Application of 5G technology to conduct tele‐surgical robot‐assisted laparoscopic radical cystectomy

Yang, Xuecheng; Wang, Yonghua; Jiao, Wei; Li, Jianmin; Wang, Bingqiang; He, DE; Long; Chen, Yongjian; Gao, Xuesong; Li, Zhaoyu; Zhang, DE; Yu; Li, Huanting; Wang, Chen; Luo, Lei; Song, Mengqi; Sun, Lijiang; Zheng, Jilu; Guo, Weidong; Cao, Yu; Yu, Zongyi; Hu, Xiao; Ding, Xuemei; Guan, Fengju; Feng, Wei; Li, Kun; Li, Linlin; Kong, Xinjuan; Wei, Lili; Wang, Hao; Wei, Bin; Xue, Hongmei; Wang, Xinsheng; Zhang, Guiming; Dong, Qian; Niu, Haitao

doi:10.1002/rcs.2412

Cited by 10 publications

(8 citation statements)

References 26 publications

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“…Zheng et al performed four laparoscopic telesurgeries in 2020, with a 5G wireless network with a mean round-trip transporting delay of 114 ms and a 1.20% data PLR [30]. Yang et al in 2022 performed an ultra-remote radical cystectomy (network communication distance of nearly 3000 km) on patient diagnosed with T2N0M0 stage bladder cancer through a 5G network with a mean round-trip transporting delay of 104 ms and a 0% data PLR [31]. In 2022, Zhang reported that their team performed Unilateral nephrectomy in 5G wireless network and deterministic networking (DetNet) mode with an average network delay of 27 ms and a 0% data PLR [32].…”

Section: Discussionmentioning

confidence: 99%

Design and application of a novel telemedicine system jointly driven by multinetwork integration and remote control: Practical experience from PLAGH, China

Wang,

Zhang,

et al. 2023

Healthcare Tech Letters

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In China, several problems were common in the telemedicine systems, such as the poor network stability and difficult interconnection. A new telemedicine system jointly driven by multinetwork integration and remote control has been designed to address these problems. A multilink aggregation algorithm and an overlay network for telemedicine system (ONTMS) were developed to improve network stability, and a non‐intervention remote control method was designed for Internet of Things (IoT) devices/systems. The authors monitored the network parameters, and distributed the questionnaire to participants, for evaluating the telemedicine system and services. Under a detection bandwidth of 8 Mbps, the aggregation parameters of Unicom 4G, Telecom 4G, and China Mobile 4G were optimal, with an uplink bandwidth, delay, and packet loss ratio (PLR) of 7.93 Mbps, 58.80 ms, and 0.06%, respectively. These parameters were significantly superior to those of China Mobile 4G, the best single network (p < 0.001). Through the ONTMS, the mean round‐trip transporting delay from Beijing to Sanya was 76 ms, and the PLR was 0 at vast majority of time. A total of 1988 participants, including 1920 patients and 68 doctors, completed the questionnaires. More than 97% of participants felt that the audio and video transmission and remote control were fluent and convenient. 96% of patients rated the telemedicine services with scores of 4 or 5. This system has shown robust network property and excellent interaction ability, and satisfied the needs of patients and doctors.

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Section: Discussionmentioning

confidence: 99%

Design and application of a novel telemedicine system jointly driven by multinetwork integration and remote control: Practical experience from PLAGH, China

Wang,

Zhang,

et al. 2023

Healthcare Tech Letters

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“…In recent years, communication networks have been improved, and communication delays and security issues are being resolved 7 . With the widespread use of optical networks and reports of remote robotic surgery using 5G lines, there are high expectations for robotic telesurgery using commercial lines 8 …”

Section: Discussionmentioning

confidence: 99%

“…7 With the widespread use of optical networks and reports of remote robotic surgery using 5G lines, there are high expectations for robotic telesurgery using commercial lines. 8 The biggest hurdle for telesurgery is the problem of delay. The delay time experienced by the surgeon consists of three elements: communication delay, information processing delay, and robot delay.…”

