Top surgical robotics companies agree on remote surgery guidelines

Top surgical robotics companies have joined forces to publish technical guidelines for robotic telesurgery.

Announced today, the guidelines are published in the World Journal of Surgery and represent a first step of major industry players working together toward eventual industry standards for remote robotic surgery procedures. Co-authors included a coalition of experts from major medtech and healthcare organizations:

• Brian Miller, chief digital officer of Intuitive;
• Bill Peine, VP and Bakken Fellow, surgical research and technology, at Medtronic;
• Shane Farritor, CTO and co-founder of Virtual Incision;
• Martin Buehler, VP and distinguished fellow, robotics, Johnson & Johnson MedTech;
• Mike Kijewski, CEO of Medcrypt;
• Mike Yramategui, fellow regulatory engineer, Intuitive;
• Dr. Yuman Fong, chief of surgery, City of Hope;
• Sovato executives Yulun Wang, co-founder and executive chair; Blair Whitney, VP of engineering; and Jordana Bernard, executive director of standards and policy. (Sovato has a system-agnostic software platform to enable remote robotic surgery.)

In addition, CMR Surgical, Nanoflex Robotics, LN Robotics, and Microport are among the companies mentioned in the paper acknowledgements.

“Thanks to the collective efforts of the many experts and leaders across the industry who collaborated with us on this critical publication, we now have a detailed, shared reference outlining the essential requirements for enabling safe, scalable remote surgery and procedure programs,” Wang, Sovato’s executive chair, said in a statement shared with MassDevice.

“This marks the beginning of an ongoing and shared commitment to maintaining the most current technical guidelines — with the aim of prioritizing patient safety, streamlining market adoption, and ultimately unlocking the full potential of remote robotic surgery and procedures to close gaps in access to high-quality care worldwide.”

Remote robotic surgery’s roots go back to 2001 and the “Lindbergh operation” — in which French surgeons located in New York remotely controlled a surgical robot across the Atlantic Ocean to perform a robot‐assisted laparoscopic cholecystectomy on a 68‐year‐old woman in Strasbourg.

However, it’s only been in recent years that advancements in robotic‐assisted technology, telemedicine, and telecommunications have enabled the telesurgery concept to take off. An especially key factor has been the rise of high‐speed, lower‐cost networks that reduce network latency challenges in the procedures.

Agreeing on technical guidelines for remote robotic surgery sets the industry up for further progress.

“These technical guidelines represent a step forward towards the future of remote surgery,” said Intuitive’s Miller. “Having helped develop the technology that supported Operation Lindbergh nearly 25 years ago, it’s exciting to see these guidelines come together, and we look forward to what’s to come.”

Bill Peine, founder and leader ot Robotic Technology Development Center at Medtronic, described the technical guidelines as an inspiring example of industry coming together to lay the groundwork for more accessible, equitable healthcare for patients around the world.

“Telesurgery has potential to be a key enabler in the future of surgery — as part of a connected surgical ecosystem that is more precise, predictable, personalized, and globally accessible. This isn’t sci-fi, the future of surgery is taking shape now — and it’s really exciting,” Peine said.

How remote robotic surgery is advancing

Last year, Sovato announced that surgeons across four specialties performed nephrectomy, hysterectomy, colectomy, and cholecystectomy procedures on pigs as part of the preclinical tests, which took place across about 500 miles between Chicago and Lincoln, Nebraska. The procedures used the Sovanto software platform run on a modified version of Virtual Incision’s MIRA Surgical System.

Early this year, SS Innovations reported that surgeons in India completed what it said were the world’s first robotic cardiac telesurgeries using its Mantra surgical robot.

In developed countries, robotic telesurgery could prove especially useful for regional hospital networks facing shortages of surgeons and staffs because the remote surgeries would enable specialized surgeons to conduct procedures from a distance, regardless of their location. Underserved communities would benefit, with the potential for people in the developing access to eventually have access to better care.

“Remote surgery has the potential to make a real impact in patients’ lives,” said Virtual Incision’s Farritor. “With remote surgery just getting off the ground, I believe this work can facilitate its growth. It’s an honor to play a part in helping to define this new area in surgery.”

The companies and organizations in the remote robotic surgery coalition plan to update the technical guidelines as remote procedures continue to evolve. They also plan to reate complementary practice guidelines covering issues such as liability, licensure, credentialing, and safety protocols. In addition, clinical leaders from the organizations, along with surgeons and administrators from leading healthcare organizations, plan to publish key clinical and operational considerations for remote robotic surgery later this year.

Said Medcrypt’s CEO Kijewski: “Creating secure, scalable frameworks for remote surgical technologies requires deep cross-functional collaboration. This initiative brought together leaders in robotics, cybersecurity, and clinical operations to develop guidelines that not only address safety and interoperability, but also reflect the collective commitment of our industry to advancing patient care through innovation.”

Visit Medical Design & Outsourcing for more information about the guidelines.