Telesurgery across continents: a scoping review

Area of Science:

• Robotics and Telemedicine
• Global Health Equity
• Surgical Innovation

Background:

• Limited access to safe and reliable surgery exists in many parts of the world.
• Intercontinental telesurgery utilizes robotic platforms and telecommunication for remote surgical procedures.
• Addressing global surgical disparities is a critical healthcare challenge.

Purpose of the Study:

• To review emerging technologies and infrastructure for intercontinental telesurgery.
• To identify enablers and obstacles in implementing remote surgical care globally.
• To synthesize current knowledge on legal, ethical, and practical aspects of telesurgery.

Main Methods:

• A scoping review of peer-reviewed and gray literature from 2001-2025.
• Searches conducted in databases including PubMed, Google Scholar, and Europe PMC.
• Thematic organization of 39 selected records covering various aspects of telesurgery.

Main Results:

• Human intercontinental telesurgeries were safely performed with 150-300 ms latency, comparable to local robotic surgery outcomes.
• Preclinical models validated long-distance viability with stable latency using hybrid networks.
• Key challenges include network instability, legal uncertainties, scalability limitations, and surgeon fatigue.

Conclusions:

• Intercontinental telesurgery shows promise in reducing global surgical inequities.
• Sustainable adoption requires robust infrastructure, equitable access, and ethical regulations.
• Future advancements should incorporate autonomy, digital twins, and global legal frameworks for broader impact.