three Internet giants have marched into the field of medical equipment. Alibaba and Foxconn Technology Group announced on June 18 that they will invest 732 million yuan in Soft Rock Robot Holding Co., Ltd. to develop and expand the robot industry and intend to enter the medical and health field.

3.2 Intelligent medical hardware is supported by national policies and is expected to develop rapidly

It is reported that the "13th Five-Year Development Plan for the Pharmaceutical Industry" (referred to as "Planning") will be completed this year. Based on the established thinking, biomedicine and high-performance medical devices have been identified as areas for achieving breakthroughs. According to incomplete statistics, there are about 15,000 medical device manufacturers in China, but 90% of them have a revenue of less than 20 million yuan. In the current medical institutions, high-end medical devices are basically monopolized by foreign products. During the "Thirteenth Five-Year Plan" period, the state will pay more attention to and support the development of the medical device industry. Medical device companies face the challenge of industrial restructuring, and relevant departments have introduced more policies to support the development of high-performance medical devices, and medical device enterprise innovation will be the focus of the market.

3.3 The domestic market of surgical robots will nearly double in 2018

At the beginning of 2013, the Health and Family Planning Commission issued the document "2013-2015 National Endoscopic Surgical Instrument Control System Configuration Plan" to clarify the standards for the deployment of surgical robots in public and non-public medical institutions. According to the planning content, a total of 90 hospitals nationwide will be able to purchase the Da Vinci system by 2018. According to the current estimate of 34 Da Vinci systems and 80% market share among the 50 domestic standard hospitals, China's current surgical robot market is 850 million yuan. Assuming that the Da Vinci system achieves a 70% purchase rate and an 80% market share estimate in 2018, the domestic market will be 1.57 billion in 2018.

3.4 Domestic and foreign surgical robots are in the early stage of research and development or clinical trials

In 2003, the “Li Yuan” robot system developed by Beijing University of Aeronautics and Astronautics, Tsinghua University and the Navy General Hospital was the first new minimally invasive surgical robotic surgery system with autonomous control, visual positioning and remote control functions.

In December 2013, Harbin Institute of Technology announced the official completion of a minimally invasive abdominal surgery robot with independent intellectual property rights in China. The results have a breakthrough in the mechanical design of the surgical robot system, the master-slave control mechanism, and the three-dimensional laparoscopic key technologies.

In March 2014, the domestically developed “Miao S S” robot successfully completed the first domestic robot operation in the Xiangya Third Hospital of Central South University. The technical advantage of "Miao S" is embodied in the multi-degree-of-freedom wire drive decoupling design technology, which can be operated flexibly and accurately in a small space. The small size and low cost advantage of the “Skills S” make it possible to become a domestic competitor of the Da Vinci system.

3.5 surgical robot technology decomposition and technical barriers

As the core of the control, the doctor's console consists of a calculation system, an operating handle and a monitor. The surgeon uses a computer signal to transmit the surgical instruments on the robot arm through the movement of the wrist and fingers. At the same time, the electric cutting and electrocoagulation operations can be completed through the foot pedal. The core of the design is the computer operating system of human-computer interaction. The core of the technology is the mechanical sensor that can accurately grasp the fine movements of human fingers.

The 3D Imaging Video Imaging System provides a realistic 3D view of the surgeon's patient anatomy and is visible to the entire surgical team through a large-screen video system. The core technology is the HD 3D endoscope.

A mobile platform composed of a plurality of robot arms, a camera arm and a surgical instrument receives a doctor's operation command to perform minimally invasive surgery on the patient. When the robot is operated, firstly, several small holes with a diameter of 25px are placed on the chest wall or the abdominal wall, and the robot arm enters the patient's body to operate. The robotic arm and core technology make the built-in wrist device difficult to imitate the subtle movements of the human arm and to experiment in a narrow space with a wider range of motion than the wrist. The design core is designed with multiple robotic arms to ensure that the movement trajectories do not interfere with each other.

3.6 Surgical robot segmentation industry brings opportunities to domestic companies

Surgical robots differ from other medical devices in that they have the potential to change the rules of the medical industry. The promotion of future surgical robots will result in the elimination and redesign of some of the devices, which is likely to change the business model in many segments of the current medical industry. Research on market segments requires research on the industry chain. The industrial chain of surgical robots can be divided into equipment development, consumables and maintenance and training services for doctors from upstream to downstream. Domestic companies have the opportunity to gradually compete with overseas giants through market segments.

