AdventHealth Global Robotics Institute, Florida, USA.
University of Central Florida -UCF, Florida, USA.
Int Braz J Urol. 2024 Nov-Dec;50(6):754-763. doi: 10.1590/S1677-5538.IBJU.2024.0458.
We reported, as a referral center in prostate cancer, our perspectives and experience performing Telesurgery using robotic surgery and 5G network.
We described and illustrated the Telesurgery applications and outcomes to treat a patient with prostate cancer located 1300 kilometers away from the surgeon (Beijing-Harbin) in China. We used the Edge Medical Robot (MP1000) in November 2023 in a 71-year-old patient with Gleason 6 (ISUP 1) in 8 cores from 13, PSA of 14 ng/dL, and clinical stage cT2a. MRI described a PIRADS 5 nodule on the left peripheral zone at the base, and 20gr prostate. We described details about the connection between centers, perioperative outcomes, and our perspectives as a referral center in prostate cancer.
We had no delays, or problems with network connection between the centers. The procedure was performed in 60 minutes, with no intra- or postoperative complications. Estimated blood loss was 100 mL. The patient was ambulating soon after anesthesia recovery. Final pathology described a Gleason 6 (ISUP 1) involving the left base and left seminal vesicle, negative surgical margins, and no lymph node involvement (pT3bN0). The patient was continent soon after catheter removal (7 days).
As technological progress introduced novel robotic platforms and high-speed networks, the concept of Telesurgery became a tangible reality while 5G technology solved latency and transmission concerns. However, with these advancements, ethical considerations and regulatory frameworks should underline the importance of transparency and patient safety with responsible innovation in the field.
作为前列腺癌的转诊中心,我们报告了使用机器人手术和 5G 网络进行远程手术的观点和经验。
我们描述并说明了远程手术应用和结果,以治疗一位距离外科医生(北京-哈尔滨)1300 公里的前列腺癌患者。我们于 2023 年 11 月使用 Edge Medical 机器人(MP1000)为一位 71 岁的患者进行手术,该患者前列腺体积为 20g,Gleason 评分 6(ISUP 1),在 13 个核心中有 8 个阳性,PSA 为 14ng/dL,临床分期为 cT2a。MRI 显示左侧外周带基底处有一个 PIRADS 5 结节,前列腺大小为 20g。我们详细描述了中心之间的连接、围手术期结果以及作为前列腺癌转诊中心的观点。
我们在中心之间没有网络连接延迟或问题。该手术耗时 60 分钟,无术中或术后并发症。估计失血量为 100ml。患者在麻醉恢复后即可行走。最终病理报告显示左侧基底和左侧精囊有 Gleason 评分 6(ISUP 1),切缘阴性,无淋巴结受累(pT3bN0)。患者在导管拔除后很快(7 天)恢复了控尿功能。
随着技术进步引入了新型机器人平台和高速网络,远程手术的概念成为了现实,而 5G 技术解决了延迟和传输问题。然而,随着这些进步,道德考虑和监管框架应强调在该领域进行负责任创新时透明性和患者安全的重要性。