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<p>Telesurgery has progressed from experimental demonstrations to clinical application, but its feasibility across true transcontinental distances has not been established. We report the first bidirectional transatlantic operation, performed across a world-record distance, and propose a clinical framework, intended to provide international guidance across surgical specialties for the safe and reproducible global implementation of telesurgery. Two bidirectional robotic transabdominal preperitoneal patch plasty (RTAPP) hernia repairs were performed between Kuwait and Brazil across 12,035&#xa0;km using EDGE MP1000 robotic systems equipped with telesurgery modules. Dedicated high-capacity fibre-optic networks with redundant pathways and real-time monitoring ensured stable connectivity. Intraoperative performance metrics and clinical outcomes were prospectively collected and compared against predefined safety thresholds. Both procedures were completed without conversion or complication, establishing a Guinness World Record for the longest distance between surgeon and patient. Mean latency was ~ 196 ms in both directions, with minimal jitter (1 ms), negligible packet loss (0.19%), and 100% connection uptime. Operative times and blood loss were consistent with conventional robotic hernia repair, and both patients recovered uneventfully. This is the first bidirectional transcontinental telesurgery, demonstrating that safe, effective robotic surgery is possible across &gt; 12,000&#xa0;km. Beyond setting a distance record, it proposes a clinical framework intended to guide the safe international implementation of telesurgery, covering technical requirements, safety protocols, and clinical governance. By linking technical feasibility with structured standards of care, this work the first structured foundation for the safe international adoption of telesurgery across surgical specialties.</p>

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Establishing an international clinical framework for telesurgery: the first bidirectional transatlantic procedure across a world-record distance

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Sulaiman Almazeedi,
  • Marcelo Loureiro,
  • Mohanned Alhaddad,
  • Leandro Totti Cavazzola,
  • Paolo R. Salvalaggio,
  • Jeronimo Fortunato,
  • Hmoud Alrashidi,
  • Ahmed Karim

摘要

Telesurgery has progressed from experimental demonstrations to clinical application, but its feasibility across true transcontinental distances has not been established. We report the first bidirectional transatlantic operation, performed across a world-record distance, and propose a clinical framework, intended to provide international guidance across surgical specialties for the safe and reproducible global implementation of telesurgery. Two bidirectional robotic transabdominal preperitoneal patch plasty (RTAPP) hernia repairs were performed between Kuwait and Brazil across 12,035 km using EDGE MP1000 robotic systems equipped with telesurgery modules. Dedicated high-capacity fibre-optic networks with redundant pathways and real-time monitoring ensured stable connectivity. Intraoperative performance metrics and clinical outcomes were prospectively collected and compared against predefined safety thresholds. Both procedures were completed without conversion or complication, establishing a Guinness World Record for the longest distance between surgeon and patient. Mean latency was ~ 196 ms in both directions, with minimal jitter (1 ms), negligible packet loss (0.19%), and 100% connection uptime. Operative times and blood loss were consistent with conventional robotic hernia repair, and both patients recovered uneventfully. This is the first bidirectional transcontinental telesurgery, demonstrating that safe, effective robotic surgery is possible across > 12,000 km. Beyond setting a distance record, it proposes a clinical framework intended to guide the safe international implementation of telesurgery, covering technical requirements, safety protocols, and clinical governance. By linking technical feasibility with structured standards of care, this work the first structured foundation for the safe international adoption of telesurgery across surgical specialties.