Telerobotic partial nephrectomy and radical prostatectomy using a hybrid network: A single-center prospective...

Advances in robotics and telecommunications have catalyzed resurgence of telerobotic surgery (TRS). This study aims to evaluate safety, feasibility, and clinical outcomes of TRS in partial nephrectomy (PN) and radical prostatectomy (RP), using a hybrid network.

A prospective, single-center study was conducted with 13 patients (7 PN, 6 RP) using Toumai® robotic system over 5G and fiber-optic networks. Surgeries were performed remotely, with surgeon operating 25 km away. Primary outcomes included successful completion of surgeries without conversion or reoperation within 24 h. Secondary outcomes included intraoperative outcomes (operative time, warm ischemia time, blood loss), network performance (latency, packet loss), and short-term functional recovery at three month follow-up.

All procedures were successfully completed with minimal delay and no major network disruptions. Median latency was 12 ms for fiber-optic and 46 ms for 5G network. For PN, median operative time was 69 min, with 9 min of warm ischemia time and 50 ml of blood loss. For RP, median operative time was 130.5 min with 25 ml blood loss. Postoperative renal function remained stable in PN cases and early continence was achieved in majority of patients at three months. No conversions or major perioperative complications were observed.

This study provides early clinical evidence suggesting the feasibility and short-term safety of telerobotic urological surgery performed over a hybrid network. Successful completion of all procedures without major complications and stable intraoperative communication support further clinical evaluation.