Dialogue | Building Surgical Robots at the 'Tip of the Pyramid'
The R&D of surgical robots demands high standards and presents significant technical challenges. Cornerstone Robotics has built a foundation of safety and stability through independent R&D and a high degree of domestic sourcing, with outstanding clinical trial results demonstrating that its products have reached world-class levels.
In the medical field, surgical robots represent the pinnacle of cutting-edge technology. As the "pyramid's peak" of medtech products, they are structurally complex, requiring not only lengthy R&D cycles but also multidimensional expertise spanning scientific research, technology development, clinical translation, and industrialization.
As a leader in the surgical robotics space, Cornerstone Robotics has spent six years building a global footprint with four R&D centers worldwide, achieving full mastery of core technologies including mechanical architecture, electrical systems, software frameworks, complex algorithms, and visual imaging—constructing an independently developed foundational technology platform for surgical robots. The company also operates a mass-production facility exceeding 10,000 square meters in the Guangdong-Hong Kong-Macao Greater Bay Area, successfully achieving "self-manufacturing" of surgical robots. Its independently developed Sentire® laparoscopic surgical robot received approval from the National Medical Products Administration (NMPA) on September 29, 2024.
At Qiming Venture Partners' 16th RMB Fund Annual Meeting and Investor Summit, William Hu, Managing Partner at Qiming Venture Partners, and Guowei Ou, Professor at The Chinese University of Hong Kong and Founder & CEO of Cornerstone Robotics, held a dialogue on "Building Surgical Robots at the Pyramid's Peak." Professor Ou shared his entrepreneurial journey and reflections, Cornerstone's technical breakthroughs and competitive advantages, AI technology innovations, as well as the company's culture and business philosophy.
William Hu, Managing Partner at Qiming Venture Partners (left), and Guowei Ou, Professor at The Chinese University of Hong Kong and Founder & CEO of Cornerstone Robotics (right)
On his motivation for starting the company, Professor Ou said it was simply to provide doctors with safe and effective tools, and to give patients access to quality care at reasonable prices. He pointed out that global surgical robot penetration remains low, with China's market holding 20x growth potential and significant unmet clinical demand. He emphasized the demanding and difficult nature of surgical robot R&D. Cornerstone has built a foundation of product safety and stability through independent development and high domestic content ratios, with outstanding clinical test results demonstrating international top-tier performance.
Hu believes the surgical robotics market has broad prospects—far from saturated domestically, with massive demand in emerging international markets. As investors, the goal is to support companies in developing globally innovative products, leveraging China's industrial chain advantages to meet unmet market needs.
The following is an edited transcript of their conversation.
01/
China's Surgical Robotics Market Has 20x Growth Potential
William Hu: Thank you, Professor Ou, for flying in from Hong Kong. First, could you tell us why you chose to start a company in surgical robotics? As we all know, Intuitive Surgical, maker of the da Vinci system—the world's largest surgical robotics company—has a market cap of $200 billion, with excellent products. Given this, what gave you the courage to challenge this industry giant? Could you share your experience and how the idea first came to you?
Guowei Ou: Cornerstone is like a child I created with my own hands, and it deserves to be treated well—so I decided to become CEO and run it with care. I'm an engineer who has focused on intelligent robotics research for about 30 years, particularly in surgical robots. As for why I chose to start a company, my thinking was quite simple when I returned from the United States in 2016. I had worked at a world-renowned surgical robotics company for nearly a decade, and I always held a belief: I wanted to create safe, effective tools for doctors to serve patients, so patients could receive excellent care at a reasonable price with more choices. So I came back alone. I joined The Chinese University of Hong Kong and simultaneously built different teams—at the university, I had the opportunity to find excellent collaborators, whether from Johns Hopkins University, Imperial College London, or universities in Hong Kong, like-minded people came together.
Our entrepreneurship started from this simple belief—nothing too complicated: serve patients, help Chinese doctors treat more patients. We also saw unmet clinical needs. Everyone knows the world-famous surgical robot brand, but if you look closely at the data, global minimally invasive surgeries total about 45 million annually, yet robot-assisted surgeries account for less than 5%—meaning 95% of surgeries don't use robots, so 95% of clinical demand remains unmet. This doesn't even include open surgeries, which add another 45 million per year, so the total surgical volume uncovered by robots reaches 90 million. The imported brand Hu just mentioned probably accounts for no more than 6% of global surgical volume—very small. Currently, only 1% of surgeries in China use robots, with just over 400 surgical robots nationwide, compared to 7,000 in the United States. Comparing the US and Chinese markets: America has 5,000 hospitals with 7,000 robots; China has 20,000 hospitals with only 450 surgical robots. Realistically, there should be at least 10,000 units, meaning 20x growth opportunity, not to mention consumables and maintenance services.
