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Remote telesurgery in humans: a systematic review

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Abstract

Background

Since the conception of robotic surgery, remote telesurgery has been a dream upon which incredible technological advances haven been built. Despite the considerable enthusiasm for, there have been few published studies of remote telesurgery on humans.

Methods

We performed a systematic review of the English literature (PubMed, EMbase, Inspec & Compendex and Web of Science) to report studies of remote telesurgery in humans. Keywords included telesurgery, remote surgery, long-distance surgery, and telerobotics. Subjects had to be human (live patients or cadavers). The operating surgeon had to be remote from the patient, separated by more than one kilometer. The article had to explicitly report the use of a long-distance telerobotic technique. Articles that focused on telepresence or tele-mentoring were excluded.

Results

The study included eight articles published from 2001 to 2020. One manuscript (1 subject) described remote surgery on a cadaver model, and the other seven were on live humans (72 subjects). Procedure types included percutaneous, endovascular, laparoscopic, and transoral. Communication methods varied, with the first report using a telephone line and the most recent studies using a 5G network. Six of the studies reported signal latency as a single value and it ranged from 28 ms to 280 ms.

Conclusions

Few studies have described remote telesurgery in humans, and there is considerable variability in robotic and communication methods. Future efforts should work to improve reporting of signal latency and follow careful research methodology.

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Acknowledgements

This research was partially supported by the Altman Clinical & Translational Research Institute (ACTRI) at the University of California, San Diego. The ACTRI is funded from awards issued by the National Center for Advancing Translational Sciences, NIH UL1TR001442. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. University of California San Diego School of Medicine, San Diego, CA, USA

    Patrick Barba

  2. Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, CA, USA

    Patrick Barba, Joshua Stramiello, Emily K. Funk & Ryan K. Orosco

  3. Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, USA

    Florian Richter, Michael C. Yip & Ryan K. Orosco

  4. Moores Cancer Center, La Jolla, CA, USA

    Ryan K. Orosco

  5. Department of Surgery, Division of Otolaryngology—Head and Neck Surgery, Gleiberman Head & Neck Cancer Center, Moores Cancer Center, 9300 Campus Point Drive, MC 7895, La Jolla, CA, 92037-7895, USA

    Ryan K. Orosco

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  1. Patrick Barba
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Corresponding author

Correspondence to Ryan K. Orosco.

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Conflict of interest

Patrick Barba has nothing to disclose. Dr. Joshua Stramiello has nothing to disclose. Dr. Emily K. Funk reports grants from NIH/NIDCD, during the conduct of the study; Dr. Florian Richter has a patent motion scaling for time delayed robotic surgery pending. Dr. Michael C. Yip has a patent motion scaling for time delayed robotic surgery pending. Dr. Ryan K. Orosco reports grants from UC San Diego—Academic Senate, grants from UC San Diego—Altman Clinical & Translational Research Institute (ACTRI), during the conduct of the study; in addition, Dr. Ryan K. Orosco has a patent motion scaling for time delayed robotic surgery pending.

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Barba, P., Stramiello, J., Funk, E.K. et al. Remote telesurgery in humans: a systematic review. Surg Endosc 36, 2771–2777 (2022). https://doi.org/10.1007/s00464-022-09074-4

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  • DOI: https://doi.org/10.1007/s00464-022-09074-4

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