Equipment development

The domestic market of equipment is monopolized by foreign companies. The main technical barriers of the DaVinci system are mainly in the design of high-degree-of-freedom mechanical wrists, high-definition speculum imaging equipment and computer integrated control systems. Innovative breakthroughs in surgical robots require the completion of surgical procedures that doctors cannot perform. As a systematic device that integrates multiple technologies, surgical robot innovation is more important than engineering. Domestic surgical robot research and development projects are mainly in the engineering research and development laboratories of key universities, while the top foreign teams are more in medical research centers or top university medical schools. Domestic companies can conduct independent research and development by recruiting top talents from abroad to form a comprehensive team with comprehensive knowledge of medical engineering.

Dealer

The current surgical robot systems used in China are all imported. Distributors will have a certain market share as the main sales bridge for foreign companies in China. Dealers as an intermediary, in addition to sales to qualified hospitals, can also build a platform for foreign supply companies and domestic company equipment maintenance, technical guidance and cooperation with domestic consumables companies.

Consumables and maintenance

As mentioned above, IntuitiveSurgical's profit is more from consumables and maintenance of equipment, which was RMB 9.3 billion in 2014. The robotic arm of Da Vinci's latest generation of surgical systems enables seamless connection of a wide range of surgical instruments and imaging equipment. Domestic surgical instrument companies may be able to cooperate with Intuitive Surgical in a range of surgical instruments used in the arm, thus occupying a certain market share.

The maintenance cost of the Da Vinci system is calculated according to the current domestic 34 systems for the market of 27.2 million RMB per year, which can reach 50.4 million yuan in three years. Domestic related companies can enter the market segment by means of contract cooperation.

Robot operation training service

The Da Vinci operating system requires a doctor to train for a certain period of time to be proficient. The practice process can cause equipment loss, and the cost of the Da Vinci system's high-priced consumables and equipment is too high, resulting in high training costs. Domestic companies can serve doctors in need by developing human-computer interaction simulation software and analog operating systems.

Surgery outsourcing

The promotion of surgical robots may break the existing medical business model. In the future, hospitals may be more likely to diagnose users, and robotic surgery may be outsourced to professional companies. Surgical robots are not only profitable products, but also strategic products for the future medical market.

4. Domestic business companies involved in medical robots

4.1 listed company

A, robot

(1) Company Profile

Shenyang Xinsong Robot Automation Co., Ltd. was established in 2000 and was listed in 2009. It was founded by Shenyang Automation of the Chinese Academy of Sciences. The company is a supplier of industrial robots and automation equipment with independent intellectual property rights. Its main products include industrial robots, logistics and warehousing automation equipment, automated assembly and inspection production lines, and transportation automation systems. The company's products can be widely used in automotive and automotive parts, engineering machinery, rail transit, low-voltage electrical appliances, electric power, IC equipment, military, tobacco, finance, medicine, metallurgy and printing and publishing industries.

(2) Medical robot layout

Shenyang Xinsong Robotics Co., Ltd. has utilized its advantages in the field of robotics and has been deployed in the field of accompanying robots, orthopedic surgery robots and mirror diagnostic and therapeutic auxiliary robots.

Accompany the robot.

The accompanying robots of Shenyang Xinsong Robotics Co., Ltd. are currently mainly for nursing homes and community services. Its functions include physiological signal detection, voice interaction, telemedicine, smart chat, and autonomous obstacle avoidance roaming. It can take care of the needs of users in life care, remote communication and medical monitoring. The robot has a smart chat function that can assist the elderly in psychological recovery. In conjunction with relevant testing equipment, the robot has physiological signal detection and monitoring functions such as blood pressure, heartbeat, and blood oxygen. It can be wirelessly connected to the community network and transmitted to the community medical center. In an emergency, it can promptly report or notify relatives. The accompanying robots provide solutions to major social problems brought about by the aging of the population.

The robot has broken through many key technologies such as robot speech recognition and interaction algorithms, data fusion of network sensing and multi-sensor, robot-assisted psychological rehabilitation of the elderly, remote monitoring and control of wireless networks. In 2012, he applied for a patent for telemedicine functional technology. It is still in the demonstration application stage.

