XIAMEN, Aug. 12 (Xinhua) -- Unlike in conventional surgical procedures, a complex cardiac operation in east China's Fujian Province was recently performed by a domestically developed cardiac surgical robot, leaving the operating table free of medical staff in lead aprons.
At Xiamen Cardiovascular Hospital of Xiamen University, Professor Wang Yan sat at a console outside the operating room, his eyes fixed on the monitor, his hands maneuvering a joystick and rotating knobs. In just 90 minutes, his team successfully performed a minimally invasive repair of a damaged mitral valve on the beating heart of a 74-year-old patient.
"Compared with our first robotic procedure, we are now much more proficient. This operation went very smoothly," said Wang, noting that it was the hospital's 29th robotic surgery since 2023.
China has approximately 25 million people affected by valvular heart disease, and with an aging population, the demand for diagnosis and treatment continues to rise. Traditional interventional cardiac procedures have long relied heavily on the surgeon's experience, while issues such as chronic radiation exposure for medical staff, limited operational precision, and uneven geographic distribution of top-tier expertise have persisted for years.
In recent years, Wang's team has achieved multiple milestones using a robotic transcatheter cardiac intervention system co-developed with a Shanghai-based company. These breakthroughs include the first human clinical trial for robotic transcatheter mitral valve repair in 2023, a landmark transnational remote robotic mitral valve repair in 2025, and the clinical feasibility trial of robot-assisted transcatheter aortic valve replacement. All of these were made possible by the system's stable, low-latency and visualized remote precision control.
On the technological front, Wang said, the team has achieved several original breakthroughs with the system. It enables zero-radiation remote operation via a master-slave console, eliminating the chronic occupational exposure inherent in conventional cath-lab work.
The team can perform submillimeter-level valve repair on a beating heart -- a notoriously difficult procedure in complex cases -- using a robotic arm that filters out physiological tremors, he noted. By equipping the system with tactile feedback and 5G-based low-latency transmission, the team has made cross-border, real-time interventions technically viable for the first time.
To fundamentally mitigate risks associated with fatigue and human error, the system's built-in safety mechanism automatically pauses instrument movement every 3 to 5 millimeters for surgeon confirmation. It also triggers an alarm or initiates a shutdown when operating beyond preset boundaries, keeping the error rate far below that of manual manipulation, Wang said.
Despite these advances, Wang noted that the system remains a precision tool rather than an autonomous one. It cannot make independent decisions or respond to emergencies, and it still requires experienced surgeons to handle intraoperative changes or device anomalies.
He also cautioned that high costs, the need for longer-term clinical trials, and incomplete supporting frameworks, including network standards, cross-regional practice protocols and liability rules, are likely to constrain large-scale deployment and routine adoption in the near term.
Wang said robot-assisted transcatheter intervention is a clear direction for future cardiac care. While the technology remains in clinical validation and refinement at leading cardiovascular centers in the short term, it is expected to enter routine use at major cardiac hospitals nationwide over the next three to five years, with intra-provincial and intra-city remote procedures gradually piloted.
"With rapid advances in AI, we believe that by training robotic systems on vast clinical data, including learning heart rhythm patterns, simulating complex cases and calculating optimal timing for clip engagement, the robot will eventually be able to position the clip precisely at the ideal moment in the heartbeat cycle. Its operational precision may one day even surpass that of human hands," said Wang. ■