Section: Discussionmentioning

confidence: 99%

Verification of delay time and image compression thresholds for telesurgery

Takahashi

Hakamada

Morohashi

et al. 2022

Asian J Endoscop Surgery

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Introduction: Telerobotic surgery relies on communication lines, causing delays, and video information requires pre-transmission compression. Such delays and video degradation will continue to be unavoidable making communication conditions verification essential. Understanding the network specification values required for telerobotic surgery entails determining acceptable levels of delay and degradation due to the video compression and restoration processes during surgery. Methods:The hinotori™ surgical robot from Medicaroid was used. Eight surgeons, skilled in robotic surgery, performed gastrectomy or rectal resection on pigs. Image compression (bitrate: 120, 60, 30, 20, 10 Mbps) was random, changing encoder settings during surgery, and delay times (30, 50, 100, 150 milliseconds) were pseudo-randomly inserted, changing emulator settings. Acceptable video levels were evaluated. Subjective evaluations by surgeons and evaluators regarding image degradation and operability, and objective evaluations of image degradation and operability were given five-point ratings. Results: Regarding delay time, 30 and 50 millisecond periods garnered average ratings of 3.6 and 4.0, respectively, signifying that surgery was feasible. However, at 100 and 150 millisecond, average ratings were 2.9 and 2.3, respectively, indicating surgery was not feasible for the most part in these cases. The average rating for image compression was 4.0 or higher for bitrates of 20, 30, 60, and 120 Mbps, suggesting that surgery is possible even at bitrates as low as 10 Mbps, with an average rating of 4.0. Conclusion: In remote robotic surgery using the hinotori™, image compression and delay time are largely acceptable, so surgery can be safely performed.

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“…Total reported average delay, including network latency, image capturing, video (de)coding and mechanical response of the robot, was 264 ms. Recently, the same team presented an ultra-remote telesurgical robot-assisted laparoscopic radical cystectomy on a human patient [ 25 ].…”

Section: Related Workmentioning

confidence: 99%

A long distance telesurgical demonstration on robotic surgery phantoms over 5G

2023

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Purpose Using robotic technology and communications infrastructure to remotely perform surgery has been a persistent goal in medical research in the past three decades. The recent deployment of the Fifth-Generation Wireless Networks has revitalized the research efforts in the telesurgery paradigm. Offering low latency and high bandwidth communication, they are well suited for applications that require real-time data transmission and can allow smoother communication between surgeon and patient, making it possible to remotely perform complex surgeries. In this paper, we investigate the effects of the 5 G network on surgical performance during a telesurgical demonstration where the surgeon and the robot are separated by nearly 300 km. Methods The surgeon performed surgical exercises on a robotic surgery training phantom using a novel telesurgical platform. The master controllers were connected to the local site on a 5 G network, teleoperating the robot remotely in a hospital. A video feed of the remote site was also streamed. The surgeon performed various tasks on the phantom such as cutting, dissection, pick-and-place and ring tower transfer. To assess the usefulness, usability and image quality of the system, the surgeon was subsequently interviewed using three structured questionnaires. Results All tasks were completed successfully. The low latency and high bandwidth of the network resulted into a latency of 18 ms for the motion commands while the video delay was about 350 ms. This enabled the surgeon to operate smoothly with a high-definition video from about 300 km away. The surgeon viewed the system’s usability in a neutral to positive way while the video image was rated as of good quality. Conclusion 5 G networks provide significant advancement in the field of telecommunications, offering faster speeds and lower latency than previous generations of wireless technology. They can serve as an enabling technology for telesurgery and further advance its application and adoption.

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Application of 5G technology to conduct tele‐surgical robot‐assisted laparoscopic radical cystectomy

Cited by 10 publications

References 26 publications

Design and application of a novel telemedicine system jointly driven by multinetwork integration and remote control: Practical experience from PLAGH, China

Design and application of a novel telemedicine system jointly driven by multinetwork integration and remote control: Practical experience from PLAGH, China

Verification of delay time and image compression thresholds for telesurgery

A long distance telesurgical demonstration on robotic surgery phantoms over 5G

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