This is part one of our series in CUHK in Focus that talks to principal investigators of the six CUHK projects chosen for the second round of the Hong Kong government’s Research, Academic and Industry Sectors One-plus Scheme (RAISe+). The scheme provides a maximum of HK$100 million to each approved project to help local universities commercialise their research outcomes. Including the seven projects accepted last year, CUHK now has 13 projects receiving RAISe+ funding, the most among local institutions.

Professor Philip Chiu Wai-yan is a science fiction film buff. The Dean of Medicine relishes the telling of Fantastic Voyage, about a secret experiment in which scientists shrink the protagonists and their submarine, then inject them into a rabbit’s body to explore its mysteries. This combo of technology and creativity is right up his alley as he is, likewise, probing intricacies inside the human body with a minuscule but deft pair of robotic arms.

Except that, in the real world, Professor Chiu’s sci-fi-like innovation helps actual people, patients of early-stage digestive tract cancer. The robotic arms, developed by his team jointly with CUHK’s Faculty of Engineering, mimic the dexterity of a surgeon’s hands. Like a fantastical scene come to life, one arm holds tissue aside with its micro-grippers while the other wields micro-blades to excise with accuracy.

This is how the cutting-edge technology he calls EndoR Surgical System is able to perform endoscopic submucosal dissection (ESD) to remove tumours. “The system has a camera separate from the robotic arms. It acts as an independent ‘eye’ that provides a clear view, significantly increasing surgical flexibility and precision,” the professor says, poised to launch human clinical trials.

Answer to bottleneck of traditional surgery

Digestive tract cancers are among the most common cancers globally, afflicting 3.4 million new cases each year. ESD removes lesions in the mucosal layer through an endoscope without the need to excise organs, preserving healthy tissue and significantly lessening trauma. Taking it further, Professor Chiu’s approach to ESD not only improves the cure rate at the early stage but may also reduce medical costs and training barriers, enabling doctors in more parts of the world to master the technique and offer hope to patients.

Professor Chiu introduced ESD to Hong Kong after learning from the pioneer of the method, Professor Haruhiro Inoue, in Japan in 2003.  However, the technique in its traditional form poses limitations.

He explains: “Endoscopes were originally designed for diagnosis, not treatment. They rely on a single duct and the tools are not flexible, making it extremely challenging for surgeons to simultaneously control the endoscope and the cutting instruments.”

Traditional ESD is also better suited to removing mucosal lesions smaller than 2 cm. For larger lesions, the edges are often hard to resect completely, raising the risk of recurrence and inconsistent treatment outcomes due to variations in doctors’ experience.