Author: Gu Ying
Medical diagnosis and surgery with the help of intelligent robots can make up for human limitations, achieve precise positioning, be minimally or non-invasive, and even be personalized. It has been proven to be safer and has significant patient benefits.
For example, for a patient with a fracture in the pelvic area, traditional surgery involves two 750px incisions, with each incision bleeding 800-1000ml. Larger wounds can cause severe muscle and soft tissue damage, and the patient's recovery time is long and costly.
With the help of orthopedic robots, the surgery can be minimally invasive. There are only three 50px incisions, and the bleeding volume of each incision is about 100ml. The wound is nearly 10 times smaller with almost no soft tissue peeling. The patient’s recovery time has changed from 1 month to 2 days to 1 day, and the cost of consumables has also increased from hundreds of thousands to 100,000 yuan. Turned into several thousand dollars. The successful application of
robots in orthopedic surgery scenarios has brought essential changes to the overall treatment of patients. Behind the improved efficacy is a new medical service model created by the combination of medicine and engineering over many years. From the idea of a medical application to the commercialization of specific products, it requires the participation of medical staff, scientists, government officials, and entrepreneurs to form a joint force to overcome the difficulties in the intersection of medicine and industry, and to find the best way for interdisciplinary cooperation and achievement transformation. Optimal path.
At the first Zhongguancun “Medical Engineering Valley” Innovation and Entrepreneurship Summit Forum held on October 25-26, 2019, the “Top Ten Hot Topics in Cross-Innovation Frontier Technologies in Medicine and Engineering in Beijing” were officially announced. Honorary Director of Beihang Robotics Institute and Zhongguancun Intelligence Cross-industry leaders such as Wang Tianmiao, director of the Youtian Research Institute, Jiang Xue, director of the Innovation and Transformation Center of Peking University Third Hospital, and Fan Yubo, director of the Beihang Medical-Industrial Interdisciplinary Innovation Research Institute, focused on the "difficulties in the industrialization of medical-industry intersections" and other directions. Sexual issues were discussed in depth.
"Top Ten Hotspots" and "10 Innovations" are released
Jiang Xue released the top ten hot topics of "Intersection of Medicine and Industry" on the forum, covering 5 fields, including artificial intelligence , medical health, and precision minimally invasive surgical robots , intelligent health care technology, biomaterials and 3D printing and hospital automation services.
• Artificial intelligence-assisted image recognition and diagnosis
This direction is based on the medical diagnosis expert database, and applies reinforcement learning and deep learning technology to medical images to achieve rapid processing, accurate identification and diagnostic suggestions.
• Artificial intelligence medical health manager and cloud service
combine artificial intelligence technology with health management equipment, use wearable technology to collect patient data, establish a patient physiological information database, achieve real-time redness and disease prediction, and truly realize chronic disease management.
•Wearable or implantable Internet of Things health intelligent system
This direction uses flexible and highly sensitive wearable systems, combined with flexible wearable concepts and micro-nano manufacturing technology, to achieve non-invasive and minimally invasive, through high-stable signal communication technology and intelligent The data analysis platform enables tracking and management of the disease before, during and after the disease. In addition, relying on the development of biocompatible fabric sensor implantation technology and 3D printing technology, the function of implanting bionic wonders is realized.
•Multi-dimensional information fusion monitoring soft endoscopic robot
In this direction, through the combination of flexible and variable software technology and endoscopic surgery technology, complex endoscopic surgeries on micro-beds can be realized in a master-slave operation mode, and comprehensively promote the minimally invasive soft tissue surgery.
•By integrating biomechanical and morphological modeling
AR and VR technology, surgical robots continue to develop in the direction of minimally invasive, precise and visual.
•Rehabilitation training system with intelligent perception and interaction
This direction promotes the intelligence of the rehabilitation training system and achieves better human-computer interaction by organically combining the wearable signal detection-assisted robot structure with control virtual reality, human-computer interaction and other technologies. Interaction.
•Emotion recognition and natural interaction companion robot
This direction combines artificial intelligence with robots through intelligent speech recognition, information acquisition, human-computer interaction and other technologies, so that the robot can interact with the companion, thereby completing patient care.
