# The Feasibility of Telerobotic Pancreaticojejunostomy Using a Surgical Robot: A Pilot Study With Commercial Optical Networks

## TL;DR

This study shows that a complex surgical procedure can be performed remotely using a surgical robot and commercial networks.

## Contribution

The study demonstrates the feasibility of telerobotic pancreaticojejunostomy using a commercial communication system.

## Key findings

- Communication latency remained stable at under 12 milliseconds during remote procedures.
- All surgical procedures were completed successfully without significant usability or quality issues.
- The system shows potential for improving remote surgical guidance and education.

## Abstract

In recent years, the practical application of remote robotic surgery has become a reality, and is expected to be applied to difficult surgeries. The purpose of this study is to demonstrate whether the pancreaticojejunostomy in a pancreaticoduodenectomy, a difficult surgery, can be performed through a remote surgery‐assisted robotic operation, as well as to verify the feasibility of remote surgery‐assisted pancreaticojejunostomy.

Hirosaki city and Goshogawara city (about 30 km) were connected via a commercial communication line using the hinotori surgical robot, and five surgeons performed remote surgery on an artificial organ model for pancreaticojejunostomy. Four local surgeons were instructed remotely. Each procedure was repeated 3–5 times in sets of 8 min, and communication latency, Image Quality Score, System Usability Scale (mSUS), and Robot Usability Score were all evaluated.

The communication latency was stable at less than 12 msec, and there were no problems in performing the surgery. No significant differences were noted in Image Quality Score, System Usability Scale (mSUS), or Robot Usability Score. Pancreaticojejunostomy was performed using the Blumgart anastomosis technique, and all procedures were completed without any issues.

We demonstrated that pancreaticojejunostomy can be performed in a telesurgical environment. This system can be applied to remote surgical guidance and support in the future and it is expected to correct regional disparities in medical care, improve surgical education, and enhance the implementation of remote surgery in society.