Leveraging 5G for Telesurgery

Alperen Acemoglu, PhD

Recent study findings demonstrate the capability of a robotic telesurgery system to exploit 5G networks and deliver data with ultralow latency and high bandwidth between the operating room and a remote surgeon.

The use of surgical robots is becoming increasingly more common in operating rooms, and the use of next-generation mobile networks and 5G can allow providers the ability to leverage the ultrafast transmission of large amounts of data.

"This could affect the healthcare of hundreds of millions of patients; its estimated economic impact by 2035 is up to $3.5 trillion and 22 million jobs," study authors wrote.

Alperen Acemoglu, PhD, and a team of Italy-based investigators sought to show how surgical expertise could be exploited and shared more effectively using new telecommunication standards. The team detailed a robotic telemicrosurgery system performing transoral laser microsurgery over a 5G network.

The transoral laser microsurgeries were performed remotely on an adult human cadaver. An otorhinolaryngologist used a novel, teleoperated, surgical robotic system to conduct the procedures. A ventriculotomy was done during the procedure to expose the vocal cords. Then, the surgeon did a type 1 cordectomy on the left vocal fold and a type IV cordectomy on the right vocal fold.

The robotic telemicrosurgery systems allowed for direct surgical interaction with the patient. A 5G network provided bidirectional data transmission connecting both ends of the system.

On the patient side, there was a computer-assisted laser microsurgery system, a medical CO₂ laser, robotic surgical forceps manipulated by a Panda robot, and a VITOM 3D stereo exoscope. On the surgeon's side, there was a Wacom tablet, an omega.7 haptic device to control the robot and surgical forceps, and an HMZ-T3 3D display to see the remote surgical site. A webcam and microphone were at both sites to allow for collaboration between the surgeon and assistants on the patient’s side.

Acemoglu and the team found the surgeon had effective control of the surgical robot, forceps, and laser, and could confidently perform high-precision laser cordectomies on the cadaver’s vocal cords. The team said the 5G telesurgery experiment was successful because of the high-quality telepresence experience delivered by the robots and interfaces which let the surgeon manipulate the vocal cords as if they were in the operating room directly operating on a patient.

It took a mean time of 40 ms between 2 devices both connected to the 5G Radio Access Network. After adding an application layer, the mean one-way latency for transmission of the video was 102±9 ms and the maximum delay was below 140 ms.

Ultimately the investigators found the robotic telesurgery system to be effective in leveraging 5G networks to deliver large amounts of data between the operating room and a remote surgeon, which the team suggested was a critical enabling technology for telesurgery. The results also proved the feasibility of field hospitals in remote communities or disaster scenarios, the team suggested.

“Technology and medicine are evolving rapidly, with artificial intelligence, robotic assistance, and now 5G telecommunications set to play a critical role in enabling not only robotic telesurgery but also teleassistance and telementoring,” the investigators concluded.

The study, “Operating From a Distance: Robotic Vocal Cord 5G Telesurgery on a Cadaver,” was published online in the Annals of Internal Medicine.