Establishment of a new practical telesurgical platform using the hinotori™ Surgical Robot System: a preclinical study

• DOI: 10.1007/s00423-022-02710-6
• Publication Date: 2022-10-14T11:33:30Z
• Authors: Masaya Nakauchi; Koichi Suda; Kenichi Nakamura; Tsuyoshi Tanaka; Susumu Shibasaki; Kazuki Inaba; Tatsuhiko Harada; Masanao Ohashi; Masayuki Ohigashi; Hiroaki Kitatsuji; Shingo Akimoto; Kenji Kikuchi; Ichiro Uyama
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Robotic Surgical Procedures; Swine; Gastrectomy; Research; Anastomosis, Surgical; Animals; Lymph Node Excision; Robotics; 3. Good health

Abstract Aim The recent development of new surgical robots and network telecommunication technology has opened new avenues for robotic telesurgery. Although a few gastroenterological surgeries have been performed in the telesurgery setting, more technically demanding procedures including gastrectomy with D2 lymphadenectomy and intracorporeal anastomosis have never been reported. We examined the feasibility of telesurgical robotic gastrectomy using the hinotori™ Surgical Robot System in a preclinical setting. Methods First, the suturing time in the dry model was measured in the virtual telesurgery setting to determine the latency time threshold. Second, a surgeon cockpit and a patient unit were installed at Okazaki Medical Center and Fujita Health University, respectively (approximately 30 km apart), and connected using a 10-Gbps leased optic-fiber network. After evaluating the feasibility in the dry gastrectomy model, robotic distal gastrectomies with D2 lymphadenectomy and intracorporeal B-I anastomosis were performed in two porcine models. Results The virtual telesurgery study identified a latency time threshold of 125 ms. In the actual telesurgery setting, the latency time was 27 ms, including a 2-ms telecommunication network delay and a 25-ms local information process delay. After verifying the feasibility of the operative procedures using a gastrectomy model, two telesurgical gastrectomies were successfully completed without any unexpected events. No fluctuation was observed across the actual telesurgeries. Conclusion Short-distance telesurgical robotic surgery for technically more demanding procedure may be safely conducted using the hinotori Surgical Robot System connected by high-speed optic-fiber communication.