We explore technology ecosystem of smart surgical medical system by analyzing patent data applied for in Korea and Japan. First, a review of trends of patent application by country/technological domain show that there exist a minority of technology domains focused on R&D, which represent their trends have been increasingly active. Also, while a number of Japanese firms mainly consist of the patent market of Japan, in case of the Korean market, a few universities, SMEs, and foreign firms are found to be the main applicants. As a result of the network analysis with the links as the relations of co-patenting, the relationships, which are active of convergence and knowledge spillover among the heterogeneous technology domains within each market, as well as the technology domains, which are the most active in international cooperation among each homogeneous domain, could get derived and visualized in the ecosystem. In addition, the technology domains in each patent market with leading locations, roles, and influence in the network can also be identified through the centrality analysis. In this study, the analysis for technology competitiveness are carried out focusing on patent activity and patent impact. The results denote that across all domains, the Japanese market may possess higher patent activity and patent impact compared to the Korean market. In consequence, we derive the position map for comparison by country and technology domain from a perspective considering comprehensively the multi-dimensional attributes based on the results of both network analysis and technology competitiveness.