Japan Surgical Society, Tokyo, Japan.
School of Medicine, Tokai University, 143 Shimokasuya, Isehara City, Kanagawa, Japan.
Surg Today. 2024 Aug;54(8):817-828. doi: 10.1007/s00595-024-02863-5. Epub 2024 Jun 3.
Telesurgery is expected to improve medical access in areas with limited resources, facilitate the rapid dissemination of new surgical procedures, and advance surgical education. While previously hindered by communication delays and costs, recent advancements in information technology and the emergence of new surgical robots have created an environment conducive to societal implementation. In Japan, the legal framework established in 2019 allows for remote surgical support under the supervision of an actual surgeon. The Japan Surgical Society led a collaborative effort, involving various stakeholders, to conduct social verification experiments using telesurgery, resulting in the development of a Japanese version of the "Telesurgery Guidelines" in June 2022. These guidelines outline requirements for medical teams, communication environments, robotic systems, and security measures for communication lines, as well as responsibility allocation, cost burden, and the handling of adverse events during telesurgery. In addition, they address telementoring and full telesurgery. The guidelines are expected to be revised as needed, based on the utilization of telesurgery, advancements in surgical robots, and improvements in information technology.
远程手术有望改善资源有限地区的医疗服务,促进新手术程序的快速传播,并推动外科手术教育的发展。尽管过去受到通信延迟和成本的限制,但信息技术的最新进展和新型手术机器人的出现创造了有利于社会实施的环境。在日本,2019 年建立的法律框架允许在实际外科医生的监督下进行远程手术支持。日本外科学会牵头开展了一项合作努力,涉及各种利益相关者,使用远程手术进行了社会验证实验,最终于 2022 年 6 月制定了日本版的《远程手术指南》。这些指南概述了医疗团队、通信环境、机器人系统以及通信线路安全措施的要求,还明确了责任分配、费用负担以及远程手术期间不良事件的处理。此外,指南还涉及远程指导和全远程手术。预计将根据远程手术的使用情况、手术机器人的进展以及信息技术的改进对指南进行修订。