Current perspectives of telesurgery applications among different specialties: first multicentric and multispecialty retrospective study.

Abstract

Telesurgery has recently emerged as a transformative technology with the potential to revolutionize surgical care with humanitarian and training opportunities. The advent of new robotic systems with telesurgical capabilities promoted the interest toward telesurgery; the Toumai (Microport, China) is among these new platforms and the only approved in Europe so far. The Toumai is a multiport robotic system with an immersive console and a single patient cart. The aim of the study is to report the largest series of telesurgical robotic procedures reported so far to prove the feasibility and safety of the technology. This is a multicenter cohort study on a series of patients who underwent robotic telesurgical procedures across China with the Toumai robotic system. The primary endpoint is to evaluate the safety of telesurgery measured as the need for conversion to local surgery or to different approaches. Furthermore, we reported the type of procedures performed and summarized the characteristics of connectivities. Overall, 66 overall surgeries-consisting of ten urological, 55 general, and one gynecological case-were performed with the Toumai across China, with an average distance of was 800, 220, and 300 km, respectively. No conversions to local surgery were recorded. The average delay time was 65, 34, and 61 ms for urological, general, and gynecological surgery, respectively. Apart from colecistectomies, gastric surgery (total gastrectomy, gastrowedge resection) and radical prostatectomies were the mostly performed interventions. Despite some issues needs to be addressed from a regulatory standpoint, technological and telecommunication advancements are willing to support the successful implementation of telesurgery; further series are expected to address the reproducibility of these outcomes in European countries.