Misra Sidharth, Motiwala Zainab Yusufali, Nadeem Fatima, Anchule Shruti, Lathkar Apoorva Sanjay, Barapatre Avanti, Bhingardive Sneha, Kar Subhankita, Lathkar Saloni Sanjay, Darlington Danny
University of Texas Southwestern Medical Center, Dallas, USA.
Jawaharlal Nehru Medical College, Aligarh, India.
J Robot Surg. 2025 Aug 30;19(1):536. doi: 10.1007/s11701-025-02694-7.
Intercontinental telesurgery is a surgery where surgeons operate on patients across continents using robots and telecommunication connections. Many parts of the world have limited access to safe and reliable surgery. This review is to understand the emerging technology and infrastructure in intercontinental telesurgery to bridge gaps in surgical care. This scoping review synthesized information from peer reviewed and gray literature published between 2001 and 2025. Databases like PubMed, Google Scholar, and Europe PMC were utilized. The review is organized thematically into schematic of intercontinental telesurgery, classification, technological enablers, real-world case studies, framework and guidelines, and legal and ethical issues. 262 records were identified through database searching and manual screening. After removing the duplicates, 250 remained; 39 met the inclusion criteria after screening and text review. The human intercontinental telesurgeries were safely completed with 150-300 ms latency, with no serious complications and outcomes comparable to local robotic surgery. Preclinical models confirmed long-distance viability via hybrid networks with stable latency. Technological catalysts included advanced robotic platforms and enhanced hepatic feedback. Constant obstacles were network instability, legal uncertainty, limited scalability, and surgeon fatigue. Intercontinental telesurgery has the potential to evolve the global surgical inequities, yet its sustainable adaptation needs more than just technological preparedness. Combined efforts in infrastructure development, equitable access, and ethical regulation are necessary. Future systems must ensure that this innovation serves all populations and not just those in high-resource environments by incorporating autonomy, digital twins, and a global legal framework.
洲际远程手术是指外科医生通过机器人和电信连接对相隔各大洲的患者进行手术。世界上许多地区获得安全可靠手术的机会有限。本综述旨在了解洲际远程手术中新兴的技术和基础设施，以弥合手术治疗方面的差距。本范围综述综合了2001年至2025年期间发表的同行评审文献和灰色文献中的信息。使用了如PubMed、谷歌学术和欧洲PMC等数据库。该综述按主题分为洲际远程手术示意图、分类、技术促成因素、实际案例研究、框架和指南以及法律和伦理问题。通过数据库搜索和人工筛选确定了262条记录。去除重复记录后，还剩250条；经过筛选和文本审查，39条符合纳入标准。人体洲际远程手术在150 - 300毫秒的延迟下安全完成，无严重并发症，结果与局部机器人手术相当。临床前模型通过具有稳定延迟的混合网络证实了远距离可行性。技术催化剂包括先进的机器人平台和增强的肝脏反馈。持续存在的障碍有网络不稳定、法律不确定性、可扩展性有限和外科医生疲劳。洲际远程手术有潜力改变全球手术不平等的状况，但其可持续应用需要的不仅仅是技术准备。在基础设施发展、公平获取和伦理监管方面需要共同努力。未来的系统必须通过纳入自主性、数字孪生和全球法律框架，确保这项创新服务于所有人群，而不仅仅是高资源环境中的人群。