•Personalization based on 3D printing
This direction is based on 3D printing, combined with three-dimensional personalized design biomechanics technology, focusing on the development of safe and stable implantation and interventional prostheses that are biocompatible, so as to achieve short-term functional compensation of defective tissues and Long-term induction of body self-healing.
• Micro-nano robots based on smart materials
This direction is based on the application of new technologies in the micro-nano direction, conducts research on new concepts of medical robot diagnosis and treatment, promotes the development of innovative medical robot technologies, and promotes the revolutionary development of medical robots from the micro scale.
•Based on the Internet-based automation of the entire pharmaceutical process
This direction uses dispensing robots, drug storage robots, and logistics robots to develop and rely on Internet of Things technology to network and informatize the entire pharmaceutical process, reducing the workload of medical workers and improving work efficiency.
In the case where there are not many predictions in the field of medical technology, the technology predictions of the top ten hot topics of "medical-industry intersection" have certain guiding significance. At the closed-door meeting of the roadshow on medical-engineering cross-projects on the 25th, 16 leaders from universities, hospitals and enterprises conducted discussions on hot areas such as AI medical treatment, robots, precision minimally invasive, biomaterials and 3D printing, sports rehabilitation and elderly care. Display of innovation and entrepreneurship projects.
Peking University Third Hospital’s Chief Physician Chen Yahong from the Department of Respiratory and Critical Care Medicine, Chief Physician Liu Junxiu from the Department of Otolaryngology, Physician Zhang Yuanmingfei from the Department of Rehabilitation Medicine, Pharmacy Physicians Yan Yingying and Song Zaiwei, and Dr. Solinger from the Department of Ophthalmology attended the project roadshow.
After selection, the Department of Otorhinolaryngology of Peking University Third Hospital "Design and Clinical Application of Minimally Invasive Nasal Stents", the Department of Pharmacy "Construction of Pharmaceutical AI Knowledge Graph (PharmCoo)" and the Department of Respiratory Medicine "Based on the Internet of Things COPD combined with sleep apnea" 10 projects including "Disease Screening and Early Warning" won the Outstanding Project Award.
In recent years, the application of domestic medical robots has gradually increased. Assisted surgical robots, rehabilitation robots, medical service robots, etc. all have great market demand. "Made in China 2025" points out that it is necessary to improve the innovation capabilities and industrialization level of medical devices, focusing on the development of high-performance diagnostic and treatment equipment such as imaging equipment, medical robots, and the 13th Five-Year Plan even lists surgical robots as a high-end equipment innovation and development project. key equipment development. How does
break through the boundary constraints of "medicine" and "work"?
Taking orthopedics, which has a large clinical demand, as an example, there are nearly 20 million cases of bone trauma every year. As aging worsens, 200 million people will suffer from spinal diseases such as lumbar and cervical spine. In addition, 400,000 joint replacement surgeries are performed every year. Surgery has become a very important means of orthopedic treatment.
Due to the high requirements for accuracy and stability in surgery, orthopedic robots have become a hot spot for development. Sun Xu, director of the Department of Traumatology and Orthopedics at Jishuitan Hospital, said that since the 1980s, representative robots from different eras with functions such as joint replacement and spinal auxiliary positioning have appeared one after another. International medical giants are also investing in the field of robots. Companies such as Stryker and Johnson & Johnson have their own robots.
Entering the 21st century, our country has also begun an attempt to combine orthopedic robots with "medical workers". In 2001, Beijing Jishuitan Hospital and Beijing University of Aeronautics and Astronautics started research on orthopedic robots in my country, starting from orthopedic trauma. The first robot-assisted orthopedic surgery begins a 0-1 transformation. In 2016, the third generation orthopedic robot was registered and certified by CFDA. By 2019, orthopedic robots will be able to assist and control remote surgeries.
The system positioning accuracy of this orthopedic surgery robot called "Tianji" has reached sub-millimeter level. It has a wide range of indications and is especially suitable for minimally invasive surgeries, achieving a breakthrough in full spinal segment surgery. At present, hospitals in more than 20 provinces, municipalities and autonomous regions across the country have become routine surgeries.
