A randomized controlled trial published in The BMJ has shown that telesurgery is noninferior to conventional local robotic urologic surgery. The findings suggest that remote robotic procedures can achieve comparable surgical success without added risk.
In an accompanying editorial, Prokar Dasgupta, MD, MSc, and Findlay MacAskill, MBBS, PhD, of King’s College London, highlighted that telesurgery achieved noninferior outcomes with minimal latency (20.1–47.5 milliseconds) across distances of 1,000 to 2,800 km. Notably, researchers reported no cybersecurity issues. Interestingly, the only robotic failure occurred in the local surgery arm.
Study Design and Patient Population
Xu Zhang, MD, of the Chinese PLA General Hospital, and colleagues conducted the noninferiority trial (ChiCTR2300077721) across five hospitals in China between December 2023 and June 2024. The team enrolled 72 patients scheduled for radical prostatectomy or partial nephrectomy and randomly assigned them to telesurgery or local robotic surgery.
As reported by Renal and Urology News, the intention-to-treat population included 36 patients in each group. Median ages were 61 years in the telesurgery arm and 65 years in the local surgery arm. In the per-protocol analysis, 32 patients underwent telesurgery and 31 underwent local surgery. Surgeons used the MP1000 robotic system, which supports telesurgical capability.
Primary Outcome: Surgical Success
Researchers evaluated surgical success using predefined criteria. In the intention-to-treat analysis, success rates reached 100% in the telesurgery group and 94.4% in the local surgery group. The Bayesian posterior probability for noninferiority was 0.99. Similarly, per-protocol analysis showed success rates of 100% versus 96.8%, confirming noninferiority.
Moreover, investigators found no clinically meaningful differences in operative time, complications, or early recovery. Positive surgical margin rates were 3% with telesurgery and 16% with local surgery, although the difference was not statistically definitive.
Implications for the Future of Surgery
Dr. Zhang’s team concluded that telesurgery met the predefined noninferiority margin and demonstrated comparable outcomes. The editorialists added that advances in robotics, improved global connectivity, and artificial intelligence could further enhance efficiency and personalization in surgical care.
The study received robotic systems from Edge Medical. Some authors disclosed industry affiliations and grant support.