Shanghai, China --- On April 24, 2020, with the bronchoscopic surgical robot system for the diagnosis and treatment of COVID-19 (hereinafter referred to as "Bronchoscopic Surgical Robot”) independently developed by Microport^® (Shanghai) Medbot Co., Ltd. (hereinafter referred to as "Microport^® Medbot”), a robotics-specialized subsidiary of Shanghai MicroPort^® Medical (Group) Co., Ltd. (hereinafter referred to as "Microport^®"), the first robot-assisted bronchoscopic alveolar lavage was completed in the Shanghai Chest Hospital on April 24, 2020. The operation was performed by Professor Sun Jiayuan, director of Respiratory Endoscopy Center of Shanghai Chest Hospital. This is the first Bronchus Surgical System for the diagnosis and treatment of COVID-19. Its teleoperation achieved physical isolation between the healthcare staffs and the surgical infection environment, which could not only reduce the risks of infection during the diagnosis and treatment but also help increase the diagnosis accuracy and cure rates of COVID-19.

At the beginning of 2020, the COVID-19 epidemic swept across China and even the whole world. The people infected around the globe exceeded 2.63 million by April 23, 2020. COVID-19 is highly contagious and bears extremely high risk of infection among medical staff working in the front line of clinical treatment. A WHO report pointed out that, as of April 8, 2020, WHO had received from 52 countries 22,073 cases of medical staff infected with COVID-19, and the situation of medical infection in individual countries is particularly more severe. Spain was an example, as of March 31, there were 12,298 medical staff infected with COVID-19 virus in this country, accounting for about 15% of the total number of confirmed cases, which became the hardest hit area for medical infection.

Bronchoscopic surgery is an important means for diagnosis and treatment of COVID-19. The method for collection of traditional pathogen sample is throat swab sampling in upper respiratory tract such as oral cavity and nasal cavity, but COVID-19 mainly acts on ACE2 receptor in lung epithelial cells of lower respiratory tract, determining that the viruses are most highly concentrated in the lung. Therefore, sampling lower respiratory tract specimens can greatly improve the positive rate of Covid-19. In face of a sudden large quantity of patients with unexplained pneumonia, no pathogens were found in the upper respiratory tract samples, and the disease control department urgently needed lower respiratory tract samples to solve the problem of diagnosis and treatment. Chen Huidong, Director of Wuhan Jinyintan Hospital performed broncholavage and specimen retention surgery through bronchoscope on December 30, 2019, and finally succeeded in isolating the COVID-19, clarified the etiology of unexplained pneumonia, and opened a new chapter in the prevention and treatment of COVID-19.

Bronchoscopy is considered to be the link with the highest level of infection risk in the diagnosis and treatment process in COVID-19. Patients with COVID-19 infection suffer weak cough and expectoration ability, which leads to further decline of pulmonary oxygenation function. Phlegm thrombus and mucus thrombus in critically ill patients add to treatment difficulties and aggravation of illness. Bronchoscopy-assisted sputum aspiration and lavage are important treatment methods for severe patients to relieve symptoms and recover from illness. Meanwhile, most critically ill patients with COVID-19 need tracheal intubation or tracheotomy for ventilator-assisted ventilation, and bronchoscopy can be used for guidance and monitoring. Because of the high infectivity of COVID-19, the high concentration of COVID-19 in the mucus of lower respiratory tract forms aerosol after the patient's airway is opened during the operation, which brings the medical staff to the extremely high risk of virus exposure and easily causes iatrogenic infection.

To solve the above-mentioned problems in the diagnosis and treatment of COVID-19, the Respiratory Endoscope Center of Shanghai Chest Hospital, MicroPort^® (Shanghai) Medbot Co., Ltd. and Shanghai Jiaotong University jointly tackled key problems, mobilized capable scientific research personnel, and innovatively and quickly changed the master-slave teleoperation control of COVID-19 bronchoscopic surgical robot system from concept to reality. After technical research, system construction, assembly test and animal experiment, the first clinical trial was finally completed on human body. Although the robot is developed for diagnosis and treatment of Covid-19, it also bears important application value in diagnosis and treatment of other highly infectious respiratory diseases, such as tuberculosis. So far, there was no relevant report on the bronchoscopic surgical robot developed for diagnosis and treatment of COVID-19 in the world.

This operation is a clinical trial for patients suspected of pulmonary infectious diseases. The 55-year-old male patient was diagnosed as having suffered pulmonary infection in hospital. As the operation of diagnosing COVID-19 viruses by collecting samples from lower respiratory tract is also applicable to patients with common pulmonary infection, Professor Sun Jiayuan's team decided to use bronchoscopic surgical robot to perform bronchoalveolar lavage after preoperative discussion. During the operation, the doctor assisted the bronchoscope in the remote isolated operation room in successfully entering the glottis and reach each segmental bronchus and completed the operations such as aspiration of bronchial sputum, lavage of alveolar and collection of lavage fluid, which took about 30 minutes.

Professor Sun Jiayuan said after the operation: "The robot has completed a series of bronchoscopy operations for patients suspected of pulmonary infectious diseases, including aspiration of bronchial sputum, lavage of alveolar and collection of lavage fluid. The whole process went on smoothly, and no adverse reactions were observed during and after operation. With the continuous emergence of new pathogenic microorganisms, bronchoscopy for patients suspected of pulmonary infectious diseases may have the risk of infecting operators. The operation may be completed with surgical robots through remote control in the isolated operation room, which reduces both the risk of infection of medical staff and the quantity of medical staff required for operation. With COVID-19 raging all over the world, there is an urgent need for such a Bronchus Surgical System to protect medical staff and ensure the safety of treatment. The new technology is also beneficial to the development of bronchial diagnosis and treatment in COVID-19, which is of great significance to the treatment of epidemic situation."

The Robot R&D team of MicroPort^® (Shanghai) Medbot Co., Ltd. is a wholly owned subsidiary of Shanghai MicroPort^® Medical (Group) Co., Ltd., and is the lead unit of Shanghai Engineering Center for Minimally Invasive Surgical Robotics. The company has a high-level, professional and all-round scientific and technological research team in the field of surgical robots. Since its establishment, it has been focusing on scientific and technological research and industrialization in the field of micro-port surgical robots, forming a multi-department and multi-dimensional product pedigree represented by endoscopic surgical robots, orthopedic surgical robots and 3D laparoscopy. DFVion™3D electronic laparoscope and Toumai™ Endoscopic Robot of the Company have entered the national green channel for review and approval of innovative medical devices.

Dr. He Chao, General Manager of Microport^® Medbot said: "The global Covid-19 epidemic situation is grim. Microport^® Medbot has shown active concern about the clinical needs since the outbreak of the epidemic. Based on the company's rapid R&D capability and application transformation capability, this surgical robotic system has been developed through close cooperation between teams, industries, universities and medical institutions, in hope of providing strong support to win the prevention and control of the epidemic, protecting medical staff and saving more patients' lives. The Company adheres to the original aspiration of "exploring the unknown and shaping the era of intelligent robot surgery", continues to innovate and provide more high-quality integrated medical solutions that can prolong and reshape the life of patients and doctors around the world."