# Enhancing telesurgical safety with predictive digital twin synchronization: a framework for latency compensation in robotic surgery

## TL;DR

This paper introduces a new system to reduce the effects of communication delays in robotic telesurgery, improving precision and reducing surgeon workload.

## Contribution

The novel DTVA system uses a tri-layered architecture with parametric 3D modeling to synchronize and compensate for latency in telesurgical procedures.

## Key findings

- DTVA maintained spatial precision within 2 mm error under typical conditions.
- Peg-transfer completion time was reduced by 13.6% under 900 ms latency.
- Operator workload was lowered by 27.2% and clinical feasibility was confirmed in nephrectomy procedures.

## Abstract

This study addresses the critical challenge of master-slave latency in robot-assisted telesurgery by introducing a Digital Twin Visual Assistance (DTVA) system. DTVA integrates parametric 3D modeling and virtual endoscopic visualization within a tri-layered architecture to enable real-time bidirectional synchronization. The system was evaluated on a geographically distributed robotic platform using programmable latency emulation. Results demonstrated that DTVA maintained spatial precision within 2 mm error under typical conditions and reduced peg-transfer completion time by 13.6% under 900 ms communication latency while lowering operator workload by 27.2%. Clinical validation through teleoperated radical nephrectomy under 300 ms communication latency confirmed feasibility, with all procedures completed successfully without complications and favorable perioperative outcomes. The study establishes DTVA’s capacity to mitigate latency effects and demonstrates preliminary clinical feasibility for telesurgical procedures.