Feasibility of long-range telesurgical robotic radical gastrectomy in a live porcine model
Daryl Kai Ann Chia, Koichi Suda, Wei-En Ho, Bu Sung Lee, Kazumitsu Suzuki, Susumu Shibasaki, Tatsuhiko Harada, Jun Murai, Masafumi Oe, Hirochika Asai, Takashi Tomine, Hirotaka Sato, Masahiro Yoro, Masanao Ohashi, Hiroaki Kitatsuji, Simon Peter Green, Ying Xiong, Asim Shabbir, Davide Lomanto, Jimmy B. Y. So, Guo Wei Kim, Ichiro UyamaBackground:
Telesurgery has been made increasingly possible with the advancements in robotic surgical platforms and network connectivity. However, long-distance trans-national complex robotic surgeries such as the gastrectomy have yet to be attempted.
Methods:
Multiple trans-national network connections by Science Innovation Network (SINET), Japan Gigabit Network (JGN) and Arterial Research and Education Network in Asia-Pacific (ARENA-PAC) were established and tested by multiple surgeons in a dry box model. Surgeons’ perceptions of the different networks were recorded. Three robotic radical D2 gastrectomies in live porcine models were performed at a hospital in Toyoake, Japan by a surgical team in a hospital in Singapore approximately 5000km away using the hinotoriTM Surgical Robot System (Medicaroid Corporation, Kobe, Japan).
Results:
The live porcine robotic gastrectomies were all completed under 205 minutes with no intraoperative complications. From the different networks that were tested, the differences in latency ranged from 107-132ms and did not translate to any significant differences in surgeon timings and perceptions.
Conclusions:
Trans-national telesurgical radical D2 gastrectomy is feasible in a porcine model. There is no appreciable difference between surgeon performance and perception with network latencies of 107-132ms. Long-range telesurgery as clinical practice may become possible in the future.