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Chu G, Yang X, Jiao W, Zhao J, Guan B, Gao Y, Wang S, Li J, Niu H. Transnational telesurgery performed with the new robot-assisted flexible ureteroscopy system. BJU Int 2024. [PMID: 38733324 DOI: 10.1111/bju.16400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Affiliation(s)
- Guangdi Chu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xuecheng Yang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Jiao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jianchang Zhao
- National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Bo Guan
- Key Laboratory of Mechanism Theory and Equipment Design, Ministry of Education, Tianjin, China
- Institute of Medical Robotics and Intelligent Systems of Tianjin University, Tianjin, China
| | - Yuan Gao
- Key Laboratory of Mechanism Theory and Equipment Design, Ministry of Education, Tianjin, China
- Institute of Medical Robotics and Intelligent Systems of Tianjin University, Tianjin, China
| | - Shuxin Wang
- Key Laboratory of Mechanism Theory and Equipment Design, Ministry of Education, Tianjin, China
- Institute of Medical Robotics and Intelligent Systems of Tianjin University, Tianjin, China
| | - Jianmin Li
- Key Laboratory of Mechanism Theory and Equipment Design, Ministry of Education, Tianjin, China
- Institute of Medical Robotics and Intelligent Systems of Tianjin University, Tianjin, China
| | - Haitao Niu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Patel V, Saikali S, Moschovas MC, Patel E, Satava R, Dasgupta P, Dohler M, Collins JW, Albala D, Marescaux J. Technical and ethical considerations in telesurgery. J Robot Surg 2024; 18:40. [PMID: 38231309 DOI: 10.1007/s11701-023-01797-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024]
Abstract
Telesurgery, a cutting-edge field at the intersection of medicine and technology, holds immense promise for enhancing surgical capabilities, extending medical care, and improving patient outcomes. In this scenario, this article explores the landscape of technical and ethical considerations that highlight the advancement and adoption of telesurgery. Network considerations are crucial for ensuring seamless and low-latency communication between remote surgeons and robotic systems, while technical challenges encompass system reliability, latency reduction, and the integration of emerging technologies like artificial intelligence and 5G networks. Therefore, this article also explores the critical role of network infrastructure, highlighting the necessity for low-latency, high-bandwidth, secure and private connections to ensure patient safety and surgical precision. Moreover, ethical considerations in telesurgery include patient consent, data security, and the potential for remote surgical interventions to distance surgeons from their patients. Legal and regulatory frameworks require refinement to accommodate the unique aspects of telesurgery, including liability, licensure, and reimbursement. Our article presents a comprehensive analysis of the current state of telesurgery technology and its potential while critically examining the challenges that must be navigated for its widespread adoption.
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Affiliation(s)
- Vipul Patel
- AdventHealth Global Robotics Institute, Celebration, FL, USA
- University of Central Florida (UCF), Orlando, FL, USA
| | - Shady Saikali
- AdventHealth Global Robotics Institute, Celebration, FL, USA.
