Tele-robotic distal gastrectomy with lymph node dissection on a cadaver.

Area of Science:

• Surgical Robotics
• Telemedicine
• Gastrointestinal Surgery

Background:

• Advancements in surgical robotics have enabled minimally invasive procedures.
• Telemedicine offers potential solutions for remote surgical training and intervention.
• Gastric cancer surgery requires precise dissection and lymph node removal.

Purpose of the Study:

• To evaluate the performance of tele-robotic distal gastrectomy (tele-RDG) with lymph node dissection (LND).
• To assess the feasibility of using the novel Japanese hinotori™ surgical robot for remote procedures.
• To determine the stability and efficacy of a long-distance telecommunication link for robotic surgery.

Main Methods:

• Tele-robotic distal gastrectomy (tele-RDG) with D2 lymph node dissection (LND) was performed on an adult human cadaver.
• A 250 km telecommunication link (1 Gbps) connected the patient cart at Hokkaido University and the surgeon cockpit at Kushiro City General Hospital.
• Surgical performance, communication stability, and operative time were recorded.

Main Results:

• The communication environment remained stable throughout the tele-RDG procedure, with no image degradation.
• The mean round trip time for communication was 40 milliseconds.
• The total operation time for tele-RDG with D2 LND was 199 minutes, with no technical issues encountered.

Conclusions:

• Tele-robotic distal gastrectomy (tele-RDG) using the hinotori™ surgical robot is a feasible and effective procedure.
• The system demonstrated stable performance and comparable outcomes to local robotic gastrectomy.
• This technology holds promise for expanding access to advanced surgical care through telemedicine.