INGENUITY CREATES MILESTONES

OF INTELLIGENT MANUFACTURING

Yunnan Tour of Honghu
2022-07-30 GMT+8 PM 07:00

Yunnan, located in southwest China, boasts a time-honored history, splendid culture and picturesque natural scenery. It is a border area wreathed by clouds and nestled amid myriad mountains and rivers. As a mountainous plateau with the majority of the province located at mid-altitude, Yunnan has diverse and changeable climate, encompassing cold, warm and hot weather simultaneously, hence the popular saying “four seasons coexist on one mountain, while different weather emerges within five kilometers”.

 

In contrast to Yunnan’s unparalleled natural beauty, its economy is relatively underdeveloped, with its GDP per capita lagging behind across the whole country, and many people still make their living by farming, which, combined with poor transportation and a predominantly walking lifestyle, places a heavy burden on the joints of local people, resulting in a high incidence of osteoarthritis there. Osteoarthritis is mostly seen in elderly population, who often choose to tolerate the disease instead of treating it due to their lack of awareness and relative poverty, thus leading to an exacerbation of their condition. In addition, medical resources in China’s remote provinces are far less than those in coastal areas, and although some local tertiary hospitals in Yunnan are capable of performing knee replacement surgeries, they still need assistance from doctors at provincial 3A-grade hospitals in times of complex cases.

 

The combination of these factors has given rise to unmet patient needs in Yunnan, making it difficult for doctors to operate and for patients to consult a doctor.

 

Bearing the original aspiration of “Make Surgery Easier, Safer and Less Invasive” in mind, MicroPort® MedBot® is committed to bringing high-end medical technology to remote areas of the motherland to empower hospitals at the primary level for the benefit of all patients.

 

Yunnan has become the starting point for MicroPort® Honghu orthopedic surgery robot to fulfill its original mission.

 

The first connection between Honghu and Yunnan was on September 17, 2021, when China's first 5G remote knee replacement surgery with a domestic orthopedic surgery robot was completed. The team led by Dr. Li Huiwu, the director of Orthopaedics Department, The Ninth People’s Hospital of Shanghai Jiaotong University School of Medicine, discussed the pre-operative plans and realized the interconnectedness of the surgery in three locations simultaneously via the 5G platform, successfully performing the remotely guided knee replacement surgeries for two patients from the 920 Hospital of the People's Liberation Army Joint Logistic Support Force in Kunming, Yunnan Province and Huizhou First Hospital in Guangdong Province.

 

In 2022, with the support of President Xu Yongqing and Dr. Li Chuan of the 920 Hospital, Honghu embarked on its "Journey to Yunnan " once again, during which Honghu started from Dali, passed through Chuxiong and Kunming, traversing as far as Zhaotong and Diqing to the north, Pu'er and Honghe to the south, Qujing to the east and Nujiang to the west, covering 14 hospitals in 9 prefectures and performing domestic robot-assisted knee replacement surgeries on 50 local patients.

 

Most of the patients were aged between 50 and 70, who had long been tortured by knee pain, even up to 20 years in severe cases. Among them complex cases such as rheumatoid arthritis, varus deformity, and massive proliferation of osteophyte are common. With traditional treatment, doctors have to perform an surgery based on their experience and feeling, leading to unstable results. However, with the assistance of robots, the surgical process becomes digital and visualized, and the doctor can make the most suitable pre-operative plan for each patient, so that the patient's line of gravity of lower limb will be precisely restored with less trauma and less bleeding.

 

Every knee replacement surgery is a hope to reshape the patient's life, for which the joint effort and mutual understanding of companies, doctors and patients are needed. Honghu’s journey to Yunnan aims to fulfill its social responsibility as a domestic medical device company by helping doctors implement their mission to treat patients and restoring patients’ right to walk normally. All the participants in this journey to Yunnan cannot forget the hardships and the meaning behind such predicaments when they recalled this extraordinary tour.

 

When it comes to the Yunnan tour, the colleagues who got engaged in it feel the same: it was not the work of one single person, but the result of close cooperation and shared commitment of every team member. Within the company alone, clinical applications, after-sales service, commercial operations, clinical training, sales, and marketing were all involved. Only the full collaboration of colleagues assuming different responsibilities can ensure the complete success of every surgery in every hospital.

 

The clinical application engineers usually need to get the full-length radiograph of the patient's lower limbs two or three days in advance, assist doctors in preoperative planning, synergize with doctors during the surgery, and summarize data after the surgery. The after-sales service engineers are responsible for the delivery and installation of the equipment, the preparation of consumables and tools needed for the surgery before the operation, the emergency protection during the operation, and the maintenance after the operation. The business operation staff are held accountable for the coordination of equipment transportation, employees in clinical training introduce products to doctors, sales personnel carry out communication with hospitals in the preliminary stage, and the marketing members timely release clinical news.

