Remote surgery conducted over thousands of kilometres can be just as reliable as robot-assisted operations done by a medical team in the same room as the patient, according to a new study led by Chinese military researchers and carried out in five cities.
The researchers said telesurgery could be a “feasible” way to overcome the lack of medical services in parts of the country as well as the growing demand for operations to treat cancer.
“As the first randomised controlled trial in the field of telesurgery, this study establishes that its reliability is non-inferior to that of conventional local surgery,” the scientists wrote in an article published in the peer-reviewed medical journal The BMJ on Thursday.
“This finding provides a foundational evidence base for the design and implementation of larger-scale clinical trials in the future.”
Telesurgery enables a surgeon to operate on a patient remotely, providing medical care to people in distant locations such as military environments, disaster zones, underserved regions and during space missions.
A surgeon controls the procedure from a console with haptic controls and 3D visualisation. Their movements are digitised and then transmitted via ultra-low-latency communication networks – such as dedicated optical fibre lines, 5G/6G wireless networks or satellite connections – to a robotic system on the patient’s side, which executes the actions.
Doctors from the Chinese People’s Liberation Army General Hospital in Beijing collaborated with peers in hospitals in Hefei, Harbin, Hangzhou and Urumqi to perform surgery between December 2023 and June 2024 on 63 patients diagnosed with either a kidney tumour or prostate cancer.
The cities in the study were between 1,000km and 2,800km (621-1,740 miles) from Beijing. They were connected via an optical transport network and a dedicated cloud connect network for surgeons in Beijing to treat patients in the four other cities, while patients in Beijing were operated on by surgeons elsewhere.
Half the patients were randomly assigned to undergo telesurgery, while the other half had local surgery to remove their prostate gland or kidney tumour by a four-armed surgical robotic system developed by Shenzhen-based Edge Medical.
The team said it found the telesurgery system to be “stable”, with an average round-trip network latency of 20 to 47.5 milliseconds and “very low” frame loss, also known as dropped frames.
They also found that outcomes relating to “operative basic data, complications, early recovery, oncological outcome and medical team workload, did not differ substantially between the two groups”.
They said the trial offered crucial evidence and reference for larger cohort studies in future, which could investigate the comprehensive benefits of telesurgery in clinical applications.
Telesurgery, once widely adopted, could enable patients to have access to high-quality medical care despite being a long way from a big medical centre, reducing wait times for hospital beds, the burden of long-distance travel and overall costs for out-of-town medical care.
It also has the potential to address the increase in cancer cases and a higher demand for surgical procedures because of the global ageing population and the trend of early onset cancer.
The team led by Zhang Xu, director of urology at the PLA General Hospital, has been testing telesurgery over long distances. In 2024, he performed a remote robotic prostate removal in Rome on a patient in Beijing. -- SOUTH CHINA MORNING POST