Orthopedic traction assisted robot.

In 2013, Xinsong Robotics Co., Ltd. developed the first orthopaedic traction robot and produced a testing machine. The orthopedic traction robot uses the traction bracket of the robot system to fix the injured part of the patient and improve the stability of traction. Then use a mechanical arm to feedback the holographic image of the surgical site in real time during surgery and traction, so that the doctor can better plan the whole process and strengthen the doctor's judgment on the fracture traction. Finally, the robotic system helps the doctor to accurately guide the fracture site and help the patient to reduce the fracture.

At present, the company has 7 patents for orthopedic robots and is applying for a license for the production of medical device products.

Gastroscope diagnosis and treatment assisted robot system.

The gastroscope diagnosis and treatment assisted robot system is one of the subjects of the National Science and Technology Support Program in the 12th Five-Year Plan. It is aimed at the huge demand for gastroscopic diagnosis and treatment of 80 million patients with gastrointestinal diseases in China, and the internationally pioneering gastroscope diagnosis and treatment assisted robot system with independent intellectual property rights carried out by the well-trained doctors. Research and development.

At present, the subject breaks through the three key technologies of gastroscope delivery technology, tumor lesion recognition algorithm, high-performance multi-power integrated high-frequency power system construction; developed flexible endoscope scope transport unit, tumor lesion recognition module, multi-power integration The core components such as the high-frequency power system; completed the development of the prototype of the gastroscope-assisted robot system, the tumor-assisted diagnostic software system, and the prototype of the argon-ion coagulation device under the microscope.

B. Boshi shares

(1) Company Profile

Harbin Bosch Automation Co., Ltd. was established in 1997 and was listed in 2012. The sponsor of the Robotics Research Institute of Harbin Institute of Technology is currently the largest shareholder of Bosch Automation. The company is a provider of automated integrated solutions for the development, production and sales of petrochemical chemical reprocessing equipment and related products. Due to the downward pressure on the prospects of the existing petrochemical industry, the company has actively formulated future strategic directions and targets to promote research and development and investment in high-end medical equipment represented by robotics.

On May 11, 2015, the company decided to set up a wholly-owned subsidiary, Boss High-end Medical Equipment Co., Ltd. to invest 100 million yuan and subscribe for the equity of Sage Rui Medical for 20 million in cash. It plans to invest in “Mini-Invasive Surgery Robotics and Smart Device Projects” through medical equipment companies.

(2) Medical robot layout

Bosch Automation aims to focus on high-end medical robots, and to develop minimally invasive surgical robots with Harbin Institute of Technology and related company Sizherui Medical, aiming to break the monopoly of Da Vinci robots in China.

Minimally invasive surgical robot.

The National “863” Program Funded Project – “Minimally Invasive Abdominal Surgery Robot System” was successfully developed by the Robotics Research Institute of Harbin Institute of Technology in 2013 and passed the acceptance of the national “863” program expert group. The robot was jointly developed by Harbin Institute of Technology and Sizhirui Medical. The robotic system is similar to the Da Vinci robotic system and consists of a robotic arm, a three-dimensional imaging system and a doctor's console. The doctor can perform minimally invasive surgery on the patient through the high-definition 3D imaging system and force feedback remote control in the console.目前该机器人可以可现微创腹腔外科手术常用的分离、切割、止血、缝合等基本动作。一代产品已完成多批次动物实验。而二代产品已完成产品定型，在进行样板机的组装。预计2015年年底可以准备申请产品形式检验，并在2017年底申请产品注册。

C、楚天科技

（1）公司简介

楚天科技股份有限公司成立于2002年，于2014年在深交所创业板上市。该公司以水剂类制药装备的研发、设计、生产、销售和服务为主营业务。水剂类制药装备是制药企业生产针剂的关键制剂。未来公司布局医药机器人和医疗机器人。利用智能机器人的市场规模将迅速放大，来完成公司的产业转型升级。

（2）医疗机器人布局

楚天科技利用自身在水剂类制药装备的经验，加以改进，计划2015年底推出药用无菌分装机器人。

在医疗机器人方面，楚天科技与国防科技大学，中南大学和华中科技大学合作。将把外骨骼机器人研究作为切入点，主要用于残疾人和老年人生活自理，起到辅助性的作用，同时该类机器人可以用于军队负重等领域，由国防科技大学负责进行列装申报。