| | - Marcio Covas Moschovas
- AdventHealth Global Robotics Institute, Celebration, FL, USA
- University of Central Florida (UCF), Orlando, FL, USA
| | - Ela Patel
- Stanford University, Stanford, CA, 94305, USA
| | | | - Prokar Dasgupta
- MRC Centre for Transplantation, Department of Urology, King's Health Partners, King's College London, London, UK
| | - Mischa Dohler
- Advanced Technology Group, Ericsson Inc., Santa Clara, CA, 95054, USA
| | - Justin W Collins
- Division of Uro-Oncology, University College London Hospital, London, UK
- Division of Surgery and Interventional Science, Research Department of Targeted Intervention, University College London, London, UK
- CMR Surgical, Cambridge, UK
| | - David Albala
- Downstate Health Sciences University, Syracuse, NY, USA
- Department of Urology, Crouse Hospital, Syracuse, NY, USA
| | - Jacques Marescaux
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
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Li J, Yang X, Chu G, Feng W, Ding X, Yin X, Zhang L, Lv W, Ma L, Sun L, Feng R, Qin J, Zhang X, Gou C, Yu Z, Wei B, Jiao W, Wang Y, Luo L, Yuan H, Chang Y, Cai Q, Wang S, Giulianotti PC, Dong Q, Niu H. Application of Improved Robot-assisted Laparoscopic Telesurgery with 5G Technology in Urology. Eur Urol 2023; 83:41-44. [PMID: 35817641 DOI: 10.1016/j.eururo.2022.06.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 12/14/2022]
Abstract
The demand for telesurgery is rising rapidly, but robust evidence regarding the feasibility of its application in urology is still rare. From March to October 2021, a surgeon-controlled surgical robot in a tertiary hospital in Qingdao was used to remotely conduct robot-assisted laparoscopic radical nephrectomy (RN) in 29 patients located in eight primary hospitals. The median round-trip delay was 26 ms (interquartile range [IQR] 5) and the median distance between the primary hospital and the surgeon was 187 km (IQR 57). Both the master unit and the slave unit were guaranteed by network and mechanical engineers, and surgical assistants were well prepared on the patient side to prevent complications. The primary evaluation metric was the success rate, defined as the percentage of patients who underwent successful remote RN without conversion to other surgical procedures and no major intraoperative or postoperative complications. The results demonstrate that the combination of 5G technology and surgical robots is a novel potential telemedicine-based therapy choice for renal tumors. PATIENT SUMMARY: Our study shows that telesurgery using 5G technology is a safe and feasible treatment option for patients with kidney tumors. The total delay between the remote location and the operating rooms where surgery was being performed was just 200 ms. This approach could reduce health care costs and improve the quality of medical services accessed by patients.
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Affiliation(s)
- Jianmin Li
- Key Laboratory for Mechanism Theory and Equipment Design of the Ministry of Education, Tianjin University, Tianjin, China; Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xuecheng Yang
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guangdi Chu
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Feng
- Department of Anesthesiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xuemei Ding
- Department of Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xulong Yin
- Department of Urology, Pingyi County Hospital of Traditional Chinese Medicine, Linyi, China
| | - Liangjun Zhang
- Department of Surgery, Zhucheng Hospital of Traditional Chinese Medicine, Zhucheng, China
| | - Wei Lv
- Department of Urology, Fei County People's Hospital, Linyi, China
| | - Lufei Ma
- Department of Urology, Juxian People's Hospital, Rizhao, China
| | - Liguo Sun
- Department of Urology, Juxian People's Hospital, Rizhao, China
| | - Run Feng
- Department of Urology, Zibo Municipal Hospital, Zibo, China
| | - Jun Qin
- Department of Urology, Yinan People's Hospital, Linyi, China
| | - Xuefeng Zhang
- Department of Urology, Weihai Central Hospital, Weihai, China
| | - Chengyi Gou
- Department of Urology, Dingxi People's Hospital, Dingxi, China
| | - Zongyi Yu
- Department of Information Management, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bin Wei
- Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Jiao
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yonghua Wang
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lei Luo
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hang Yuan
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Chang
- Shandong Development and Reform Commission, Jinan, China
| | - Qiliang Cai
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China.
| | - Shuxin Wang
- Key Laboratory for Mechanism Theory and Equipment Design of the Ministry of Education, Tianjin University, Tianjin, China.
| | | | - Qian Dong
- Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Haitao Niu
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China; Institute of Medical Robotics and Intelligent Systems, Tianjin University, Tianjin, China.
