{"title":"Feasibility and Initial Outcomes of Telesurgery in Urology: a Systematic Review of the Literature.","authors":"Sávio Valadares Ferreira, Murilo Henrique Sugai, Guilherme Corrêa Nascimento, Antonino Caetano Souza, Gustavo Colombo Cabrini, Fernando Martins Rodrigues, Cleverson Luiz Rocha D'Avila, Geovanne Furtado Souza, Ricardo Vieira Zerati, Miguel Zerati","doi":"10.1590/S1677-5538.IBJU.2024.0494","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Telesurgery allows the procedures to be carried out over long distances, however due to lack of data, its feasibility has not been consolidated yet. Since it is a promising modality, it is important to illustrate the current scenario on this subject.</p><p><strong>Objective: </strong>To review the literature aiming at the surgical success rate as a primary objective, and secondly, the most important patient outcomes and the network system.</p><p><strong>Materials and methods: </strong>In June 2024, we followed PRISMA guidelines to research trials on urological robotic surgery in humans. We used as exclusion criteria: editorials, specialist's opinions, tele-mentoring, tele-training, small procedures, non-remote surgeries, absence of interest outcomes, telesurgeries in non-humans or in cadaver.</p><p><strong>Results: </strong>Five hundred and ninety eight studies were identified with peer review and a third reviewer for divergencies, both directed by previously established inclusion and exclusion criteria, selecting 6 studies after the exclusions. We found 54 patients who underwent urological telesurgeries; all of them were accomplished with no complications or need for conversion to open surgery. Almost all the procedures were carried out in China (98.14%) and the most used robotic model was MicroHand S (83.33%). Nephrectomy was the procedure of choice (57%). Mean surgical time was 66.2 (IQR) 56.6 minutes. Intraoperative bleeding time was 68.6 ± 76.7 milliliters. Hospital stay was 5.5 (IQR) 5 days. The distance between main surgeon and the patient was between 2,581.5 (IQR) 2,871 kilometers. 5G network was used the most (98.14%). The total network latency time was 176 (IQR) 10.9 milliseconds.</p><p><strong>Conclusion: </strong>Despite its limitations, there was evidence demonstrating that robotic surgery in the genitourinary system is safe and feasible, however it is a subject that must be well discussed, and further studies must be carried out.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 3","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052020/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Braz J Urol","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/S1677-5538.IBJU.2024.0494","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Telesurgery allows the procedures to be carried out over long distances, however due to lack of data, its feasibility has not been consolidated yet. Since it is a promising modality, it is important to illustrate the current scenario on this subject.
Objective: To review the literature aiming at the surgical success rate as a primary objective, and secondly, the most important patient outcomes and the network system.
Materials and methods: In June 2024, we followed PRISMA guidelines to research trials on urological robotic surgery in humans. We used as exclusion criteria: editorials, specialist's opinions, tele-mentoring, tele-training, small procedures, non-remote surgeries, absence of interest outcomes, telesurgeries in non-humans or in cadaver.
Results: Five hundred and ninety eight studies were identified with peer review and a third reviewer for divergencies, both directed by previously established inclusion and exclusion criteria, selecting 6 studies after the exclusions. We found 54 patients who underwent urological telesurgeries; all of them were accomplished with no complications or need for conversion to open surgery. Almost all the procedures were carried out in China (98.14%) and the most used robotic model was MicroHand S (83.33%). Nephrectomy was the procedure of choice (57%). Mean surgical time was 66.2 (IQR) 56.6 minutes. Intraoperative bleeding time was 68.6 ± 76.7 milliliters. Hospital stay was 5.5 (IQR) 5 days. The distance between main surgeon and the patient was between 2,581.5 (IQR) 2,871 kilometers. 5G network was used the most (98.14%). The total network latency time was 176 (IQR) 10.9 milliseconds.
Conclusion: Despite its limitations, there was evidence demonstrating that robotic surgery in the genitourinary system is safe and feasible, however it is a subject that must be well discussed, and further studies must be carried out.