Remote telepresence surgery: the Canadian experience

Area of Science:

• Robotics in Medicine
• Surgical Technology
• Telemedicine

Background:

• Established the world's first telerobotic surgical service on February 28, 2003.
• Connected St. Joseph's Healthcare Hamilton (teaching hospital) with North Bay General Hospital (community hospital) 400 km away.
• Aimed to enhance advanced laparoscopic surgical services in a community hospital setting.

Purpose of the Study:

• To describe key lessons learned from the initial implementation of a telerobotic surgical service.
• To inform the design and development of future telesurgical robotic platforms.
• To guide the establishment of global telesurgical networks for disseminating surgical techniques.

Main Methods:

• Collaborative performance of 22 remote telepresence surgeries.
• Inclusion of procedures such as laparoscopic fundoplications, colon resections, and inguinal hernia repairs.
• Analysis of critical factors including telecommunication needs, haptic feedback absence, latency adaptation, and ethical/medicolegal considerations.

Main Results:

• Successfully performed 22 assisted robotic telepresence surgeries (ARTS).
• Identified significant challenges and lessons related to telecommunication, surgeon adaptation to latency, and the impact of missing haptic feedback.
• Documented ethical and medicolegal issues encountered during the service's operation.

Conclusions:

• This represents the largest clinical experience with ARTS globally to date.
• The findings provide crucial insights for advancing telesurgical technology and establishing interconnected surgical networks.
• The project facilitates the rapid and safe global adoption of novel surgical methodologies.