Reliability of urological telesurgery compared with local surgery: multicentre randomised controlled trial

Area of Science:

• Urology
• Robotic Surgery
• Telemedicine

Background:

• Robotic surgery offers precision but is limited by surgeon proximity.
• Telesurgery aims to extend the reach of robotic surgery.
• Investigating the feasibility and reliability of telesurgery is crucial for its adoption.

Purpose of the Study:

• To evaluate if telesurgery is non-inferior to standard local robotic surgery for urological operations.
• To compare surgical success rates and patient outcomes between telesurgery and local surgery.

Main Methods:

• A multicenter, non-inferiority, randomized controlled trial was conducted across five Chinese hospitals.
• 72 patients undergoing radical prostatectomy or partial nephrectomy were randomized to telesurgery or local surgery.
• Surgical success probability was the primary outcome, with a non-inferiority margin of 0.1 reduction.

Main Results:

• Telesurgery was found to be non-inferior to local surgery in terms of surgical success probability (difference 0.02; 95% CI -0.03 to 0.15).
• The telesurgery system demonstrated stability over distances of 1000-2800 km with acceptable network latency and frame loss.
• No significant differences were observed in clinical secondary outcomes, including complications, recovery, and oncological results, between the two groups.

Conclusions:

• Telesurgery is a reliable alternative to local robotic surgery for urological procedures.
• The study supports the non-inferiority of telesurgery within a defined margin for surgical success.
• Telesurgery can be effectively implemented over long distances without compromising patient outcomes.