# Feasibility and safety of remote robotic hepatectomy: a prospective single-arm study with MP1000 system in China

## TL;DR

This study shows that remote robotic liver surgery is feasible and safe, with successful outcomes in six patients using the MP1000 system.

## Contribution

The first prospective study to evaluate the safety and effectiveness of robotic remote liver resection using the MP1000 system.

## Key findings

- All six surgeries were successfully completed without conversion to open or local robotic surgery.
- Patients recovered smoothly, with only one case of postoperative bacteremia that resolved with treatment.
- Surgeons reported low workload during the remote procedures.

## Abstract

Telesurgery has demonstrated many advantages in certain scenarios. However, given the high risks of liver resection, there have been no prospective studies to evaluate the safety and effectiveness of robotic remote liver resection. This study aimed to evaluate the safety and effectiveness of the MP1000 remote surgical system in robot-assisted remote liver resection using the first prospective single-arm cohort study.

This study was approved by the Clinical Trial Ethics Committee of Huazhong University of Science and Technology ([2024] (324)) and registered at Chinese Clinical Trial Registry (ChiCTR2500097679). Six patients were continuously recruited from March 1 to April 18, 2025. After strict preoperative evaluation, robotic liver resection was performed using the MP1000 remote surgical system. The primary outcomes were the surgical success rate and the incidence of complications. The postoperative task load of surgeons was assessed using the NASA–TLX scale.

The network connection of the remote system was smooth. All surgeries were successfully completed without conversion to open surgery or local robot—assisted surgery. Surgeons reported a relatively low workload. All patients recovered smoothly and were discharged. However, the second patient developed bacteremia within 30 days after surgery and was readmitted but recovered after antibiotic treatment.

Robotic remote liver resection is a feasible and effective minimally invasive treatment modality that can provide high-quality medical services to areas with constrained medical resources. Nevertheless, further multi-center, large-scale randomized controlled trials are required to verify its effectiveness and safety.

This work was supported by the Noncommunicable Chronic Diseases- National Science and Technology Major Project (2023ZD0502001), 10.13039/501100001809National Natural Science Foundation of China (82473040), Hubei Province Key Technology Breakthrough Project (2023BAA016-3), Tongji Hospital Clinical Research Fund (2024TJCR014).