5G robotic telesurgery: Revolutionary medical approach (literature review)

Background. The problem of uneven distribution of quality medical resources and limited access to highly qualified surgical help for patients from distant regions has existed for a long time. 5G-based telesurgery opens up the prospects for overcoming geographical barriers. However, its clinical use is still at the starting stage.

Aim. To analyze perioperative outcomes and safety profile of robot-assisted surgeries performed remotely using 5G-based systems.

Materials and methods. Systematic search of sources in the PubMed, Embase, Web of Science and Cochrane Library databases was performed. The analysis included clinical trials added to the databases since their creation and until April 10, 2026. Special attention was paid to the articles on radical gastrectomy due to stomach cancer, as well as hepatopancreatobiliary and urological surgery. The key limitations of these interventions were identified. Descriptions of single-patient clinical cases were excluded from the analysis.

Results. Oncological gastroenterology: 2 Chinese studies, prospective single-center (n = 27) and retrospective (n = 10), demonstrated that 100 % of resections were R0. Perioperative outcomes were similar to outcomes of non-remote robot-assisted surgery, delay of the roundtrip signal was only 31–91 ms. Hepatopancreatobiliary surgery: 3 studies (n = 5, n = 6, n = 20) confirmed the possibility of remote cholecystectomy and liver resection with delay of 43–126 ms; episodic network disruptions were observed but they did not affect safety of the surgery. Urology: 5 studies (between 6 and 37 patients) involving radical prostatectomy, nephrectomy, adrenalectomy, and other interventions with success rates up to 100 % and identical perioperative outcomes as in non-remote surgeries (delay varied between 29.1 and 129.6 ms). All studies share the same limitations of small sample sizes, absence of data on long-term oncological outcomes, variability of network characteristics, absence of tactile feedback in robotized systems, absence of ethical and legal base, and uncertain economic efficiency.

Conclusion. Feasibility and safety of robot-assisted surgeries performed remotely using 5G networks was demonstrated in cases of carefully selected patients. Perioperative outcomes of remote and non-remote robot-assisted surgeries are similar. However, telesurgery is still at the early stage of validation and carries many uncertainties and limitations; currently, it cannot replace non-remote robot-assisted surgery.

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