BEIJING, July 2 (China Economic Net) - When Professor Prokar Dasgupta operated in London on a 62-year-old prostate-cancer patient from Gibraltar earlier this year, the distance drew the headlines: about 1,500 miles between a surgeon at a console in Britain and a robotic system moving inside an operating room in Gibraltar, at the southern edge of the Iberian Peninsula. The robot was Chinese-made — Toumai, developed by Shanghai MicroPort MedBot.

The operation was a milestone, not proof of routine adoption. But it pointed to a broader shift: China is moving beyond the demand side of robotic surgery.

International firms are localising more manufacturing and clinical evidence work in China, while Chinese makers are scaling at home and testing overseas demand. Together, those shifts are moving China closer to the centre of robotic surgery — as a place where systems are made, studied, adapted and exported.

International players dig in

For international surgical-robotics companies, China is no longer only about how many machines its hospitals will buy. The market has become large enough — industry estimates put it at nearly 10 billion yuan in 2024 — that companies are treating China as a place to manufacture, validate and adapt the technology itself.

Intuitive Surgical is the clearest example. It is spearheading a multi-year evidence synthesis study with Peking University to evaluate how robotic procedures impact patient outcomes and costs. That evidence, its Asia-Pacific president Glenn Vavoso said in a recent interview with China Economic Net (CEN), is what wider adoption depends on: helping governments and hospital operators assess the "true value" robotics brings, not only clinical outcomes but cost savings, resource use and hospital throughput.

That effort sits on top of a deeper local base. Intuitive has been part of China's healthcare ecosystem for more than two decades and says its technology has helped treat nearly 1 million patients in the country. Its da Vinci Xi systems for the Chinese market are assembled locally through Intuitive Fosun, a joint venture established in 2017; by the company's account, more than 80 percent of Xi systems installed in China in 2025 were locally made, Glenn told CEN.

Intuitive also operates the da Vinci Innovation Hub in Beijing, and Glenn noted it is seeking partnerships with Chinese digital and AI companies that, combined with its own products, "could do great things for the China population, and even beyond the borders of China."

Intuitive is not the only foreign firm using China as more than a sales destination. At a health forum during the recent China International Supply Chain Expo, Medtronic said its China strategy had entered a "3.0" phase, shifting from a traditional importer of global medical technologies to a co-builder of the local innovation ecosystem. The company pointed to a pacemaker manufacturing base in Shanghai Lingang, which it described as the only pacemaker production base set up by a multinational company in China, and a digital innovation centre opened in Beijing E-Town last October to work with local partners on AI and digital healthcare.

Domestic makers scale up and head out

Chinese companies are growing from the other direction. For years, surgical robotics in China meant imported systems in top-tier hospitals. That is changing as domestic makers win approvals across endoscopic, orthopedic, neurosurgical and vascular systems, and as hospitals look for robots that can be bought, maintained and used at lower cost.

That home base is giving some Chinese companies a platform to expand overseas.

MicroPort MedBot's Toumai is the clearest case. The company said revenue reached 551.1 million yuan in 2025, up 114 percent from a year earlier, with overseas markets contributing about 400 million yuan, or 73 percent of the total. In its annual results presentation, the company also said Toumai received more than 100 new orders in 2025 and that more than 140 systems had been installed globally.

Its early overseas footprint shows where that proposition is landing first. In Morocco, the company says four Toumai systems have been put into use and completed more than 500 procedures. In India, Kokilaben Dhirubhai Ambani Hospital in Mumbai became one of Toumai's early flagship overseas installations, with the company saying doctors there performed more than 50 urology procedures in the first month. In Thailand, Rajavithi Hospital has been positioned as a training site for the system. In Brazil, MicroPort MedBot said Hospital Nove de Julho completed what it described as Latin America's first commercial remote human surgery using Toumai.

Those cases do not make Toumai a global benchmark. They show something narrower but important: Chinese surgical-robot makers are finding early traction in markets where cost, training and service support have long shaped whether robotic surgery can scale.

Why now — and what is still missing

Two changes underneath the Chinese market might help explain the timing. The first is regulatory. Since 2018, endoscopic surgical robot systems have been managed as Category B large medical equipment, with permits handled by provincial health authorities rather than the central health commission — loosening a constraint that had limited how many machines a province could install. The 14th five-year national plan then raised the quota for laparoscopic surgical robot systems to 559 units, from 225 in the previous cycle.

The second change is how buyers and policymakers talk about value. Recent policy signals put more emphasis on clinical needs and the value of drugs and medical devices, said Alicia Zhang, head of the China office of the Singapore-headquartered medtech association APACMed, which supports healthcare innovation across Asia-Pacific. This signals a change from earlier years, she noted, when the discussion focused more on products and procurement by quantity. The shift is uneven and still in pilots, she and analysts caution.

What still lacks is the system around the machine. Building payment rules, data standards and training pipelines is not. Hospitals and payers are still learning to translate clinical outcomes into procurement terms. Data for training the next generation of systems remains fragmented across hospitals. Cross-border rules for AI-enabled surgical robots are also still being written, and the field has no settled definition of what even counts as an AI-enabled medical device. "AI can be added to almost anything," Alicia told CEN, "which is precisely the problem."

For Alicia, that makes governance and trusted platforms part of China's opportunity. She said China could work with Global South countries to develop an AI governance system so that responsible, qualified AI medtech products can be sourced from China. The demand is already there. Friends in Southeast Asia have asked her a practical question: "If I want to buy some AI medtech products, where should I go? Who should I talk to?"