European Urology Open Science (Dec 2024)
Expanding Surgical Frontiers Across the Pacific Ocean: Insights from the First Telesurgery Procedures Connecting Orlando with Shanghai in Animal Models
Abstract
Background and objective: Telesurgery is as a promising solution to support and deliver advanced health care services to underserved areas. The primary endpoint of our study was to prove the concept of low-latency long-distance connectivity and to describe the feasibility of remote surgery. Methods: A prospective study was conducted from February 29 to March 1, 2024, in live animal models (porcine) connecting surgeons from Orlando (USA) to the animal laboratory in Shanghai (China) using 5G and Wi-Fi connections, in combination with continental and transpacific fiber. We performed ten radical nephrectomies and two partial nephrectomies in five animals using the MicroPort MedBot robotic platform. Intraoperative and telesurgery connection variables were reported with a descriptive statistical analysis. Key findings and limitations: No complications or conversions were reported. The mean animal weight was 38.2 (35–40) kg, the mean operative time was 32.7 (21–45) min, and the mean blood loss was 23.3 (20–30) ml. The mean latency was 296 (±50) ms. Findings from animal studies may not always translate directly to human outcomes. Conclusions and clinical implications: We described the feasibility of transpacific low-latency telesurgery in live porcine models with no intraoperative complications. Achieving optimal low-latency connectivity via telecommunication networks was essential for effectively performing the surgical procedures. However, we still need further investigation to achieve even lower latencies for human trials. We found that long-distance telesurgery is safe and feasible in animal models. However, it is a complex practice, and we still need further studies before translating these results to human trials. Patient summary: Our research has demonstrated the feasibility of low-latency long-distance telesurgery in live animal models. However, this type of telesurgery is a complex procedure, and further work is needed to translate these results to human trials.