Why has surgical robot adoption been so slow? One crucial factor is cost—a single system runs $2-4 million. Before I returned, domestic prices exceeded RMB 20 million, and in Hong Kong about HKD 30 million. Additionally, annual maintenance costs RMB 2 million per unit, with consumables around RMB 30,000 per procedure. Given the 45 million global surgical demand I mentioned, the potential is enormous. We saw this need and hoped to build safe, effective, reliable surgical robots to serve patients, giving them better choices and bringing robotic surgery benefits to every hospital—this is our simple mission. We also dream that someday every hospital will have at least one surgical robot, just as they now have at least one MRI or CT machine—making surgical robots a basic medical facility configuration was our goal from day one.
02/
"Aviation-Grade Robotics" in Medical Robotic Arms
William Hu: I can feel the tremendous market potential, especially comparing China and US penetration rates. Surgical robots are among the most technically complex and demanding categories in medical devices. Taking da Vinci as the benchmark, how does Cornerstone's hardware capability compare? Is it a me-too product or something different? Please elaborate.
Guowei Ou: First, what's the difference between surgical robots and ordinary medical robotic arms? Many are familiar with image-guided robotic arms—their common characteristic is that they don't directly affect patient safety; even if navigation is suboptimal, fatal risks on the operating table are rare. Surgical robots differ: if control is lost during surgery, patients face immediate life-threatening danger. That's why we call surgical robots "Aviation-Grade Robotics" in the medical robotic arm field—extremely low fault tolerance, where any error can have severe consequences, like aircraft. We never compare surgical robots to aesthetic medicine systems; we liken them to airplanes because both share this trait: once an error occurs, irreversible tragedy may follow.
One particularly difficult aspect: surgical robots have over 10,000 components. Perhaps "10,000" lacks concrete meaning, so let me compare: ordinary industrial robots have about 1,000 components; surgical robots have 10,000, and ours has 13,000. Ordinary electric vehicles have 28,000 components, but most relate to comfort rather than powertrain—actually only 8,000 for the power structure. So surgical robot system complexity far exceeds familiar electric vehicles.
Most critically, surgical robots fundamentally differ from ordinary equipment. A phone error allows restart or repair; a surgical robot error during operation may directly endanger patient life. So we must control every aspect meticulously—including component quality, software control, and operating system control. Poor control and complete reliance on externally sourced components risk system failure due to compatibility or performance issues, leading to severe consequences. Compared to imported brands, we have a clear R&D philosophy: first, all components are self-designed—from motors, gearboxes, sensors, operating systems to endoscopic camera systems, entirely independently developed. For motors alone, our robot carries over 100 self-developed units, as purchased motors often fail to meet clinical precision requirements. Our system contains over 300 PCB circuit boards; ordinary industrial robots typically have 20-30—a tenfold difference. Comprehensively controlling so many precision components is challenging; overall, surgical robot safety requirements far exceed image-guided medical robotic arms.
Why are we called Cornerstone? I chose this English name clearly six years ago when founding the company. Cornerstone means foundation stone—six years ago we committed to building the foundation of surgical robots, insisting on self-developing every component. Now many focus on supply chain stability and regionalization; actually, I began addressing these issues when returning in 2016. We deeply understand that any substandard component ultimately affects clinical outcomes. Today, our domestic content ratio reaches 99%, with only 1% non-core components imported—leading domestically. In comparison, some imported brands still rely on external procurement for about 20% of key components. We fully leverage China's industrial advantages, integrating high-end talent from Hong Kong and Shenzhen, successfully building the most fundamental base. With this foundation well-built, different robot types become possible. Precisely because we accumulated this base from the ground up, in system stability and safety, we can achieve and partially exceed international benchmark product levels.