D、迪马股份

迪马股份于2015年4月1日与成都电子科技大学签订产学研协议，共同合作开发外骨骼机器人。

E、海思科

海思科于2015年6月25日公告，参股公司Haisight将使用1,050 万美元认购MST 优先股174,993 股，占其完全稀释基础上26.66%的股权。

MST 是一家位于以色列的领先的医疗器械研发公司，其主要产品为“AutoLap”，一种腹腔镜手术用图像引导腹腔镜智能定位装置，可以成为医生“自己的第三只手”。 AutoLap技术全球领先，拥有医疗领域全球唯一的实时图像引导定位系统，产品已获美国食品药品监督管理局（FDA）及CE 认证。MST计划在近期申请中国食品药品监督管理局（CFDA）的认证。Autolap全球市场机会超过30亿美元，预计2018年将超过50亿美元。

根据相关协议，海思科将获得“AutoLap”在中国的15 年独家销售代理权，有望为公司未来业绩带来显着提升。

4.2非上市国内医疗机器人公司

A、妙手机器人科技集团

（1）公司简介

南京妙手机器人科技集团成立于2012年，是南京321人才计划支持的初创企业之一。公司专注于提供智能的机电一体化技术、机器人产品和数字化制造设备；关注的领域有：医疗服务、工业生产、制造加工、交通运输、以及智慧城市。目前公司主要研发产品有医疗及辅助手术机器人、工业机器人、服务机器人和科教机器人。

（2）医疗机器人布局

妙手机器人公司致力于研发高端的微创外科手术机器人系统，志在打破达芬奇手术机器人系统的垄断。公司与天津大学合作研发“妙手机器人系统”是国家863计划和国家杰出青年科学基金重点支持项目，已进入临床测试阶段。该机器人系统拥有4个美国SensAble公司6自由度的PHANTOM? DESKTOP机械臂，三维成像仪，和重力感应操作台。妙手S已与中南大学湘雅三医院合作，先后为3位患者进行了胃穿孔修补和阑尾切除。手术过程顺利，患者术后恢复良好。并预计在3年后投产使用。

B、重庆金山科技有限公司

（1）公司简介

重庆金山科技有限公司成立于1998年，是中国最具发展潜力的民营企业50强之一。公司是集数字化医疗设备研发、生产、销售和服务于一体的国家级高新技术企业。其主要产品有胶囊内镜，胶囊机器人，电阻抗成像等。

（2）医疗机器人布局

胶囊机器人

金山科技研发出全球首款的“胶囊机器人”。传统的胶囊内镜口服内置摄像与信号传输装置的智能胶囊，借助消化道蠕动使之在消化道内运动并拍摄图像。但传统胶囊内镜只能借助消化道蠕动，无法对胃部进行完整精确观察。而胶囊机器人可让医生通过体外的“胶囊内镜姿态控制器”控制病人体内的胶囊运动，实现对胃等大型消化道的全方位检查。

手术机器人系统

目前金山科技已布局手术机器人系统，研发的微创手术机器人预计将在2015年7月在重庆的几家医院进行临床试验。该机器人系统由三维成像系统，机械手术臂和触觉感应操作台组成。

C、深圳市桑谷科技有限公司

（1）公司简介

深圳市桑谷医疗机器人有限公司成立于2003年，是深圳市机器人协会、银星集团国家高新技术企业的子公司。目前从事专业智能医疗机器人技术开发应用、生产经营和销售。目前公司旗下产品有集清洁机器人和医疗机器人。

（2）医疗机器人布局

桑谷医疗机器人与美国全球领先生产机器人制造工厂—Unmaion公司和南方科大附属医院发明了中国第一台智能静脉输液药物配制机器人。该机器人可用于医院门诊、肿瘤化疗科、传染病科、全肠道外营养及液体净化的配药。机器人的机器手整个工作过程是无须接触药液，利用无菌的传递操作系统在洁净环境空间室，进行全自动药物的配置，保证了配制输液的无菌性、相容性、稳定性和减少微粒污染。同时也有效防止在配制细胞毒性药物时所带来周边环境的污染，提高了临床合理用药的安全性。

来源：健康智汇

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