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Li J, Jiao W, Yuan H, Feng W, Ding X, Yin X, Zhang L, Lv W, Ma L, Sun L, Feng R, Qin J, Zhang X, Gou C, Wang S, Yu Z, Wei B, Luo L, Xie F, Chang Y, Wang Y, Giulianotti PC, Dong Q, Niu H. Telerobot-assisted laparoscopic adrenalectomy: feasibility study. Br J Surg 2022; 110:6-9. [PMID: 35997257 DOI: 10.1093/bjs/znac279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Jianmin Li
- Key Laboratory for Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin, China
| | - Wei Jiao
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hang Yuan
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Feng
- Department of Anaesthesiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xuemei Ding
- Department of Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xulong Yin
- Department of Urology, Pingyi County Hospital of Traditional Chinese Medicine, Linyi, China
| | - Liangjun Zhang
- Department of Surgery, Zhucheng Hospital of Traditional Chinese Medicine, Zhucheng, China
| | - Wei Lv
- Department of Urology, Fei County People's Hospital, Linyi, China
| | - Lufei Ma
- Department of Urology, Juxian People's Hospital, Rizhao, China
| | - Liguo Sun
- Department of Urology, Juxian People's Hospital, Rizhao, China
| | - Run Feng
- Department of Urology, Zibo Municipal Hospital, Zibo, China
| | - Jun Qin
- Department of Urology, Yinan People's Hospital, Linyi, China
| | - Xuefeng Zhang
- Department of Urology, Weihai Central Hospital, Weihai, China
| | - Chengyi Gou
- Department of Urology, Dingxi People's Hospital, Dingxi, China
| | - Shuxin Wang
- Key Laboratory for Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin, China
| | - Zongyi Yu
- Department of Information Management, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bin Wei
- Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lei Luo
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fei Xie
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Chang
- Shandong Development and Reform Commission, Jinan, China
| | - Yonghua Wang
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Pier C Giulianotti
- Department of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Qian Dong
- Department of Paediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haitao Niu
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
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Mulita F, Verras GI, Anagnostopoulos CN, Kotis K. A Smarter Health through the Internet of Surgical Things. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22124577. [PMID: 35746359 PMCID: PMC9231158 DOI: 10.3390/s22124577] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 05/14/2023]
Abstract
(1) Background: In the last few years, technological developments in the surgical field have been rapid and are continuously evolving. One of the most revolutionizing breakthroughs was the introduction of the IoT concept within surgical practice. Our systematic review aims to summarize the most important studies evaluating the IoT concept within surgical practice, focusing on Telesurgery and surgical Telementoring. (2) Methods: We conducted a systematic review of the current literature, focusing on the Internet of Surgical Things in Telesurgery and Telementoring. Forty-eight (48) studies were included in this review. As secondary research questions, we also included brief overviews of the use of IoT in image-guided surgery, and patient Telemonitoring, by systematically analyzing fourteen (14) and nineteen (19) studies, respectively. (3) Results: Data from 219 patients and 757 healthcare professionals were quantitively analyzed. Study designs were primarily observational or based on model development. Palpable advantages from the IoT incorporation mainly include less surgical hours, accessibility to high quality treatment, and safer and more effective surgical education. Despite the described technological advances, and proposed benefits of the systems presented, there are still identifiable gaps in the literature that need to be further explored in a systematic manner. (4) Conclusions: The use of the IoT concept within the surgery domain is a widely incorporated but less investigated concept. Advantages have become palpable over the past decade, yet further research is warranted.
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Affiliation(s)
- Francesk Mulita
- Intelligent Systems Lab, Department of Cultural Technology and Communication, University of the Aegean, 81100 Mytilene, Greece;
- Department of Surgery, General University Hospital of Patras, 26504 Rio, Greece;
- Correspondence: (F.M.); (K.K.); Tel.: +30-6974822712 (K.K.)
| | | | | | - Konstantinos Kotis
- Intelligent Systems Lab, Department of Cultural Technology and Communication, University of the Aegean, 81100 Mytilene, Greece;
- Correspondence: (F.M.); (K.K.); Tel.: +30-6974822712 (K.K.)
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Horiguchi A. Paradigm shift in gastroenterological surgery by meta‐analysis: Navigation surgery and telesurgery. Ann Gastroenterol Surg 2022; 6:188-189. [PMID: 35261943 PMCID: PMC8889850 DOI: 10.1002/ags3.12553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Akihiko Horiguchi
- Department of Gastroenterological Surgery Graduate School of Medicine Fujita Health University School of Medicine, Bantane Hospital 3‐6‐10 Otobashi Nakagawa ward Nagoya454‐8509Japan
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