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First Randomized Trial Finds Telesurgery Matches Local Robotic Surgery Over Long Distances

Experts urge larger, longer studies before any broad rollout, citing small sample size, short follow-up, plus reliance on highly experienced surgeons.

Overview

  • Published in The BMJ, the multicenter Chinese trial randomized 72 patients across five hospitals for radical prostatectomy or partial nephrectomy between December 2023 and June 2024.
  • Telesurgery met the study’s non-inferiority benchmark for probability of surgical success, with outcomes reported as 100% for telesurgery versus 94.44% for local surgery and a posterior probability of 0.99.
  • Network performance remained stable across 1,000–2,800 km (about 621–1,740 miles) with round-trip delays of 20.1–47.5 milliseconds and low frame loss.
  • Secondary measures, including complications, early recovery, oncologic surrogate outcomes, and medical team workload, were similar in both groups; one preoperative malfunction in the local group delayed surgery.
  • Nine patients withdrew (12.5%), surgeons each had more than 500 prior robotic cases, and follow-up was limited to 4 and 6 weeks, prompting calls for broader trials, governance, cost-effectiveness assessments, training standards, patient experience evaluation, and attention to public trust and potential uses in underserved, disaster, military, and space settings.