5G Remote Robot-Assisted Hepatobiliary and Pancreatic Surgery: A Report of Five Cases and a Literature Review

Background: This study aimed to explore the feasibility and safety of using 5G communication technology for domestic surgical robots to perform ultra-remote hepatobiliary and pancreatic surgery.

Methods: A retrospective analysis was conducted on the clinical data of five cases of ultra-remote domestic robot-assisted laparoscopic hepatobiliary and pancreatic surgery completed at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (referred to as Hangzhou, Zhejiang) and Sir Run Run Shaw Hospital, Alaer Hospital, Zhejiang University School of Medicine (referred to as Alaer city, Xinjiang) from February to September 2023. The main system of the operating desk at Hangzhou, Zhejiang, uses 5G network signal transmission to remotely control the bedside operating system at Alaer City, Xinjiang. The physical distance between the two locations is 4670.2 km, and the network communication distance is 5031.2 km. The operators and assistants are immobilised.

Results: The operations were successful. The number of network image frames was 50, the median delay was 73 (70.25-126.1) ms, and the median operation time was 39 (31-128) min. The median intraoperative blood loss was 2 (2-30) mL. No occurrence of network disruption or data packet loss was observed. One case of instrument adverse event occurred, and the patient returned to normal after replacement. The median times taken to get out of bed, ventilation, and hospitalisation were 19 (15-46) h, 2 (2-4) d, and 3 (3-13) d, respectively. According to the Clavien-Dindo classification, the postoperative complications in one patient were Grade I; no other surgical complications were observed. No abnormalities were observed in the patients after a 30-day re-examination. All patients successfully recovered after a 2-month follow-up.

Conclusions: It is safe and feasible for domestic robots to perform 5G remote robot-assisted hepatobiliary and pancreatic surgery.