For doctors, the application of orthopedic robots can be more intelligent in some aspects. This demand also points out the direction for scientists' scientific research. The innovative research and development of "medical-industrial intersection" of orthopedic robots in China is constantly advancing.
Current situation: In minimally invasive surgery, the doctor needs to complete the reset before the robot can take action.
Difficulties: Fixed reduction is difficult, and it is a link where minimally invasive surgery is limited.
progress: will soon launch a robot that completes intelligent reset under the control of a mechanical mechanical arm.
goal: can transform orthopedic surgery from open surgery and minimally invasive surgery to robotic surgery. Preoperative planning to postoperative recovery can all be completed under intelligent operation.
From a global perspective, the market demand for orthopedic medical devices is second only to the cardiovascular market, and its research and development and application will be able to serve more medical scenarios. The application of 3D printing technology will solve the three major problems of clinical homogeneity, standardization, and popularization. However, the development of 3D printing technology in China still faces problems such as insufficient material accuracy resulting in poor fit.
Director of the Department of Radiotherapy oncology at Peking University Third Hospital Wang Junjie believes that in order to achieve complete localization of 3D technology, the problem of material accuracy must be solved. In addition, with robotics, image processing systems, image tracking systems, and computer algorithms must also be accurate enough. "To achieve such precise requirements, first of all, the organization must form a synergy to solve the problems of lack of unified leadership and over-dispersion of projects." Wang Junjie emphasized.
As a research-oriented hospital, Peking University Third Hospital is at the forefront of the country in building an achievement transformation platform, which has effectively solved the problems of lack of unified leadership and over-dispersion of projects.
In order to encourage doctors to conduct scientific research, Peking University Third Hospital has formed an incentive plan for the intersection of medicine and engineering and the transformation of scientific research results. If a doctor's R&D project can be transformed, 70% of the patent share belongs to the individual doctor, and the department and hospital each share 15%.
"The incentive program can make doctors and nurses more enthusiastic about scientific research, and have the motivation to collect and analyze data on the front line to solve clinical pain points." Jiang Xue also told the health industry that Peking University Third Hospital currently has 43 patents, with a conversion rate of 15%-18% , has exceeded the average level.
In May 2019, Haidian District Government released the first batch of 17 technology application scenario construction projects, including artificial intelligence, medical imaging, etc. Among them, the application scenarios of high-end medical devices and intelligent auxiliary diagnosis and treatment application scenarios are all applications in the intersection of medicine and industry. Scenes.
Jin Hui, a specially appointed expert from the Haidian District Government, shared that in order to build a demonstration smart hospital, the Haidian District Government has promoted the further opening of Haidian Hospital. In 2018, we also promoted the cooperation between Tianzhixing and Haidian Hospital and coordinated with relevant departments. In the end, it helped Tianzhixing and Tianji Orthopedic Robot successfully obtain the first national Class III medical machine registration certificate for medical surgical robots.
It seems to be a consensus that a good medical-engineering cross-project has the characteristics of modularity, versatility, system upgradeability and openness. The intersection of medicine and industry must take medicine as the main body and work as the platform. There are good practices in this, but there are also the following barriers:
1. Medical resources are not open enough. At present, most hospital departments and enterprises cooperate, and the internal data of the hospital is not really connected. Various departments No data is shared between them.
2. There is a lack of overall guidance at the policy level, and there is no way to give full play to the enthusiasm of the hospitals themselves in wanting to open up. Not all hospitals are willing to open up data.
3. The medical resources of various hospitals cannot truly embrace excellent technology companies.
4. The top-level technology applied in medical technology needs to be improved. A number of new medical and industrial intersection fields such as
5 and medical devices in the field of artificial intelligence lack technology and certification standards.
Faced with the realistic barriers to the intersection of medicine and industry, Jin Hui believes that discussions can focus on the essential issues in the intersection of medicine and industry, the prediction of technology trends, and the focus of government support.
