Beijing Shijitan Hospital Successfully Completes World's First Robotic-Assisted TIPS Surgery

Background

Portal hypertension can lead to serious complications including bleeding from esophageal and gastric varices. One established interventional treatment is the transjugular intrahepatic portosystemic shunt (TIPS) procedure, which creates an artificial channel to divert blood flow and reduce pressure in the portal venous system.

In cases of portal vein thrombosis accompanied by cavernous transformation, where the main portal vein is severely narrowed or occluded and replaced by a network of small collateral vessels, traditional TIPS carries high risks. These include difficult puncture, procedural failure, and potential major intra-abdominal bleeding, leading it to be viewed as a challenging or forbidden area for the procedure. Beijing Shijitan Hospital's interventional treatment department began performing surgically assisted TIPS (SATIPS) in December 2023. By the period surrounding the reported innovation, it had successfully completed the procedure in more than 50 such complex cases, including four that were laparoscopic-assisted.

What was achieved

On the night of May 12, 2025, in operating room 17 at Beijing Shijitan Hospital, Dr. Fan Zhenhua of the interventional treatment department led a multidisciplinary team that successfully completed the world's first robotic surgically assisted transjugular intrahepatic portosystemic shunt procedure, referred to as RSATIPS or Robotic Surgically Assisted TIPS. The team included collaboration with gastrointestinal surgery and anesthesiology.

A technology novelty search report issued by Capital Medical University on June 10, 2025, confirmed that a comprehensive search of domestic and international literature found no prior reports of surgical robot technology-assisted transjugular intrahepatic portosystemic shunt, verifying the procedure as an international innovation. The achievement was noted in official communications in September 2025 amid the hospital's broader rollout of robotic techniques across departments. In June 2025, during its 110th anniversary activities, the hospital established a Robotic Minimally Invasive Surgery Medical Center.

How it works

In a standard TIPS procedure, access is gained through the internal jugular vein in the neck. Catheters and instruments are advanced under imaging guidance into a hepatic vein. A needle then creates a tract through the liver parenchyma to connect to a portal vein branch. The tract is dilated and a covered stent is placed to maintain an open shunt, allowing portal blood to flow directly into the systemic circulation and thereby lowering portal pressure.

Complex cases involving portal vein thrombosis and cavernous transformation make standard puncture difficult because there is no single clear target vessel, increasing risks of multiple failed attempts or hemorrhage. The hospital had previously addressed this through hybrid surgical assistance, using open or laparoscopic methods to expose and catheterize suitable mesenteric or portal branches to guide the interventional puncture.

The RSATIPS approach integrates robotic minimally invasive surgical technology with interventional radiology. According to reports, this enables more precise control and visualization during the hybrid procedure, facilitating safer access and stent placement in anatomically challenging cases where traditional methods have been limited.

What it means for international patients

This reported first-of-its-kind procedure may expand options for patients with complex portal hypertension and thrombosis who face significant treatment challenges. The hospital's development of robotic capabilities in interventional treatment and other fields could be relevant for those seeking advanced care in China.

The hospital maintains an English-language version of its official website. International patients interested in this or related procedures should contact Beijing Shijitan Hospital directly to confirm current availability, assess individual eligibility based on their specific medical condition, and inquire about any support services. Suitability must be determined through consultation with the interventional treatment department and multidisciplinary team.

About the hospital

Beijing Shijitan Hospital, formally known as Capital Medical University Affiliated Beijing Shijitan Hospital, is a comprehensive tertiary Grade A public hospital located in Haidian District, Beijing, adjacent to the China Millennium Monument and Beijing West Railway Station. Originally founded in 1915 as the Beijing Railway General Hospital, it serves as an affiliated hospital of Capital Medical University and includes roles supporting the university's cancer-related education and research.

The facility has approximately 1,100 beds and more than 2,300 staff members. It features 54 clinical departments and is known for work in interventional treatment, oncology with emphasis on gastrointestinal, hepatobiliary and peritoneal tumor surgery, and other areas. In 2025 it established a dedicated Robotic Minimally Invasive Surgery Medical Center and was approved as a Beijing artificial intelligence assisted treatment technology training base.