Meanwhile, we conducted extensive clinical testing—our surgical robot has completed over 250 clinical surgical applications, with data and clinical test results showing our product has reached equivalent levels to international top-tier brands, with some key parameters even more advantageous. For example, in intraoperative bleeding control, surgeon operational efficiency, and system setup time, we outperform international brands. Using car brands as analogy: if the imported brand represents "the Ferrari of surgical robots," our product is comparable to "Lamborghini"—maintaining excellent performance while incorporating more innovative technologies. Most importantly, our costs are controllable, enabling us to provide surgical robot solutions rivaling international top-tier products at more competitive cost structures. This is like getting "Ferrari"-level performance at a "BMW" price—that's our overall direction.
03/
Product Strength Is Core Competitiveness
William Hu: Cornerstone's surgical robot has received approval in China and begun commercialization. In Europe, the Middle East, and elsewhere, many doctors have started using our product. From a clinical perspective, what feedback do you expect from clinicians in China and overseas? Do you believe our product is on par with the world's best, or are there performance gaps?
Guowei Ou: As I mentioned, the video shows our team's clinical testing results in Hong Kong. Hong Kong doctors began using surgical robots in 2005, with nearly 20 years of experience with top international systems. Their data after using our robot shows global leading performance, with feedback indicators matching top international products. Based on this successful Hong Kong validation, we've partnered with multiple top mainland hospitals, such as The First Affiliated Hospital of Zhejiang University, and recently conducted clinical testing at Peking University First Hospital. Doctor feedback indicates our robot is likely the closest to imported brands among domestic surgical robots, achieving imported brand-level operational performance, with advantages in surgical field clarity and other aspects.
With these clinical achievements, we collaborate with university research forces to gradually build a global robotic network—this is crucial. Surgical robotics has very high professional technical barriers; traditional commercial promotion models often struggle to establish deep partnerships. Therefore, we choose to partner with the most prestigious hospitals. Starting from Hong Kong, we've initiated clinical collaboration with Nanyang Technological University, and are conducting clinical trials with Imperial College London and Portsmouth Hospital—the first domestic brand to conduct clinical trials in a global medical high ground like the UK. We also have research cooperation with Johns Hopkins University, all leveraging our academic network advantages. We can rapidly promote surgical robots to global medical high grounds, while these world-class surgeons come to Hong Kong for academic lectures and clinical testing—many international experts, after experiencing our product firsthand, actively invite us to promote in their countries. Three weeks ago, a leading Japanese authority in gastric cancer surgery tested our product and concluded its performance rivals international top-tier brands, even surpassing Japanese domestic products. He's now happy to help us promote in Japan, and we're planning to visit for further clinical collaboration discussions.
Meanwhile, we've submitted EU CE certification application, expecting market access by year-end for global promotion. The Middle East shows tremendous market demand with very large needs for medical robots, and Southeast Asian medical institutions have also expressed cooperation intentions. In this highly specialized field, product strength is core competitiveness—if they test your product and approve, they're interested in partnering. So it's entirely product-driven, promoting through R&D innovation capabilities in medical high grounds—this is a crucial business model for us now.
William Hu: Thank you, Professor Ou. As investors, we feel strong satisfaction, especially enjoying product discussions with founders. Hearing feedback like "our product is exceptionally good, globally top-tier" is genuinely exciting, because our investment purpose is seeing portfolio companies truly create globally innovative products, especially in extremely difficult fields. One of today's themes is artificial intelligence—does our industry have AI components? Or what impact does AI have on our field?
Guowei Ou: AI influences surgical development in multiple ways. Currently, we've conducted substantial research on AI-automated surgery, though full disclosure isn't yet appropriate. Actually, robots can now perform certain procedures fully automatically, but certification depends on regulatory system openness—I believe the technology exists. Another critical factor, is that AI's foundation is data; collecting data from a single surgical robot alone isn't very effective. So we're building a collaborative surgical robot network—connecting robots across different locations enables doctors to operate remotely, for example, a doctor in Shanghai's Pudong New Area could directly control a robot in Shanghai's Minhang District for surgery. These explorations are currently underway. This is foundational—connecting entire systems together, like the IoT concept, allowing multiple doctors to simultaneously collaborate on surgery for one hospital, like team combat in online gaming rather than solo play. This is forward-thinking, and we've begun relevant layout. Another important aspect is training young doctors.