 

In addition to these corporate employees, medical support is also the key to success. Dr. Li Chuan of the 920 Hospital offered guidance patiently, often discussing pre-operative plans with local doctors until late at night and continuing to carry out guidance on the surgical console early the next morning. The hospitals also communicated well with the patients early and wait for the arrival of Honghu, preparing a suitable operating room, and assigning staff to secure all the work needed for the equipment.

 

The success of the Yunnan tour comes as a result of our joint effort and dedicated endeavor under one common goal.

 

Before the Spring Festival, Honghu completed its first surgery in Yunnan Province in No.1 People's Hospital of Dali City. After the Spring Festival, the Honghu team left Dali and went to Nujiang People’s Hospital. The experience of three after-sales service engineers, Mr. Wu, Mr. Pu and Mr. Yang, could be described with the term of “twists and turns”. When leaving Dali, in order not to delay the use of the elevator of the operating room, the three had to get up at 5 a.m. to go to the hospital, brought down and loaded the equipment onto the truck, and then went to Nujiang People’s Hospital. Due to the lack of public transportation, they had to take a local taxi via online hailing service and arrived at the Nujiang border checkpoint around 3:00 p.m. that day, and that was when the accident happened. According to the local epidemic prevention policy, Mr. Wu and Mr. Pu were unable to enter the city. However, the surgery would be performed the next day, therefore the installation and commissioning of the equipment was of vital importance. Although the border checkpoint was only 20 to 30 kilometers away from the hospital, Mr. Wu and Mr. Pu cannot move a single step.

 

On one hand, Mr. Yang decided to go to the hospital firstly by himself in order not to delay the surgery. After completing the installation alone, it remained tough to do the commissioning. Fortunately, there were two clinical application engineers on site, therefore the three people joined hands to carry out the preoperative commissioning preparation. On the other hand, Mr. Wu and Mr. Pu rushed to the operating room of Nujiang People's Hospital after the problem was solved by expedited testing, preparing for the next surgery together with other people.

 

When everyone finished all the preparations and came out of the hospital, it was already 2:00 a.m. After a short break, they appeared in the operating room again at 7:00 a.m. What awaited them was the arduous task of five surgeries in one day. As after-sales service engineers, they must stay on site and stay the course to deal with any unexpected emergencies.

 

In an effort to enhance efficiency, the five surgeries were done in two operating rooms. When the first surgery was completed, the second one was immediately carried out. Such intense, around-the-clock operations were a test of endurance and stamina for all three. When they recalled this experience, they felt that three things helped them tide over the difficulties: their excellent expertise, strong willpower, and uncompromising sense of responsibility.

 

Mr. Xia was one of the first after-sales service engineers to arrive in Yunnan after the Spring Festival. Following the three surgeries at the First People’s Hospital of Zhaotong, the equipment was loaded onto a truck at 5:00 p.m., waiting to be transported to Yanjin County People’s Hospital. The two locations were about 140 kilometers apart, but there was neither train nor other public transportation. Mr. Xia and his colleague Liu made a last-ditch effort to follow the truck transporting the equipment all the way to the destination.

 

Known as “China's narrowest county”, the entire Yanjin County is nestled in the canyon with cliff walls perching on both sides of the river course. The narrowest part is even less than 30 meters, while even the widest part is merely 300 meters. There is only one main road in the whole county, and the hospital is built on higher ground, so they had to embark on an uphill road. Hampered by the narrow road and heavy snow halfway, the truck could hardly move forward when the visibility was only about 20 meters. The hospital appeared unreachable due to the seemingly unmovable truck. At this very moment, Mr. Xia jumped out of the truck and walked in front of it, while identifying the road ahead and directing the vehicle to move forward. The buildings on both sides of the road were less than two meters away from the truck, so it took extreme caution to trudge forward. In this way, one person and one car gradually inched along. At 10:00 p.m., upon seeing the hospital’s front door, Mr. Xia and the truck driver both heaved a sigh of relief.

 

After their arrival, the hospital arranged a nurse to receive them. Mr. Xia and Mr. Liu transported the equipment to the 5th floor, and it was already 2:00 a.m. the next day after the installation and commissioning. There were three more surgeries on that day, so they had to go to the operating room for preparation at 5:00 early in the morning. The two had little time to rest and could only take a short nap. Despite their comments on this tortuous journey, they still quickly engaged themselves to work and left behind all distractions.

 

Diqing Prefecture People’s Hospital, also known as Shangri-La People’s Hospital, is located in the legendary secret land of Shangri-La, as the name implies. The prefecture is situated in the highland area with more than 3000 meters above sea level. Before entering Shangri-La, the Honghu team was worried that “altitude sickness” would negatively affect their working condition.

