Surgeons in Tibet have remotely performed robotic surgery on patients more than 2,000 miles away via satellite link.
The team developed a remote surgical operation control system that remains stable and accurate, despite long connection delays.
They aimed to demonstrate that robotic telesurgery could be safely performed over great distances using a satellite connection.
A satellite in geostationary orbit linked a surgical team console in Lhasa, Tibet, to the patient-side robotic system in Beijing, China.
Major liver resections were performed utilising a robotic system provided by MicroPort Medbot on two patients – a 68-year-old liver cancer patient and a 56-year-old with benign hepatic haemangioma.
The setup featured a real-time system that compensates for transmission delays by combining delayed-error synchronisation with predictive algorithms that anticipate the surgeon’s movements, allowing the robotic arms to respond with precision.
It was also designed with dual-link redundancy. In the event of connection disruptions, the robotic arms automatically freeze in place, and the system switches from satellite to backup 5G in less than a third of a second.
The setup delivered high-definition video at 7.2 megabits per second, reportedly using 60% less bandwidth than existing systems, while maintaining a stable video feed even with fluctuating satellite links.
The study has demonstrated that remote telesurgery is feasible via satellite connection, with distances potentially covering up to 150,000 kilometres, or approximately 93,000 miles.
It also showed, through a simulation test, that the safety mechanisms in place were effective during a satellite signal drop.
The operation could even proceed when network delays exceeded three times the safety threshold of 200 milliseconds for remote, precise surgical procedures, such as liver resections.
The system preserved video quality while using significantly less bandwidth than existing telesurgery systems. This, according to the researchers, indicates potential for conducting telesurgery in remote or high-latency settings.
Both patients recovered quickly and without significant complications. They only experienced minimal blood loss during surgery, which lasted between 1.75 and 2 hours. The patients were discharged on the day of their procedures, and postoperative issues were minor.
According to the surgeons, the clinical outcomes were comparable to those of the standard robotic liver procedure.
Their study was published in Intelligent Surgery, a journal jointly published by a joint venture between the Chinese government-owned KeAi Publishing and Elsevier.
It is reportedly the first of its kind in the world to confirm the feasibility and safety of remote telesurgeries via satellite connection. It improves upon 5G-connected telesurgery systems, which currently only cover distances of up to 5,000 km (over 3,000 miles) and are enabled by Earth-based network coverage.
Although satellite communication causes long transmission delays, the research team introduced a system that combines:
• Smart latency compensation
• Redundant safety measures
• Optimised data transmission.
All enable a safe and precise robot-assisted procedure to be performed remotely over vast distances.
The surgeons suggest that the system is ideally placed to provide care to remote island communities, disaster areas, and regions without reliable networks, offering access to expert surgical care without the need to transport patients or specialists.
