1.Introduction The continuous integration of advanced technologies into medicine has brought profound changes across nearly all specialties.In urology,a field traditionally characterized by its reliance on delicate,pr...1.Introduction The continuous integration of advanced technologies into medicine has brought profound changes across nearly all specialties.In urology,a field traditionally characterized by its reliance on delicate,precision-driven procedures,the impact of innovations such as robotics,artificial intelligence(AI),telepresence,and telesurgery has been transformative.展开更多
Background:Telesurgery has the potential to overcome spatial limitations for surgeons,which depends on surgical robot and the quality of network communication.However,the influence of network latency and bandwidth on ...Background:Telesurgery has the potential to overcome spatial limitations for surgeons,which depends on surgical robot and the quality of network communication.However,the influence of network latency and bandwidth on telesurgery is not well understood.Methods:A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya(Hainan province),covering a distance of 3000 km.In total,108 animal operations,including 12 surgical procedures,were performed.Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding.Network latency,jitter,frame loss,and bit rate code were systemically measured during these operations.National Aeronautics and Space Administration Task Load Index(NASA-TLX)and a self-designed scale measured the workload and subjective perception of surgeons.Results:All 108 animal telesurgeries,conducted from January 2023 to June 2023,were performed effectively over a total duration of 3866 min.The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps.Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions.The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions.Conclusions:This telesurgery system demonstrated safety and reliability.A total of 320 ms latency is acceptable for telesurgery operations.Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth,offering a new method to reduce the impact of latency on telesurgery.展开更多
As an emerging field,telesurgery robotic system is changing the traditional medical mode and can delivery remote surgical treatment anywhere in the world.Advances in telesurgery robotic technology achieve the remote c...As an emerging field,telesurgery robotic system is changing the traditional medical mode and can delivery remote surgical treatment anywhere in the world.Advances in telesurgery robotic technology achieve the remote control beyond the current limitation of distance and special medical environment.This review introduces the development history,the current status and the potential in future of the telesurgery robotic system.In addition,it presents the construction of control platform and the application,especially in trauma treatment,as well as the challenge in clinic.展开更多
The fifth generation of mobile communication technology(5G technology)features large system capacity,fast data transmission rate,support for large-scale device connection,low latency,and high reliability.With the deve...The fifth generation of mobile communication technology(5G technology)features large system capacity,fast data transmission rate,support for large-scale device connection,low latency,and high reliability.With the development and popularization of 5G technology,it is also widely used in medicine.In recent years,5G telesurgery has been paid attention to and made continuous progress,and the research related to its combination with urology has also made significant achievements.We collect the combination of 5G technology and urology improves the uneven distribution of medical resources,provides timely,highquality remote surgical interventions for urology patients,reduces the financial burden on patients,surgical complications,and the difficulty of accessing medical care from a distance,and brings new opportunities for medical development.展开更多
As robotic surgery provides clinical benefits and increases on a global scale,it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation.The digital c...As robotic surgery provides clinical benefits and increases on a global scale,it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation.The digital coupling between human control inputs and surgical motion replaces the previous physical link.Robotic surgery is therefore in effect‘surgery-by-wire’,the term capturing the engineering phenomenon that has also occurred in the‘fly-by-wire’of aviation and‘drive-by-wire’of cars.This paper reviews the fundamental commonality across domains.Intrinsic to‘by-wire’control is digital processing,which generates the control signal to the effector.This processing enables a progressive spectrum of motion modulation,from precision and stability of motion,through assistance and envelope protection,to automation.Precision now manifests in all three domains.In modern aircraft and cars,higher-order assistance is commonplace,such as flight envelope protection,with analogous support in driving,as well as significant automation.In robotic surgery,such assistance and automation have not yet entered wider clinical practice,with concepts such as envelope protection requiring further definition.The digital interface combined with telecommunication has also enabled teleoperation in all domains.Therefore,motion‘by-wire’has enhanced performance across industries.A cross-domain perspective will be increasingly useful to facilitate technology transfer and catalyse progress in robotic surgery.As the pan-industry digital transformation evolves,important principles can be derived for application in robotic surgery.展开更多
Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review art...Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.展开更多
Fifth-generation wireless network,5G,is expected to bring surgery to a next level.Remote surgery and telementoring could be enabled and be brought into routine medical care due to 5G characteristics,such as extreme hi...Fifth-generation wireless network,5G,is expected to bring surgery to a next level.Remote surgery and telementoring could be enabled and be brought into routine medical care due to 5G characteristics,such as extreme high bandwidth,ultrashort latency,multiconnectivity,high mobility,high availability,and high reliability.This work explores the benefits,applications and demands of 5G for surgery.Therefore,the development of previous surgical procedures from using older networks to 5G is outlined.The current state of 5G in surgical research studies is discussed,as well as future aspects and requirements of 5G in surgery are presented.展开更多
Traditional telemedicine makes it possible to provide diagnosis,advice,monitoring and other medical services,for example,using audio-visual communication technologies,despite physical distance.Telemedicine is an impor...Traditional telemedicine makes it possible to provide diagnosis,advice,monitoring and other medical services,for example,using audio-visual communication technologies,despite physical distance.Telemedicine is an important part of medical health care,especially in rural areas.Telemedicine is an important tool for the further development of care.Against this background,new areas of application for telemedicine are constantly being developed.Telemedicine also plays an important role in the digitalisation strategy for the health care sector.展开更多
Though laparoscopic cholecystectomy(LC)was highly criticized in its early stages,it quickly grew to become a new standard of care and has revolutionized the field of general surgery.Now emerging robotic technology is ...Though laparoscopic cholecystectomy(LC)was highly criticized in its early stages,it quickly grew to become a new standard of care and has revolutionized the field of general surgery.Now emerging robotic technology is making its way into the minimally invasive arena.Robotic cholecystectomy(RC)is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC.However,this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure.RC can be performed in a cost-effective manner as the volume of robotic procedures increases.In addition,improved visualization and capability to perform fluorescence cholangiography can improve the safety profile of cholecystectomy to a level that has not yet been achieved with conventional laparoscopy.Advanced simulation technology for robotic surgery,and newer single-site robotic platforms have the potential to further revolutionize this technology and lead to improved patient satisfaction.In this review,we will present current data,trends,and controversies in robotic-assisted cholecystectomy.展开更多
文摘1.Introduction The continuous integration of advanced technologies into medicine has brought profound changes across nearly all specialties.In urology,a field traditionally characterized by its reliance on delicate,precision-driven procedures,the impact of innovations such as robotics,artificial intelligence(AI),telepresence,and telesurgery has been transformative.
基金National Natural Science Foundation of China(No.M-0735)
文摘Background:Telesurgery has the potential to overcome spatial limitations for surgeons,which depends on surgical robot and the quality of network communication.However,the influence of network latency and bandwidth on telesurgery is not well understood.Methods:A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya(Hainan province),covering a distance of 3000 km.In total,108 animal operations,including 12 surgical procedures,were performed.Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding.Network latency,jitter,frame loss,and bit rate code were systemically measured during these operations.National Aeronautics and Space Administration Task Load Index(NASA-TLX)and a self-designed scale measured the workload and subjective perception of surgeons.Results:All 108 animal telesurgeries,conducted from January 2023 to June 2023,were performed effectively over a total duration of 3866 min.The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps.Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions.The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions.Conclusions:This telesurgery system demonstrated safety and reliability.A total of 320 ms latency is acceptable for telesurgery operations.Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth,offering a new method to reduce the impact of latency on telesurgery.
文摘As an emerging field,telesurgery robotic system is changing the traditional medical mode and can delivery remote surgical treatment anywhere in the world.Advances in telesurgery robotic technology achieve the remote control beyond the current limitation of distance and special medical environment.This review introduces the development history,the current status and the potential in future of the telesurgery robotic system.In addition,it presents the construction of control platform and the application,especially in trauma treatment,as well as the challenge in clinic.