 

They were not overthinking. When the equipment arrived at the hospital, Mr. Xia and Mr. Yang had to unload the goods together with the truck driver because they were not able to find someone to help them. When unloading the equipment, Mr. Xia felt that he could not breathe well, and it took ten seconds to breathe for a little relief to move the equipment. Mr. Yang still remembered that they needed to push the equipment up a small slope, and when they did that, they almost ran out of all their strength and virtually collapsed on the ground. When the locals saw their predicament, they joked that even Shangri-La people won’t do such heavy work in daily life.

 

Mr. Zhang, a clinical application engineer, unfold his experience in Diqing as follows: He arrived at the hospital at 9:00 p.m., discussed the pre-operative plan with the doctor and it was already 12:00 p.m., and then he had to get up at 6:00 a.m. the next day to go to the hospital to follow the surgeries. A total of five surgeries were performed on that day from 8 a.m. to 3 p.m. in seven hours, and he felt the whole process was incredibly smooth. Talking about the “altitude sickness”, Mr. Zhang thought that he was probably too focused on his work and hardly noticed anything different.

 

Mr. Lyu, also a clinical application engineer, felt vastly differently. He remembered that the night he arrived in Diqing, it was snowing heavily and the temperature was almost minus 10 degrees, so Dr. Li Chuan reminded them not to take a bath at night and must open the window for ventilation. Because of the huge temperature difference and lack of oxygen on the plateau, Mr. Lyu didn't sleep almost the whole night.

 

Because of the tight schedule, all the members of the Honghu team were working almost all the time until they left Shangri-La, and everyone sort of regretted that they didn’t have time to fully experience this legendary and beautiful place.

 

When it came to the experience in Yunnan, the participants felt that they still got immersed in it and there were many stories to unfold. For example, the night before going from Nujiang Prefecture to Zhenxiong County, suddenly it began to snow heavily. Due to the expressway closure, the truck driver transporting the equipment had to opt for the national highway, and was stuck in the high-speed railway station which is 50 kilometers from the hospital, almost missing the operation in Zhenxiong County People’s Hospital. Another example was the experience from Chuxiong Prefecture to Kunming Municipal Hospital of Traditional Chinese Medicine. The original truck driver who had been appointed suddenly said he would not come, catching the team off guard who had to contact everyone to find a truck.

 

The most tragicomical thing was that even SF Express cannot catch up with the speed of the Honghu team. Surgeries require replenishment of consumables, which need to be delivered by courier. Since the team stayed in the same place for only a short time and then it had to rush to the next hospital immediately after the surgery in one hospital, the after-sales service engineers often filled in the next destination of the trip as the address to receive the courier. However, when the team arrived at the next destination, finished the surgery and was ready to leave, the S.F. Express was not yet delivered. The team members had no choice but to change the receiving address to the next destination again. Just like this, the S.F. Express chased the pace of the Honghu team all the way, and everyone joked that it was a race with the express.

 

At Qujing Second People’s Hospital of Yunnan Province, the local doctors were very curious about Honghu. Since only Prof. Yang Bing had attended the training of Honghu in the local hospital, other doctors were still utterly unknown about the orthopedic surgery robot. In order to satisfy the curiosity of the medical staff, colleagues from the clinical training department held a special training session for all the doctors in the department. Because the doctors had different work schedules, they came to the training site one after another. Manager Zhao, who was in charge of the training, was extremely patient and introduced Honghu to the newly-arrived doctors over and over again.

 

As a research validation project, the number of patients in each hospital in the Yunnan trip was limited. However, after completing all the surgeries at one hospital, patients often came forward and asked if they can have the robotic surgery. The local doctors were amazed at the precision of the surgical results after experiencing the domestic orthopedic robot-assisted surgery. Looking at the Honghu team who was about to leave, they eagerly hoped that they could also participate in the next clinical research project of the robot.

 

Facing the enthusiasm and expectation of the patients and doctors, the Honghu team and MicroPort® MedBot® were more determined to bring the domestic orthopedic surgery robot to every corner of our country. In the future, our Honghu vehicle-mounted mobile training platform will also be launched. We will not only return to Yunan, but also go to more remote areas in need of high-end medical technology. We firmly believe that in the near future, a growing number of domestically-made orthopedic surgery robots will emerge and deliver benefit to more people, which will effectively transform the situation of uneven medical resources in China, enabling more doctors and patients to enjoy the scientific achievements, in order to make surgery easier, safer and less invasive.

 

Great ambitions are set to scale new heights. A journey of one thousand miles begins with Yunnan.

 

(*This article is based on the real experiences of the colleagues who participated in the Honghu Yunnan tour. We thank every department and colleague who contributed to the success of the trip, as well as all the medical and related personnel who were engaged in the journey.)

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