Li Jianmin, Yang Xuecheng, Chu Guangdi, Feng Wei, Ding Xuemei, Yin Xulong, Zhang Liangjun, Lv Wei, Ma Lufei, Sun Liguo, Feng Run, Qin Jun, Zhang Xuefeng, Gou Chengyi, Yu Zongyi, Wei Bin, Jiao Wei, Wang Yonghua, Luo Lei, Yuan Hang, Chang Yuan, Cai Qiliang, Wang Shuxin, Giulianotti Pier Cristoforo, Dong Qian, Niu Haitao
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.
Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China.
Eur Urol. 2023 Jan;83(1):41-44. doi: 10.1016/j.eururo.2022.06.018. Epub 2022 Jul 9.
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.
远程手术的需求正在迅速增长，但关于其在泌尿外科应用可行性的有力证据仍然很少。2021年3月至10月，青岛一家三级医院的外科医生控制的手术机器人被用于对位于8家基层医院的29例患者进行远程机器人辅助腹腔镜根治性肾切除术（RN）。往返延迟中位数为26毫秒（四分位间距[IQR]5），基层医院与外科医生之间的距离中位数为187公里（IQR 57）。主单元和从单元均由网络和机械工程师提供保障，患者一侧的手术助手也做好了充分准备以预防并发症。主要评估指标是成功率，定义为成功接受远程RN且未转为其他手术方式且无重大术中或术后并发症的患者百分比。结果表明，5G技术与手术机器人的结合是一种基于远程医疗的新型肾肿瘤潜在治疗选择。患者总结：我们的研究表明，使用5G技术的远程手术对于肾肿瘤患者是一种安全可行的治疗选择。远程地点与进行手术的手术室之间的总延迟仅为200毫秒。这种方法可以降低医疗成本并提高患者获得的医疗服务质量。
