Telesurgery across continents: a scoping review

Intercontinental telesurgery is a surgery where surgeons operate on patients across continents using robots and telecommunication connections. Many parts of the world have limited access to safe and reliable surgery. This review is to understand the emerging technology and infrastructure in intercontinental telesurgery to bridge gaps in surgical care. This scoping review synthesized information from peer reviewed and gray literature published between 2001 and 2025. Databases like PubMed, Google Scholar, and Europe PMC were utilized. The review is organized thematically into schematic of intercontinental telesurgery, classification, technological enablers, real-world case studies, framework and guidelines, and legal and ethical issues. 262 records were identified through database searching and manual screening. After removing the duplicates, 250 remained; 39 met the inclusion criteria after screening and text review. The human intercontinental telesurgeries were safely completed with 150-300 ms latency, with no serious complications and outcomes comparable to local robotic surgery. Preclinical models confirmed long-distance viability via hybrid networks with stable latency. Technological catalysts included advanced robotic platforms and enhanced hepatic feedback. Constant obstacles were network instability, legal uncertainty, limited scalability, and surgeon fatigue. Intercontinental telesurgery has the potential to evolve the global surgical inequities, yet its sustainable adaptation needs more than just technological preparedness. Combined efforts in infrastructure development, equitable access, and ethical regulation are necessary. Future systems must ensure that this innovation serves all populations and not just those in high-resource environments by incorporating autonomy, digital twins, and a global legal framework.