An Essential Trend in the Future of SurgeryHow a Chinese professor helps to transition from conventional surgery to minimally-invasive treatment

Minimally-Invasive Procedures as the Future of Surgery

February 05, 2014 | Despite an almost 30-year history in China, minimally-invasive interventional radiology is still underused in the country's eastern province of Henan. Professor Han Xinwei, MD, believes the majority of diseases should be diagnosed and treated using such technologies: A major trend for the future of Chinese surgery. 


Article: Chen Yi
Photos: Tang Ting Ting


The vast majority of patients treated in the Interventional Radiology Department at Zhengzhou University First Affiliated Hospital are fighting illnesses such as stomach cancer, liver cancer, and esophageal cancer.
Professor Han Xinwei, MD, states: “I use the simplest and most easily understandable language and describe this kind of procedure as ‘grabbing the cancer cells by the throat and making them drink a poisonous potion.’ Interventional therapy doesn’t require a large knife.”
Despite having already been in use for more than 40 years globally, and with a history reaching back almost 30 years in China, minimally-invasive interventional radiology is still underused in the Henan province. Han, who entered the field of interventional radiology in 1992, believes that minimally-invasive technologies represent the main trend for the future of surgery in China. The latest imaging equipment should be used for the majority of specialist diagnosis and surgical treatment using minimally-invasive technologies.
There are currently five Artis imaging systems at Zhengzhou University First Affiliated Hospital, with two Artis zeego systems installed in 2009 and 2012, respectively. “These five systems are in use for 24 hours a day, with doctors working in shifts.”

Minimally-Invasive Procedures as the Future of Surgery
Entrance area of Zhengzhou University First Affiliated Hospital

By 7 a.m., Professor Han Xinwei, MD, has already changed into his white coat in the Interventional Radiology Director’s office of Zhengzhou University First Affiliated Hospital in Zhenghzou, the capital of Henan province in north-central China: “I first check on seriously ill patients, listen to reports, then visit the interventional operating room. I spend almost the entire day in the operating room providing guidance and conducting procedures.”


Advantages of Interventional Radiology
The hospital’s Interventional Radiology Department, with 208 beds and 161 doctors and nurses, is one of the largest in the world. Interventional therapy can be used for previously hard-to-treat and even untreatable illnesses, such as stomach cancer, liver cancer, and esophageal cancer, as well as diseases that would usually have required full surgery. Interventional radiology doesn’t require a knife. The interventional radiologist makes a small opening in the patient’s body no larger than a grain of rice. An interventional device about one to three millimeters thick is inserted into a blood vessel. Next, an embolization agent is introduced through the device into the vessels feeding the tumor. This delivers targeted localized treatment.

Minimally-Invasive Procedures as the Future of Surgery
Professor Han Xinwei, MD

Benefits of Minimally Invasive Surgery
The approach is highly efficient and safe, and has minimal side-effects. Patients enjoy a shorter recovery period. Treatment can be easily repeated and has the benefit of not doing harm to healthy anatomical structures and physiological functions. The moment Professor Han starts to work, he is just like the Artis zeego robotic operating system in the hybrid operating room of the department that runs around the clock. 


Raising Awareness of New Treatment in China
The real challenge for Han, however, is that interventional radiology has only 30 years of history in China. Here, where there are over six million registered doctors and over ten million nurses, only 10,000 medical workers are familiar with and can perform interventional radiology. According to Professor Han, the transition from conventional surgery to minimally-invasive treatment is an essential future trend. Compared with other countries, China is not inferior in terms of the capacity for interventional radiology but its application has yet to be widely promoted. When Chinese patients visit a doctor, they want to have their illness treated without affecting their body as a complete entity. Interventional radiology is the best approach to achieve this goal. 


Minimally-Invasive Procedures as the Future of Surgery
Patients hope for treatment of cancer and cardiac disease.

Need for Education and Training in Interventional Radiology
To promote interventional radiology, it is necessary to educate young professionals and introduce new equipment. In 2009, Professor Han attended an international conference during which the Artis zeego robotic angiography system captured his attention. Afterwards, he introduced the advantages of the system and the benefits of using it to Hospital Director Kan Quancheng, who saw the potential in interventional radiology and gave the go-ahead for purchasing the system, making the hospital the first large hospital in China to introduce the equipment.


The Eyes and Hands of an Interventional Radiologist
But how does the Artis zeego help make interventional surgery successful? As Han says, the system is just like the eyes and hands of an interventional radiologist. “It is thanks to the Artis zeego that the interventional device can reach the tumor-feeding vessels accurately,” says Han.
Good equipment not only helps treat patients but also brings considerable revenue to the hospital. According to Professor Han, the Artis zeego vascular imaging system has an arm that can move and rotate flexibly and is nicknamed ‘The Miraculous’ by the medical staff. Moreover, the two ‘eyes’ installed on the robot are two monitors that help interventional radiologists to observe their device at any time during the procedure. Data related to this process is simultaneously entered into the hospital information system so that treating physicians have access to it.  


Minimally-Invasive Procedures as the Future of Surgery
Educating young doctors is key for a modern technology’s success.

Spreading the Good Word About the Future of Surgery
In China’s various county-level hospitals, a large number of patients are diagnosed every day. However, these hospitals lack advanced treatment technology and imaging equipment as well as properly trained medical staff. Some institutions, despite having invested in the purchase of equipment, still require the technical expertise and ability to operate the equipment, leading to a tremendous waste of human and material resources. “We have a responsibility to go to county and village hospitals to spread the knowledge about minimally-invasive interventional treatment,” says Professor Han. Therefore, in 2008 he started his interventional radiology ‘promotion plan’, as he calls it, by leading a team of interventional radiology experts out from provincial hospitals to various county-level hospitals to provide training to local medical staff.


Hard Work Paid Off
Han’s efforts have achieved a win-win outcome. Over the past several years, he has helped more than 30 county-level hospitals conduct interventional radiology. His recognition has grown with countless patients coming from counties and villages across the province, and even from beyond the province, to the provincial capital to undergo minimally-invasive treatment at Zhengzhou University First Affiliated Hospital. “We performed 9,300 procedures in 2012, and the number is expected to increase to 12,000 this year. Interventional radiology is like a buried treasure. We couldn’t have achieved so much without the help of The Miraculous,” says Professor Han. 


Chen Yi is an award-winning author and Senior Reporter at Economic Daily, one of China’s most-read business publications.