Implementation of Robotic Telesurgery in Brazil: The First Experimental Remote Surgery Performed Between Two Brazilian Cities.

Background: Telesurgery represents a revolutionary milestone in medicine, allowing surgeons to perform complex procedures at a distance through advanced robotic systems. Although the first telesurgery in Brazil was performed in 2000 with a single-arm robotic platform between São Paulo and Baltimore (USA), no telesurgery had ever been conducted between two distinct Brazilian cities with a state-of-the-art robotic system. The aim is to report the first telesurgery performed between two Brazilian cities, connecting Scolla-Surgical Training Center in Campo Largo and CEONC Hospital in Cascavel, both in the state of Paraná, approximately 600 km apart, using high-performance fiber optic technology with 5G redundancy to perform robotic cholecystectomy in a swine model. Methods: A prospective experimental study was conducted using a 40 kg swine (Sus scrofa) as an animal model. Connectivity was established through high-speed fiber optic cable, allowing minimal latency and real-time data transmission. A robotic cholecystectomy was performed remotely, with continuous monitoring of delay parameters and connection quality. Results: Telesurgery was performed without complications, demonstrating the technical feasibility and safety of the procedure between two Brazilian cities. Transmission delays remained within acceptable limits for robotic surgery, and no technical or surgical complications were observed during the procedure. Image quality and responsiveness of robotic commands remained stable throughout the surgery. Conclusion: This study establishes a historic milestone in Brazilian medicine, demonstrating that telesurgery between Brazilian cities is technically feasible and safe. The results open promising perspectives for expanding access to specialized surgical care in remote regions of Brazil, potentially revolutionizing the distribution of medical expertise in the country and Latin America.