Make surgery succeed; bring better care to more people

Traditional monopolar electrocautery burns tissue with high heat to stop bleeding; the heat spreads laterally along the cut edge, burning tissue the surgeon cannot see at that moment. In thyroid surgery, the recurrent laryngeal nerve is millimeters away; in gynecological surgery, the ureter may be right beside it. There is also surgical smoke, and the fact that current must pass through the patient's body.

The ultrasonic scalpel vibrates the blade surface at 55.5 kHz, denaturing protein at a low 50–100°C — not by burning, but by mechanically breaking the hydrogen bonds of protein. Cutting and coagulation complete in the same motion, with minimal smoke and no current passing through the patient's body.

An in-vivo study on the peritoneal incision of 100 patients showed: mean lateral thermal damage was 215.79 μm for monopolar electrocautery versus only 90.42 μm for the ultrasonic scalpel (power 3) — about 40% of the former, a statistically significant difference (p < 0.001). In thyroid surgery, independent meta-analyses (n = 5) agree: operating time shortened by about 18.7–23.1 minutes, with blood loss, drainage, post-operative pain and length of stay all falling in parallel, and no observed increase in recurrent laryngeal nerve injury risk.

Industry claims of "seals 7 mm vessels", "higher vascular burst pressure", or "0.5 mm differences in thermal damage" are laboratory metrics built for commercial differentiation. In the real operating room, however, the variables introduced by human operation already far exceed those infinitesimal differences on the spec sheet.

Taiwan has 1,256 medical-device firms, 50,254 employees, and 2025 medical-device industry revenue of about NT$1,568 billion; in the same year 66 Taiwan medical-device products obtained US FDA 510(k) clearance, mostly surgical and therapeutic. Precision machinery in central Taiwan, metalworking in the south, ICT in Hsinchu — transducer, power, blade, sterilization and packaging: Maxima's 30 local suppliers are all on the same island.

What a surgeon says at the table becomes an engineer's spec almost immediately. The clinical site and the manufacturing line are on the same island — no cross-time-zone round trips, no waiting for samples to ship; the same product can ship its next-generation optimization in less time.

Gen 1 shipped in Taiwan in 2022; Gen 1.5 (Maxima UDAC) obtained TFDA in 2026, with a generator rated for 100 plasma resterilization cycles; Gen 2 MAXXONIC generator rated for 150 steam resterilization cycles, battery reusable 200 cycles, 6 models across the series. Every change starts from clinical feedback and returns to clinical validation.

Same hospital, same type of device — the publicly disclosed out-of-pocket charges look like this: Medtronic Sonicision 7　NT$49,650, J&J ACE+7　NT$34,500, Maxima　NT$31,950 — all prices filed by China Medical University Hospital on the NHI self-pay device price-comparison website. Same scalpel, same hospital, the patient's out-of-pocket can differ by NT$17,700 — about 36%, equal to 1.55×. Price is the result of negotiation, not an iron law; once a second supply source exists in the market, the hospital gains one more option to negotiate — that is the mechanism we call "driving the majors to lower prices". This is not won by lowering requirements, but squeezed out by supply-chain proximity, iteration speed and process discipline.