基金Taishan Scholar Program of Shandong Province,Grant/Award Number:tstp20221165Major Scientific and Technological Innovation Project of Shandong Province,Grant/Award Number:2022CXGC020505。
文摘The fifth generation of mobile communication technology(5G technology)features large system capacity,fast data transmission rate,support for large-scale device connection,low latency,and high reliability.With the development and popularization of 5G technology,it is also widely used in medicine.In recent years,5G telesurgery has been paid attention to and made continuous progress,and the research related to its combination with urology has also made significant achievements.We collect the combination of 5G technology and urology improves the uneven distribution of medical resources,provides timely,highquality remote surgical interventions for urology patients,reduces the financial burden on patients,surgical complications,and the difficulty of accessing medical care from a distance,and brings new opportunities for medical development.
文摘As robotic surgery provides clinical benefits and increases on a global scale,it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation.The digital coupling between human control inputs and surgical motion replaces the previous physical link.Robotic surgery is therefore in effect‘surgery-by-wire’,the term capturing the engineering phenomenon that has also occurred in the‘fly-by-wire’of aviation and‘drive-by-wire’of cars.This paper reviews the fundamental commonality across domains.Intrinsic to‘by-wire’control is digital processing,which generates the control signal to the effector.This processing enables a progressive spectrum of motion modulation,from precision and stability of motion,through assistance and envelope protection,to automation.Precision now manifests in all three domains.In modern aircraft and cars,higher-order assistance is commonplace,such as flight envelope protection,with analogous support in driving,as well as significant automation.In robotic surgery,such assistance and automation have not yet entered wider clinical practice,with concepts such as envelope protection requiring further definition.The digital interface combined with telecommunication has also enabled teleoperation in all domains.Therefore,motion‘by-wire’has enhanced performance across industries.A cross-domain perspective will be increasingly useful to facilitate technology transfer and catalyse progress in robotic surgery.As the pan-industry digital transformation evolves,important principles can be derived for application in robotic surgery.
文摘Robotic systems have become popular in modern surgical procedures.The option of telesurgery has effectively addressed geographic limitations.These systems are offered by numerous companies worldwide.In this review article,we discuss four models of robotic systems to determine their advantages:the Sina flex system from Iran and the da Vinci Xi,SP,and 5 systems from the USA.We compared aspects such as architecture,instruments,visualizations,clinical use,and costs.Our findings suggest that the da Vinci robot,which was introduced earlier than the Sina system,utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities,including three-dimensional optical,tomographic,and fluorescence imaging.It is well established and widely utilized in various surgical procedures.Conversely,the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard,with optional three-dimensional and fluorescence imaging upgrades available.Despite its affordability,the Sina flex system is relatively new and has not yet been clinically tested.Additionally,the Sina flex system is more user-friendly.
文摘Fifth-generation wireless network,5G,is expected to bring surgery to a next level.Remote surgery and telementoring could be enabled and be brought into routine medical care due to 5G characteristics,such as extreme high bandwidth,ultrashort latency,multiconnectivity,high mobility,high availability,and high reliability.This work explores the benefits,applications and demands of 5G for surgery.Therefore,the development of previous surgical procedures from using older networks to 5G is outlined.The current state of 5G in surgical research studies is discussed,as well as future aspects and requirements of 5G in surgery are presented.
文摘Traditional telemedicine makes it possible to provide diagnosis,advice,monitoring and other medical services,for example,using audio-visual communication technologies,despite physical distance.Telemedicine is an important part of medical health care,especially in rural areas.Telemedicine is an important tool for the further development of care.Against this background,new areas of application for telemedicine are constantly being developed.Telemedicine also plays an important role in the digitalisation strategy for the health care sector.
文摘Though laparoscopic cholecystectomy(LC)was highly criticized in its early stages,it quickly grew to become a new standard of care and has revolutionized the field of general surgery.Now emerging robotic technology is making its way into the minimally invasive arena.Robotic cholecystectomy(RC)is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC.However,this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure.RC can be performed in a cost-effective manner as the volume of robotic procedures increases.In addition,improved visualization and capability to perform fluorescence cholangiography can improve the safety profile of cholecystectomy to a level that has not yet been achieved with conventional laparoscopy.Advanced simulation technology for robotic surgery,and newer single-site robotic platforms have the potential to further revolutionize this technology and lead to improved patient satisfaction.In this review,we will present current data,trends,and controversies in robotic-assisted cholecystectomy.
