on June 27, 2019, Professor Tian Wei, president of Beijing Jishuitan Hospital, performed operationswithTian-Ji Orthopedic Surgery Robotson two patients in separate hospitals in parallel using 5G technology in the Robot Teleoperation Centre. It is the first 5G-assisted Tian-Ji operation in the world. Prof. Tian implanted a total of 12 pedicle screws in the spine of the two patients with spine fracture, who were in Yantaishan Hospital, Shandong Province andJiaxing No.2 Hospital, Zhejiang Province respectively. The operation required Prof. Tian to switch between two robots frequently and smoothly. Although miles apart, 5G technology enabled seamless coordination betweenBeijing experts, local surgeons and Tian-Ji robots, making the old legend of seeing from far away come true.

Professor Tian Wei, president of Beijing Jishuitan Hospital,Xiang Huangmei, a member of the Party committee and deputy general manager of Beijing branch of China Telecom, and Zhang Songgen, chairman of Beijing TINAVI Medical Technology Co., Ltd,are in robot teleoperation center.

With the support of China Telecom's 5G network and Huawei’stelecommunication technology, the operation made important advances in the field of 5G telemedicine and artificial intelligence.It’s amilestone in surgical technology.

At 9:05 a.m., the telesurgery began.The core steps of the two operations were performed alternatingly. The patient in Jiaxing had a lumbar fracture at L1 with 50% compression and anterior longitudinal fissure. Traditional surgeries cannot determine the fracture line accurately. If the pedicle screw weretoo long, it wouldpush the fracture forward and burst the vertebral body. However with the help of Tian-Ji orthopedic surgery robot, the screw can be positioned accurately.

The patient in Yantaishan Hospital had a burst fracture at T12 and complicatedwith kyphosis. The fracture line on the right side was in the lower part of the vertebral body, so that the pedicle screw had to be placed higher than usual. And the fracture line on the left side was in the higher part of the vertebral body, so thatthe pedicle screwhad to be placed lower than usual. If the pedicle screwswere placed into the fracture line, it wouldimpair the healing process. Therefore, it is difficult to operate precisely in the past by relying solely on the experience of doctors.Tian-Ji orthopedic surgery robot enablessurgeons to design positions before surgery and to operate in sub-millimeter precision.

Professor Tian Wei, president of Beijing Jishuitan Hospital,switches between two robots in different places in robot teleoperation center.

Professor Tian performedpreoperative planning and 3D surgical positioning for the two patients remotelyonTian-JiOrthopaedic Surgery Robot Platform. At 9.40 am, Prof. Tian completed all key steps. A total of 12 pedicle guide pins were inserted in two patients within 35 minutes. The 3D images showed the guide pins were inserted accurately. There were only six small incisions of about 1.5 cm and no muscle dissection in the surgical site. The surgery completed successfully at 10.45 am.

Professor Tian Wei, president of Beijing Jishuitan Hospital, communicates with robot surgeons in Yan Taishan and Jia Xing NO.2 hospital in robot teleoperation center.

During the operation, the signal transmission was smooth. There wasno signal jamming, delayed processing orstagnated feedbacks in spite of thousands of kilometers of distance. The features of 5G network such ashigh speed, wide bandwidthand low delay benefited thetelesurgery. The robotic teleoperations have developed in the past 10 years. Nowadays, with 5G technology, the high-definition 4K images and remote-control signalswere transmitted stably with high speed overlong-distance. This makes robotic teleoperations a reality.

Professor Tian Wei, president of Beijing Jishuitan Hospital, views the accurate position of guide pin on three-dimensional scanned images with robot surgeons in Yan Taishan and Jia Xing NO.2 hospital in robot teleoperation center.

Immediately after surgery, Beijing Jishuitan Hospital held a press conference for 5G multi-center robot-assisted teleoperation. Professor Tian Wei, president of Beijing Jishuitan Hospital and chiefscientist of Tian-Jiorthopedic surgery robot, Xiang Huangmei, a member of the Party committee and deputy general manager of Beijing branch of China Telecom, Zhang Songgen, chairman of Beijing TINAVI Medical Technology Co., Ltd, and Zheng Weining, director of Beijing operator business department of Huawei Technologies Co., Ltd, attended the press conference.

Professor Tian Wei, president of Beijing Jishuitan Hospital and chief scientist of Tian-Ji orthopedic surgery robot,presented the surgeries on the press conference.

Xiang Huangmei, a member of the Party committee and deputy general manager of Beijing branch of China Telecom,attended the press conference.

Zhang Songgen, chairman of Beijing TINAVI Medical Technology Co., Ltd,attended the press conference.

Zheng Weining, director of Beijing operator business department of Huawei Technologies Co., Ltd, attended the press conference.

Professor Tian Wei presented the surgeries during the press conference. “Unlike remote video guided surgery and remote surgical planning in the past, these surgeries achievedremote planning and manipulation through the hybrid of 5G and Tian-Jiorthopedic surgery robot. Theimage capture, surgical planning, and real-time remote manipulation of robots in different places were simultaneously controlled by an expert in Beijing. This is a quantum leap.” Tian said.

Press conference scene

The combination of 5G technology and Tian-Ji orthopedic surgery robot is a powerful “weapon” thatconnects doctors in different areas, and enablesremote guidance. Controlling robots through 5G transmission improves the quality and safety of the operations. In this way, top experts can serve patients all around China.

Group photo of leaders

At present, with the support of the Ministry of Industry and Information Technology and the National Health Commission in China, more than 20 hospitals are involved in developingthe National RoboticOrthopedic Surgery Application Center, with 300 more to follow. This will improve quality of medical services, helpachievegradedmedical system and accomplish a more evenly distributed medical resource.