Ultra-remote robot-assisted right upper lobectomy between the Shanghai and Kashi Prefectures: a case report.

Background: Robot-assisted thoracic surgery has been shown to have several advantages over conventional surgery. As mobile communication technology and surgical robotic devices in China continue to progress rapidly, the conditions for performing remote surgery have been optimized. Consequently, informatized and remote advanced medical cooperation is becoming a new direction for supporting the medical development of border regions and promoting the equitable distribution of medical resources in China.

Case description: In this case, a 53-year-old female patient in Kashi was admitted with a mixed ground-glass lesion in the right upper lobe. The size and density of the lesion were found to be increasing progressively. After a comprehensive multidisciplinary team consultation, the patient was clinically diagnosed with early stage lung cancer. The patient gave informed consent to undergo remote robot-assisted right upper lobectomy and lymph node dissection, which was performed on July 13, 2024 between Shanghai and Kashi using a dedicated network and 5G mobile communication. The procedure was successfully conducted with an average delay of 100 ms and no connection interruptions. Pathology and immunohistochemistry confirmed invasive mucinous adenocarcinoma (T1aN0M0). Postoperative imaging showed good lung re-expansion; the patient had an ideal recovery and was discharged smoothly.

Conclusions: We reported the first case in which a remote robot-assisted lobectomy was performed using a robotic surgical system, 5G technology, and corresponding procedures. More cohorts or clinical studies need to be conducted to further clarify the guidelines and promote the application of remote thoracic surgery.