Why are surgical robots difficult to popularize? Because learning and training opportunities for doctors are insufficient—most must specially take time to travel to distant training centers, perhaps only once or twice yearly, making training very difficult. But now, through our network system, young doctors can practice anytime in their own labs—even at 2 a.m., they can remotely operate our Shenzhen lab system for training, meaning doctors can receive 24-hour training.
We just deployed this remote training system at Beijing Shijitan Hospital, where doctors can directly operate our Shenzhen lab system without specially flying to Shenzhen. Doctors can now autonomously arrange training time, skill improvement accelerates significantly, and soon many robot surgery-capable doctors will be available—this is an unprecedented global breakthrough, and we've solved this problem.
Meanwhile, through this network, we can connect doctors across different locations. For example, when a young doctor practices at 2 a.m., we can invite experienced doctors for online guidance. If young doctors can obtain professional support anytime, overall medical service quality improves—this was previously impossible. More importantly, accumulating this data brings us closer to truly fully automated surgical robot operation.
William Hu: One final small question—we first invested in Cornerstone during the pandemic. I remember our first investment discussion call; I was traveling, calling you from a hotel lobby. Under pandemic conditions, everyone couldn't meet. You transitioned from scientist and professor to entrepreneur, which hasn't been easy. Cornerstone has developed very rapidly with efficient execution, producing China's best surgical robot in just a few years. From your perspective, in this identity transition from academic to entrepreneur, in what ways has Qiming Venture Partners provided support?
Guowei Ou: It definitely helped—our current success is because of your support. First, I'm a scientist accustomed to seeing things with clear logic, deeply understanding physics principles. Entrepreneurs need to communicate with people, understand human nature—both mastering physics principles and understanding human needs. Scientific research, though lengthy, has the benefit of helping establish correct direction and navigate development cycles, so building a large enterprise requires scientist thinking to clarify direction.
Second, in entrepreneurship every day is different—not only product progress, but personal progress too.
Third, learn to listen. We need to hear customer needs, investor opinions, and team voices. Because team members have various needs, my responsibility is understanding and addressing these needs, ultimately moving everyone in the same direction.
In summary, with scientist or engineer background, plus entrepreneurial spirit and understanding of human nature, combined with sound business models, transformed into our company culture—this enables people from different fields to gather and strive toward the same goal.
Our corporate philosophy is simple: hope to serve the public and patients with our products, so we call this culture "Mother's Test" (not necessarily mother, could be other loved ones). The concept is simple: imagine someday, our surgical robot might serve our employees' loved ones. Whether in finance, sales, or R&D, every oversight could directly affect patient safety—and this patient might be your family member. So we use this concept to motivate employees, uniting the entire company to build the world's best robots and serve global patients.
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Founded in 2006, Qiming Venture Partners currently manages 11 USD funds and 7 RMB funds, with total assets under management reaching $9.5 billion. Since inception, the firm has focused on investing in early and growth-stage outstanding enterprises in Technology and Healthcare sectors.
To date, Qiming Venture Partners has invested in over 580 high-growth innovative companies, of which more than 210 have listed on the New York Stock Exchange, NASDAQ, Hong Kong Exchanges and Clearing Limited, Shanghai Stock Exchange, and Shenzhen Stock Exchange, or exited through M&A and other means. Over 80 portfolio companies have become recognized unicorns or super-unicorns.
Many Qiming Venture Partners portfolio companies have grown into the most influential companies in their respective fields, including Xiaomi (01810.HK), Meituan (03690.HK), Bilibili (NASDAQ:BILI, 09626.HK), Zhihu (NYSE:ZH, 02390.HK), Roborock (688169.SH), UBTECH (09880.HK), WeRide (NASDAQ:WRD), Insta360 (688775.SH), Gan & Lee Pharmaceuticals (603087.SH), Tigermed (300347.SZ, 03347.HK), Zai Lab (NASDAQ:ZLAB, 09688.HK), CanSino Biologics (688185.SH, 06185.HK), Schrödinger (NASDAQ:SDGR), MicroPort EP MedTech (688617.SH), Sanyou Medical (688085.SH), Amoy Diagnostics (300685.SZ), Berry Genomics (000710.SZ), Sinocelltech (688520.SH), Yuanxin Technology, Insilico Medicine, MediLink Therapeutics, LaNova Medicines, Zhipu AI, StepFun, Biren Technology, and others.