[건강한 가족] A joint structure is attached to the forceps of a laparoscopic instrument, mimicking the doctor’s hand movements.

K-surgical instrument mini robot ‘Articential’

The clamp part is bent 90 degrees up, down, left and right.

Operate without restrictions as the doctor wants

Reliably performs even difficult sutures

Laparoscopic surgery is a representative minimally invasive surgery. Unlike open surgery, which is performed by making a long incision in the abdomen and then opening the incision window, surgery is performed by making a small hole in the abdomen and moving a camera and various surgical instruments into it. By reducing the incision area during surgery and leaving minimal scars, post-operative pain is reduced, the risk of complications is reduced, and the recovery period is shortened. The field of laparoscopic surgery has continuously improved its technology to increase convenience and accuracy. Among them, one that has recently attracted attention is the K-surgical instrument. LivesMed’s laparoscopic surgical instrument ‘ArtiSential’, developed purely with domestic technology, is being recognized for its value both at home and abroad.

Multi-joint function is advantageous for precision surgery

Artistic is a compound word of articulation and essential. It contains the meaning of a surgical instrument with a multi-joint structure that is essential for laparoscopic surgery. Existing laparoscopic surgery basically utilizes straight surgical instruments. It restricts the operator’s movements, making it difficult to approach the surgical site at certain angles. Although it provides an improved surgical experience for patients, it brings inconvenience to the doctors performing the surgery. The difficulties caused by these straight instruments have been greatly improved with the introduction of articulated surgical robots. The pincer portion of the robot arm bends freely through the joints, allowing the doctor to implement the desired movement without significant restrictions. However, there are limitations in that the cost burden on patients is high and the facilities available for surgery are limited.

Articential complemented and improved these pros and cons. It is the world’s only medical device equipped with a joint structure in a passive laparoscopic instrument. Professor Kang Chang-moo of Severance Hospital’s Hepatobiliary-Pancreatic Surgery Department explained, “To increase the mobility of laparoscopic surgical instruments, we equipped the end of the surgical instrument with technology to enable wrist movement. It is a device that is like the final solution to complement the shortcomings of existing laparoscopic surgery.” Currently, Professor Kang’s team is participating in Artistic multi-center overseas clinical research projects hosted by the Korea Health Industry Development Institute as part of the ‘Support for commercialization of innovative medical device companies’ technology’ project in countries such as the United States, Canada, Japan, Singapore, Thailand, and Turkey. We are currently researching the clinical efficacy and safety of Articential with surgeons.

Articential’s greatest strength is that the clamp at the end of the instrument has the same degree of freedom as a human hand. The forceps that are inserted into the human body have a multi-joint structure. Thanks to the joint’s ability to bend 90 degrees up, down, left, and right, precise and stable surgery can be performed by replicating the doctor’s hand movements. Professor Kang said, “As we become more familiar with joint function, the level of surgery has changed,” adding, “All types of high-level suturing that cannot be performed with straight laparoscopic instruments are possible.”

Another feature is that intuitive control is possible. Artistic is a handheld type that allows the surgeon to intuitively control the joint structure. This means that if a doctor places his hand on the instrument control panel and moves it, he can perform surgery while feeling as if the joints of the instrument are the surgeon’s joints. Additionally, since the forceps and the control unit are mechanically connected, the reaction force applied to the forceps is transmitted to the control unit, allowing the doctor to perform surgery more safely. Above all, it is meaningful in that it is a high-performance, low-cost medical device that can be universally used by anyone. It is the only handheld instrument that implements the multi-joint structure of the robot’s forceps, making it easier to enjoy the benefits of high-performance surgery.

Reduces patient pain immediately after surgery, making recovery easier

Articential was released in an 8mm thickness, but an additional 5mm thickness lineup was introduced to hospitals at home and abroad starting in September 2023. It is the first product introduced in the world in a multi-joint, multi-degree of freedom form. There is also a 5mm lineup of surgical robots, but the forceps are bent like a snake, so the development technology is considered less difficult than the multi-joint type. 5mm is considered the smallest incision size for surgical procedures. It helps reduce patient pain and bleeding, removes tumors more precisely, and shortens the recovery period.

This is also confirmed in actual clinical experience. Articential is useful for cholecystectomy, the most frequent surgery in the field of hepatobiliary pancreatic surgery. Previously, surgery was performed using four ports (incisions), but there is a recent trend to reduce the number. Professor Kang’s team used Artisential to successfully develop a laparoscopic cholecystectomy technique using ‘Single Port+1’ with a small incision. The incision was reduced by 50% compared to existing laparoscopic surgery, increasing clinical utility.