Several major difficulties must be overcome from "industrialization" to "commercialization"
The complete industry chain of medical and industrial intersection can be seen as clinical needs - policy support - interdisciplinary construction - medical and industrial intersection technology - application scenarios ——Cooperation in investment and financing, production supply chain, user feedback and other links. During the discussions among the participants, corporate strategic thinking, multi-party cooperation and talent cultivation became the most valued topics in addition to policy support.
Some experts pointed out that there must be a cooperation mechanism in the innovation and industrialization stage. Because it is impossible for one person to do everything, everyone needs to work together to promote it.
So, what kind of mechanism can a platform use to make projects sustainable from creativity to commercialization, and ultimately benefit patients?
As an interdisciplinary subject, the intersection of medicine and engineering must have interdisciplinary knowledge and vision, understand both the engineering language and the doctor's language, understand the pain points of doctors, and be able to innovate. Zhang Chun, director of the Scientific Research Department of Peking University Third Hospital, believes that talent is a problem. If it must meet the clinical standards of doctors, it will limit talent. Doctors must be able to use the platform to proactively contact engineering departments.
has this kind of trouble mainly due to the difference in the teaching system between China and the United States. In the United States, only undergraduate students can choose to study medicine, so many doctors have science and engineering backgrounds. For example, in companies such as Medtronic and Johnson & Johnson, 70% of product innovations are carried out by doctors. This also provides talent conditions for medical innovation.
With talents, it is very important to build a platform for technological transformation. Transform doctors’ patents into the market, bring the market back to clinical practice, and establish a complete chain. For example, some experts at
said that it may not be difficult to make a prototype, but to make it into a product, you need to connect various resources, including the support of investors, doctors and entrepreneurial mentors, as well as supply chain resources. Because any device will involve hundreds of parts suppliers. If repeated iterations are required, the employer may lose patience, and with the long approval time, it will be difficult for the product to proceed.
"The research and development stage will actively involve enterprises, allowing enterprises to participate from the application level. " Zhao Yijiao mentioned that many scientific research projects at the national policy level require a cooperative unit when applying, for example: 3D printing projects require 3D printing Corporate participation. This will allow national scientific research results to be implemented as soon as possible and turned into products.
Sun Jingsheng, executive vice chairman of the Clinical Trial Branch of the China Medical Device Industry Association, believes that the approval of medical robots is too strict, mainly because artificial intelligence is relatively special. The underlying reason is mainly that IT will iterate rapidly, and a large part of it iterates in the market. On the other hand, in the medical industry, medical devices and medical equipment cannot be iterated in the market, but can only be iterated in the laboratory, so a relatively perfect thing must be brought to the market. There is such a particularity in
. For enterprises, it is necessary to systematically establish their own product lines. "Although the more systematic a company's product line is, the fewer core functional products it independently develops. But systematization is very important to the company." Sun Jingsheng mentioned, "Only commercialization investments can bring returns, such as commodity prices, medical insurance, Tendering, maintenance, adverse event reporting, etc. can only be done with a complete system. Taking Medtronic as an example, in addition to the truly original pacemakers, they have a complete system. It is directly linearly related to the size of the company. The difficulty with medical devices is that different varieties have different systems, and the specific technical content is very different, so it is difficult to establish. Sun Jingsheng suggested not to blindly invest in medical device entrepreneurship, but to know what the goal is and how to build the system, rather than simple functional research and development.
"Currently, robot research and development is synchronized around the world, mainly focusing on quality and safety, followed by price. The development of China's robotics technology has a process. The core components must advance rapidly and the ductility of the product must be taken into consideration." Fan Yubo told the health industry.
In 2018, 38,000 people died in traffic accidents in the United States, and as many as 260,000 people died due to doctor's errors. When faced with this set of data, Zhang Yizhao, deputy director of Microsoft Research Asia, has an expectation that the emergence of artificial intelligence may allow hospitals to no longer make low-end common sense mistakes in order to meet the requirements of conventional guidelines.
In this context, the announcement of the top ten hot directions of "medical-industrial intersection" innovative cutting-edge technologies may have guiding significance for all participants and make everyone's expectations possible as soon as possible.
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