This article was originally published on MedTech Intelligence.
Driven by an aging population with growing needs for new medical technologies—and more means to pay for them—governments and hospitals in China, Japan, Singapore, Thailand and Korea are joining forces to purchase an increasing number of robotics systems from abroad, and also developing medical robotics technologies themselves.
Today, Asian surgeons in the region utilize more surgery assistance robots, operated by remote control and outfitted with miniature cameras, forceps, suturing tools and other surgical instruments. Increasingly, robots are also used for medical transport, therapies, pharmacy automation and data processing for diagnoses.
With affluent populations demanding better medical care, Asian investors are becoming more adventurous. Governments, faced with doctor shortages and cognizant of the advantages robotics hold for alleviating surgical errors, are increasingly backing the development of cutting-edge medical technologies. Spending by healthcare providers on robotics in the Asia Pacific region, excluding Japan, was about $3.7 billion in 2019 and is forecasted to double by 2022, according to a report in IDC Health Insights.
But medtech robotics, particularly surgical robots, which are still wildly expensive, to truly take hold in Asia, costs to purchase, operate and maintain the machines will have to go down. Also, robotics will have to become simple enough, so that surgeons without the time to undergo extensive training can use them.
Robotics for Surgery and Other Medical Applications
Robotics have widespread uses in medicine, but it is in the field of surgery that the greatest advances have been made over the past two decades. Since the da Vinci Surgical System, developed by Sunnyvale, California-based Intuitive Surgical, Inc., was first approved by the FDA in 2000, the global surgical robotics market has surged. Valued at more than $3 billion in 2017, it is projected to reach between $12 and $16 billion by 2025, according to Research and Markets and Asian Robotics Review.
The da Vinci system, the most widely used clinical robotic surgical system, includes a camera arm and mechanical arms with surgical instruments attached to them. The surgeon controls the arms while seated at a computer console near the operating table. The console gives the surgeon a high-definition, magnified, 3-D view of the surgical site. The surgeon leads other team members who assist during the operation.
Surgeons who use the robotic system find that for many procedures it enhances precision, flexibility and control during operations. Compared with traditional techniques, it may allow doctors to better view a surgical site. That allows them to perform delicate and complex procedures that may have been difficult with other methods.
But the application of the Da Vinci system, and others that have been developed in its wake, has been relatively slow in the Asian medical device markets because of their extraordinary expense. One da Vinci robotics system costs more than $2 million.
Development of MedTech Robotics in Asia
To date, the vast majority of medtech robotics systems have been developed and manufactured in North America and exported to Asia and beyond. But that is changing. The governments of China, Thailand, Japan, Singapore and Korea are making it a priority to catch up on robotics technology.
China Leads the Way
According to the South China Morning Post, while the da Vinci system is broadly used in China—in more than 60,000 operations to date—the Chinese government is eager to reduce its dependence on foreign technology. For more than two years, it has backed more than 30 medtech manufacturers developing intelligent robots and robotic medical devices, including surgical robots.
In the Zhongkai Hi-Tech zone in Huizhou, SS Innovations, a Chinese robotics company, is developing and testing an affordable, modular robotic surgical system capable of complex motion control. The company is working with a budget of $15 million from the Chinese government to recruit and train talent from around the world.
At Beijing Jishuitan Hospital, surgeons are using robotics technology developed by a domestic manufacturer and promoting it throughout the country. The TiRobot system, developed by the hospital and Beijing Tinavi Medical Technologies, uses robotics technology to create surgical pathways using 3-D scans. The system also drills holes and secures screws with precision pressure.
The system, first approved for manufacture in 2016, is used in more than 40 Chinese hospitals nationwide. Some of its components, including an electro-optical system from Canada and a scanning arm from Germany, are made abroad.
Another Chinese company, Medical Healthcare Robot BU, a unit of Shenyang Siasun Robot and Automation, a leading manufacturer in China of industrial robots, is also moving into the medical robotics field. It is developing a robot capable of operating on tumors.
Another, a neurosurgical robot developed by PLA Navy General Hospital and Beihang University in Beijing, was awarded a license last year.
Despite the progress, Chinese firms have a long way to go to compete with the da Vinci system. China, for the moment, lags behind the United States and Europe in precision medicine, materials science, and the capacity to manufacture core robotics components.
Thailand Invests in Medical Robotics
Ever since 2017, when the first robotics-assisted surgery was performed in the country at Bangkok’s Ramathibodi Hospital, the Thai government has sought to invest in similar technology. The Thailand Board of Investment offers incentives to promote the manufacture of automation machinery, the assembly of robots, and the manufacture of high-risk medical devices. Among those, there is an exemption from corporate income tax, for companies developing surgery assist robots, therapeutic robots, and patient care robots.
Dinsow, an elderly care robot produced by Bangkok-based CT Asia Robotics, BUMBEE, a medical dispenser robot, and ROBODOCTOR, a remote diagnostic system, are also produced in Thailand.
Singapore and Korea Both Home to Robotics Startups
With interest in robotics fueling investment in the technologies, in 2017 a Korean company Curexo paid Hyundai Heavy Industries $9.7 million for its medical robotics division. Since then, it has developed Robodoc, which allows surgeons to perform knee and hip replacement surgeries using 3-D computer imaging.
Another Korean firm, The Meere Co., brought the Revo-i, a robot for laparoscopic surgeries, to market last year. The machine has been in development since 2007.
Among the robotics technologies developed in Singapore is SensibleTAB and SensibleSTEP, which help patients with arm and leg injuries, practice movements with the aid of robots.
In Singapore, robotics startup EndoMaster is developing a tiny robotic endoscope to remove gastrointestinal tumors. It is designed to cost considerably less than products currently on the market.
In Japan, Collaboration Between Government and Universities
For several years, Japan has worked with five universities and more than a dozen companies to develop EMARO, a cost-effective endoscopic robot that gives surgeons hands-free control and enhances visualization inside a patient’s body with three movable cameras.
Looking Ahead: Lower Price Is the Key
Over the past several years, Asian governments and public and private researchers have moved firmly in the direction of promoting, developing and adopting medical robotics systems in a way they never had before.
Driving the development is an awareness that the new technologies will be essential to provide quality care to people of the region. Foreign medtech robotics company, watch out!