NSRS Natural Orifice Surgical Robot

The Novel Surgical Robotic System (NSRS) developed by NISI (HK) Limited represents a pioneering approach to minimally invasive surgery, designed to perform complex abdominal and pelvic procedures through natural body openings without external incisions. First demonstrated in animal experiments in 2015, NSRS features internally motorized robotic arms with haptic feedback capability, addressing key limitations of conventional surgical robot systems.

Product Overview

NSRS distinguishes itself from existing surgical robots through its fundamental design philosophy: rather than entering the body through multiple abdominal ports, the entire robotic system inserts through a natural orifice (rectum or vagina) and unfolds inside the patient’s body cavity. This approach eliminates the need for external incisions, resulting in truly scarless surgery.

The system was developed through collaboration between NISI, The Hong Kong Polytechnic University, and The University of Hong Kong, with engineering expertise adapted from precision instruments designed for space exploration missions. NSRS is the first surgical robot system featuring in-vivo motors that achieve both the miniaturization required for natural orifice access and the power output necessary for surgical manipulation.

Key Features

Internally Motorized Arms

Unlike conventional surgical robots that rely on external drive mechanisms with cable-driven instruments, NSRS positions its motors directly adjacent to the end-effectors inside the body. This architecture enables:

• High precision instrument control
• Reduced mechanical complexity
• True haptic (force/tactile) feedback to the surgeon

Transformable Design

Inspired by morphing robot concepts, NSRS robotic arms feature articulated components that can be disassembled for insertion and reassembled inside the surgical field. This transformable architecture allows adaptation to different surgical procedures and anatomical constraints.

Haptic Feedback

NSRS provides tactile sensation to surgeons, allowing perception of the force applied to tissues during manipulation. This capability addresses a widely recognized limitation of many commercial surgical robots that operate without force feedback.

Portable Platform

The system mounts on standard surgical tables without requiring dedicated operating room infrastructure, offering deployment flexibility compared to larger fixed-installation surgical robot systems.

Technical Specifications

Demonstrated in 2015 at HKU, NSRS positions up to 10 degrees of freedom inside the body via 4–8 mm brushless DC motors mounted directly at the end-effectors.

Clinical Applications

NSRS is designed for abdominal and pelvic surgical procedures where conventional approaches require multiple incisions. Target applications include:

• General Surgery: Cholecystectomy and other abdominal procedures
• Gynecology: Hysterectomy, oophorectomy, and pelvic surgery
• Colorectal Surgery: Procedures accessible via transrectal approach

The transrectal and transvaginal access routes provide optimal positioning for pelvic cavity procedures while avoiding any external abdominal wall trauma.

Development Status

NSRS remains in the research and development phase. Key milestones include:

As of the most recent public communications in 2019, NISI planned to initiate human clinical trials in 2021. Updated information regarding clinical trial status or regulatory submissions has not been publicly disclosed.

Regulatory Status

Comparison with Conventional Systems

Technology Background

NSRS development benefits from technology transfer from space exploration instrument design. Prof. Yung Kai-leung of The Hong Kong Polytechnic University, who has contributed to precision instruments for space missions, applied the same principles of miniaturization, power efficiency, and reliability to surgical robotics.

The micro-motors used in NSRS prototypes are supplied by maxon, a manufacturer of precision drive systems, with ongoing collaboration to further reduce motor dimensions while maintaining surgical performance requirements.

Frequently Asked Questions

What is the NSRS surgical robot?

NSRS (Novel Surgical Robotic System) is a natural orifice surgical robot developed by NISI (HK) Limited. It features internally motorized robotic arms that enter the body through natural openings and expand inside to perform abdominal and pelvic surgery without external incisions.

How does NSRS differ from da Vinci and other surgical robots?

Unlike da Vinci and similar systems that require multiple abdominal incisions for instrument insertion, NSRS enters through natural orifices (rectum or vagina) and leaves no external scars. It also provides haptic feedback, which many conventional systems lack.

What procedures can NSRS perform?

NSRS is designed for abdominal and pelvic procedures including cholecystectomy, gynecological surgeries (hysterectomy, oophorectomy), and other operations accessible through transrectal or transvaginal approaches. Animal experiments have successfully demonstrated cholecystectomy and gynecological procedures.

Is NSRS available for clinical use?

No. NSRS remains in the research and development phase. While successful animal experiments were conducted from 2015-2018 and human trials were planned for 2021, no regulatory approvals have been announced and clinical availability has not been confirmed.

Who developed NSRS?

NSRS was developed through collaboration between NISI (HK) Limited, The Hong Kong Polytechnic University, The University of Hong Kong, and the University of Cambridge. The project received support from the Innovation and Technology Commission of the Hong Kong SAR Government.