Telesurgery, which is also known as remote surgery or telementoring, is a segment of telemedicine that uses technology to let surgeons operate on patients remotely. It involves using robotic systems, advanced imaging, and sensory devices to perform surgeries while the surgeon is physically distant from the operating table. 

The innovative technique could potentially provide specialized care in remote areas, facilitate in training, and reduce the need for surgeons to travel.

In mid-July, surgical robotics leader Intuitive revealed that it demonstrated remote telesurgery capabilities with its new da Vinci 5 robotic surgical system. Two surgeons were remotely connected in Peachtree Corners, Ga., and Strasbourg, France.

Using a dual console da Vinci 5 robotic surgical system, Doug Stoddard, M.D., (Georgia) and Andrea Pakula, M.D., (France) performed a telesurgery on an advanced tissue model built by Intuitive to replicate live tissue’s behavior. Dr. Stoddard’s console was alongside the da Vinci 5 patient cart and tissue model—he could pass surgical instrument control back and forth remotely to Dr. Pakula, who was at the remote surgeon console.

This also included force feedback so both surgeons could feel forces exerted on the tissue by the instruments, despite being over 4,000 miles apart.

Telesurgery first became feasible in 2001 when surgeons performed the first transatlantic procedure between the U.S. and Strasbourg, France, named Operation Lindbergh. Brian Miller, Ph.D., Intuitive’s executive VP and chief digital officer, was an engineer supporting Operation Lindbergh.

“While not a new idea for Intuitive, telesurgery requires a high performing network infrastructure and a robotic system designed for remote collaboration to be successful and sustainable,” Dr. Miller said. “Our focus is not on being first but on being rigorous in building the infrastructure to support safety, reliability, and consistent use.”

In January of this year, India-based SS Innovations recorded world-first robotic cardiac telesurgeries over the course of two days. The company’s SSi Mantra 3 surgical robotic system was used for these surgeries. It remotely connected SS Innovations’ headquarters in Gurugram, India, with Manipal Hospital in Jaipur, Rajasthan, a distance of 286 kilometers.

The procedure was a robotic-assisted internal mammary artery harvesting. The surgical team was led by Dr. Sudhir Srivastava, founder, chairman, and CEO of SS Innovations, from the company’s headquarters in Gurugram, and supported by Dr. Lalit Malik, chief of Cardiac Surgery at Manipal Hospital, Jaipur, along with his expert team at the remote location in Jaipur.

The telesurgery showed precision, with a low latency of 35-40 milliseconds (less than 1/20th of a second). This groundbreaking procedure was followed by another world-first, a robotic beating heart totally endoscopic coronary artery bypass (TECAB), a procedure known as one of the most complex cardiac surgical procedures. It was performed via telesurgery under the same collaboration, also with a low latency of just 40 milliseconds.

The SSi Mantra 3 surgical robotic system is the only robotic system in the world to have received regulatory approval for telesurgery and tele-proctoring, according to SS Innovations.

“We are extremely thrilled to have advanced the capabilities of surgery to benefit humanity, especially in areas that need it the most,” said Dr. Srivastava. “By enabling telesurgery, we can bridge gaps in access to medical expertise and deliver the highest standard of care, regardless of geographical barriers. For a country like India, with its vast rural population and significant healthcare disparities, this innovation has the potential to be transformative.”

A 2,000-kilometer cardiac telesurgery followed in April, bridging a distance between the company’s headquarters in Gurugram, New Delhi, and the Aster CMI Hospital in Bengaluru. 

The long-distance robotic-assisted intracardiac telesurgery was performed on a 35-year-old patient and lasted for two hours and 40 minutes. The procedure closed a complex Atrial Septal Defect (ASD), a congenital condition characterized by a small hole between the heart’s two upper chambers. The procedure was led by Dr. Srivastava (from Gurugram) and was supported by Dr. Arul Furtado, a consultant of Cardiovascular & Thoracic Surgery at Aster CMI Hospital, Bengaluru. The surgery demonstrated exceptional precision, achieving a low latency.

In July, the company reported the first robotic telesurgery for weight loss using SSi Mantra 3. The bariatric telesurgery spanned a distance of 560 miles between the company’s headquarters in Gurugram, India, and the Mohak Bariatric & Robotic Surgery Centre in Indore, India. The surgery was done with zero perceptible lag, precision, and seamless robotic control.

The procedures involved two one-anastomosis gastric bypass (OAGB) surgeries, which reduces stomach size and reroutes the digestive tract to support long-term weight loss and improve metabolic health. The robotic procedures were performed by Dr. Mohit Bhandari, a renowned bariatric surgeon, president of IRCAD India, and founder and director of Mohak Bariatric & Robotic Surgery Centre, Indore.

Operating from Gurugram, Dr. Bhandari remotely led his Indore-based surgical team, which provided on-site assistance, ensuring expert execution and clinical excellence throughout. Dr. Srivastava said the company views this achievement as an additional defining moment for the future of global healthcare.