Reliability of urological telesurgery compared with local surgery: multicentre randomised controlled trial

作者：Ye Wang, D J Xia, Wanhai Xu, Mulati Rexiati, Wuyi Zhao, Qingbo Huang, Taoping Shi, Baojun Wang, Shuo Wang, Sheng Tai, Bingzhang Qiao, Yubai Zhang, Sunyi Ye, Xiangping Zhang, Jianle Mao, Yi Zhu, Hao Wang, Shuangyu Ma, Cheng Yang, Weijun Fu, Tao Song, Qing Ai, Yong Song, L. Xu, Guoqiang Yang, Yu Gao, Shaoxi Niu, Jing Guo, Guojun Liu, Xueyuan Xiang, Chaozhao Liang, Xin Ma, Hongxia Li, Xu Zhang · 发表于：BMJ · 年份：2026 · DOI：10.1136/bmj-2024-083588 · 被引用次数：12 · 研究领域：Surgical Simulation and Training、Intraoperative Neuromonitoring and Anesthetic Effects、Telemedicine and Telehealth Implementation

OBJECTIVE: To investigate whether the reliability of telesurgery is non-inferior to that of standard local surgery in patients undergoing urological robotic operations. DESIGN: Multicentre, non-inferiority, randomised controlled trial. SETTING: Five hospitals in China from December 2023 to June 2024. PARTICIPANTS: Patients scheduled to undergo radical prostatectomy or partial nephrectomy. INTERVENTIONS: Patients were randomly assigned 1:1 to undergo telesurgery or local surgery. MAIN OUTCOME MEASURES: The primary outcome was the probability of success of surgery, determined by the medical team on the basis of pre-established criteria. The pre-specified non-inferiority margin was an absolute reduction in probability of 0.1. Thirteen clinical secondary outcomes were associated with the operation and early recovery, and one secondary outcome related to the workload of the medical team. Four technical secondary outcomes for the surgical system were also explored, including network latency, display latency, frame loss during telesurgery, and system malfunction. The participants were followed up at four and six weeks postoperatively for the secondary outcomes of recovery and complications. RESULTS: A total of 72 participants were enrolled in the study and randomised 1:1 to the telesurgery group and the local surgery group for the intention-to-treat set. The median age of patients was 61.0 (interquartile range 57.5-68.0) years in the telesurgery group and 65.0 (56.5-70.0) years in t...