Feasibility and preliminary safety of urologic telesurgery using Chinese surgical systems: a single-center exploratory case series

Telesurgery offers a solution to the uneven distribution of surgical resources by enabling telesurgery through surgical robotic systems. This study aimed to describe the technical feasibility and preliminary short-term safety of urologic telesurgery using Chinese surgical systems (CSS).

This single-center exploratory descriptive case series evaluated urologic telesurgery using CSS between January 2023 and October 2025. A total of 6 consecutive eligible telesurgeries were included: 3 robot-assisted radical prostatectomies (RARP) and 1 robot-assisted partial nephrectomy (RAPN) were performed with the Edge MP1000 (MP1000) system, and 1 RAPN and 1 robot-assisted radical cystectomy (RARC) were performed with the KangDuo SR-2000 (KD-SR-2000) system. Six locally performed RARP cases using the da Vinci Xi (DV-Xi) system during the same study period were retrospectively collected as a limited contextual reference for the RARP subgroup. The primary outcome was technical success, defined as completion without conversion. Secondary descriptive outcomes included perioperative safety events, 30-day Clavien-Dindo complications (CDC), network performance, and, in the RARP subgroup, positive surgical margin (PSM) rate, estimated blood loss (EBL), operative time, suture-per-stitch time, and 4-week urinary continence recovery after catheter removal.

All six telesurgeries were completed without intraoperative conversion or major complications. In the RARP subgroup, remote MP1000 procedures were summarized alongside locally performed DV-Xi procedures as a limited contextual reference. PSM rate and early urinary continence recovery showed no obvious unfavorable signal in this small contextual cohort, whereas operative time and suture-per-stitch time were longer, and EBL was numerically higher, in remote procedures. Mean Network round-trip latency for telesurgery ranged from 6.13 ± 0.71 ms (Harbin-Harbin, 2 km) to 54.12 ± 0.58 ms (Harbin-Hangzhou, 2200 km), with no frame loss.

In this small selected case series, urologic telesurgery using CSS was technically feasible and preliminary safety under stable telecommunication conditions.