At the same time, by moving the existing solar plexus port to the upper left abdomen, the pain index complained of by patients immediately after surgery decreased by about 50% compared to the surgical robot. Professor Choi Moon-seok of the Hepatobiliary and Pancreatic Surgery Department at Yongin Severance Hospital, who is participating in the study, said, “As we confirmed that pain was less immediately after surgery when Artisential was used in cholecystectomy, it appears to have an impact on the qualitative aspect of recovery.” “We expect that many patients will benefit from the technique as much as the robot.”

“Overseas surgeons are highly interested in domestically produced medical devices, and we expect them to be distributed around the world.”


Interview with Professors Changmoo Kang and Moonseok Choi

Articential has established itself as a major surgical instrument in Korea. Overseas medical staff are also very interested. Professor Kang Chang-moo’s team at Severance Hospital’s Hepatobiliary-Pancreatic Surgery Department will conduct clinical research related to Artistic at the front line, announce research results, and disseminate the technique domestically and internationally. I heard from Professor Kang and Professor Choi Moon-seok of the Hepatobiliary and Pancreatic Surgery Department at Yongin Severance Hospital about their experiences using Artisential.

-When is it best to use it?


Professor Changmoo Kang (hereinafter referred to as Professor Kang) In the case of pancreaticoduodenectomy, the process of connecting the pancreas and bile ducts remaining after surgery was quite difficult, so surgical robots were often used. According to recent research results, when Articential was properly used in such complex pancreatic surgery, the clinical surgical results were similar to robots. It is expected that Articential, created with Korean technology, can be further applied and expanded in the liver and pancreas area.

-What is it like when you try it?

Professor Choi Moon-seok (hereinafter referred to as Professor Choi) Artistic is a device that can simultaneously satisfy the advantages of laparoscopic surgery, which allows the user to feel some degree of reaction force against the tissue during surgery, and the advantages of a surgical robot that allows free joint movement.

-Are there any difficulties in applying it?

Professor Choi Any surgical method requires a learning curve to reach a certain level. Although it may take some time to get used to it, the advantage of using Articential compared to regular laparoscopic surgery seems to be that the learning curve is relatively short. There is no significant difference in surgical results, so it is currently being applied well to patients.

-I heard you wrote an educational textbook.

Professor Kang This is a textbook on cholecystectomy, a basic surgical procedure. There is part 1, which explains the basic concepts and surgical methods, and part 2, which describes surgical methods applied in more difficult conditions. Part 2 describes the new technology called Artistic and how to apply it. Using this, students learned how to use it and received training on how to apply it during surgery.

-Is there a lot of interest from overseas?


Professor Kang Cholecystectomy using Articential was demonstrated at an international conference held in Mongolia in August last year. Many surgeons showed considerable interest. On the one hand, there were concerns about whether the new technology could be applied well. In that sense, it is necessary to strive for distribution and education so that medical devices developed with domestic technology can become established globally.

-What are the remaining tasks to increase clinical usability?

Professor Kang In the meantime, as part of a national project, multi-national and multi-institutional clinical trials were conducted to evaluate clinical safety and efficacy. Based on clinical data on new technologies and application methods, related papers were submitted to academic journals and research results were presented at domestic and international academic conferences. Since I know the basic concepts and characteristics of Artistic, I think it is important to create conditions for more effective use of surgical instruments by developing training programs through methods such as small research groups.

Sunyeong Kim (kim.sunyeong@joongang.co.kr)

⁢1. Can you tell us more about the⁢ benefits of using ⁢Artificial in surgery compared to traditional tools and methods?

2. How has the development of Artificial impacted the field of hepatobiliary and pancreatic surgery​ specifically, and what ⁤are some notable ‍successes or breakthroughs that have been achieved using this technology?

3. What are some of the challenges associated with‍ the adoption and learning curve of using Artificial in surgical procedures?

4. What role does education and training play in increasing the clinical⁢ utility of Artificial, both for domestic ​and international medical professionals?

5. ⁣Are there any potential ethical considerations or​ concerns related to⁢ the use of Artificial in surgery, and how are these being addressed or addressed in the development⁣ process?

6. ⁣How‌ does Artificial compare to other surgical robots or minimally invasive techniques on⁣ the market, and what makes it stand ‍out in terms of cost and effectiveness?

7. Can you share any future plans or research directions for improving or expanding the use of Artificial‌ in various surgical procedures, and ⁢how might this technology ‍evolve in ⁣the ⁣coming years?