Research by Chinese scientists has revealed what could be a lifesaver for under-resourced rural facilities or for people in disaster or war zones, with findings showing that surgeons can safely perform two common operations from distances of up to 2 800km away, they said.
The remarkable achievement is akin to a medic in southern Europe operating on a patient in the United Kingdom, reports The Independent.
The research into telesurgery, a cutting-edge technique allowing medical professionals to operate on patients remotely using a surgical robot connected via a secure video-link, was initiated by a Chinese academic team who said that robust evidence on this method has previously been scarce.
Their primary aim was to ascertain whether the method could achieve results comparable to, or “non-inferior” to, those from robotic-assisted surgery performed locally.
The specific procedures investigated were prostatectomy, the surgical removal of the prostate gland, and partial nephrectomy, which involves the removal of a kidney tumour.
A total of 72 patients were randomly assigned to be given telesurgery or local surgery, with the main measure of success the outcome of the surgery.
The researchers found telesurgery “was not inferior to local surgery in terms of the probability of surgical success”.
The system was stable with a distance from 1 000km-2 800km, they found.
Writing in The BMJ, the authors said: “Telesurgery has evolved over more than three decades, progressing from conceptual inception to advanced clinical exploration, however, despite the accumulation of many single arm and uncontrolled studies, robust evidence confirming its reliability remains scarce.
“As the first randomised controlled trial in the field of telesurgery, this study establishes that its reliability is non-inferior to that of conventional local surgery.”
They highlight the importance of the finding in rural hospitals lacking specialist surgeons, and for care for people in disaster or war zones.
But they also called for much larger studies to confirm their findings.
Commenting on the study, Naeem Soomro, Professor of Urology and member of council of the Royal College of Surgeons of England, said: “Telesurgery is an exciting advancement which offers surgeons greater flexibility, access to specialist expertise, and the ability to operate remotely using advanced robotic systems in real time, even from the other side of the world.
“This study provides a useful perspective on whether telesurgery could be as reliable as standard robotic surgery.
“However, while early findings suggest that telesurgery may be feasible for selected urological procedures, caution is needed before any wider adoption.
“The researchers acknowledge that clinical use remains limited and that a full assessment must go beyond technical feasibility to consider long-term clinical outcomes, cost-effectiveness, workforce training, and patient experience – areas not addressed in this study.
“The risks to patients therefore are not yet fully understood, and current findings do not yet show that it matches the safety and effectiveness of standard robotic surgery in routine clinical practice.
“Its role in the broader expansion of robotic surgery therefore remains uncertain.”
The scientists said that with strong governance and further comparative research, telesurgery could eventually become a scalable alternative rather than simply an additional tool.
Study details
Reliability of urological telesurgery compared with local surgery: multicentre randomised controlled trial
Ye Wang, Dan Xia, Wanhai Xu et al.
Published in The BMJ on 26 November 2025
Abstract
Objective
To investigate whether the reliability of telesurgery is non-inferior to that of standard local surgery in patients undergoing urological robotic operations.
Design
Multicentre, non-inferiority, randomised controlled trial.
Setting
Five hospitals in China from December 2023 to June 2024.
Participants
Patients scheduled to undergo radical prostatectomy or partial nephrectomy.
Interventions
Patients were randomly assigned 1:1 to undergo telesurgery or local surgery.
Main outcome measures
The primary outcome was the probability of success of surgery, determined by the medical team on the basis of pre-established criteria. The pre-specified non-inferiority margin was an absolute reduction in probability of 0.1. Thirteen clinical secondary outcomes were associated with the operation and early recovery, and one secondary outcome related to the workload of the medical team. Four technical secondary outcomes for the surgical system were also explored, including network latency, display latency, frame loss during telesurgery, and system malfunction. The participants were followed up at four and six weeks postoperatively for the secondary outcomes of recovery and complications.
Results
A total of 72 participants were enrolled in the study and randomised 1:1 to the telesurgery group and the local surgery group for the intention-to-treat set. The median age of patients was 61.0 (interquartile range 57.5-68.0) years in the telesurgery group and 65.0 (56.5-70.0) years in the local surgery group. Telesurgery was not inferior to local surgery in terms of the probability of surgical success in the intention-to-treat population, accounting for clustering by surgeon (success probability difference 0.02 (95% credible interval −0.03 to 0.15) with bayesian posterior probability of 0.99 for non-inferiority). The telesurgery system was stable with a distance from 1000 km to 2800 km, a mean round trip network latency of 20.1-47.5 ms, and frame loss of 0-1.5 per telesurgery. Secondary outcomes, including operative basic data, complications, early recovery, oncological outcome, and medical team workload, did not differ substantially between the two groups.
Conclusions
The reliability of telesurgery was non-inferior to that of local robotic surgery according to the non-inferiority margin of a 0.1 reduction in success probability.
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