New research suggests that a surgeon no longer needs to be in the same room as the patient, and that operating on a patient remotely using a surgical robot through a secure video-link is also viable. London (PA Media/dpa) – Surgeons can safely perform two common operations from up to 2,800 kilometres away, the equivalent of a medic in southern Europe operating on a patient in the UK, according to a study. Researchers said the evidence on telesurgery – operating on a patient remotely using a surgical robot through a secure video-link – remains “scarce” as they set out to examine the success of common procedures on the prostate and kidney. Academics from China wanted to examine whether telesurgery is comparable, or “non-inferior”, to surgery performed locally using robotic-assisted techniques. They set out to assess patients who had a prostatectomy – the surgical removal of a prostate gland – or a partial nephrectomy, which is the removal of a kidney tumour. Some 72 patients were randomly assigned to be given telesurgery or local surgery, with the main measure of success the outcome of the surgery. The researchers found telesurgery “was not inferior to local surgery in terms of the probability of surgical success”. The telesurgery system was stable with a distance from 1,000km-2,800km they found. Writing in The BMJ, the authors said: “Telesurgery has evolved over more than three decades, progressing from conceptual inception to advanced clinical exploration, however, despite the accumulation of many single arm and uncontrolled studies, robust evidence confirming its reliability remains scarce. “As the first randomised controlled trial in the field of telesurgery, this study establishes that its reliability is non-inferior to that of conventional local surgery.” They highlight the importance of the finding in rural hospitals which lack specialist surgeons, and for care for people in disaster or war zones. But they also called for much larger studies to confirm their findings. Commenting on the study, Naeem Soomro, professor of urology and member of council of the Royal College of Surgeons of England, said: “Telesurgery is an exciting advancement which offers surgeons greater flexibility, access to specialist expertise, and the ability to operate remotely using advanced robotic systems in real time, even from the other side of the world. “This study provides a useful perspective on whether telesurgery could be as reliable as standard robotic surgery. “However, while early findings suggest that telesurgery may be feasible for selected urological procedures, caution is needed before any wider adoption. “The researchers acknowledge that clinical use remains limited and that a full assessment must go beyond technical feasibility to consider long-term clinical outcomes, cost-effectiveness, workforce training, and patient experience – areas not addressed in this study. “The risks to patients therefore are not yet fully understood, and current findings do not yet show that it matches the safety and effectiveness of standard robotic surgery in routine clinical practice. “Its role in the broader expansion of robotic surgery therefore remains uncertain. “With strong governance and further comparative research, telesurgery could in time become a scalable alternative rather than simply an additional tool.” The following information is not intended for publication pa dpa coh
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