For a patient lying inside an operation theatre (OT) in Banjara Hills, Hyderabad, India, the surgeon performing the procedure was not standing nearby, but hunched over an instrument over 4,000 km away in a medical facility on Jiefang Boulevard, Wuhan, China. Yet, according to Syed Mohammed Ghouse, the experience felt almost identical to performing a regular robotic surgery inside the same OT.
On May 18, Dr. Ghouse, robotic surgeon at the Asian Institute of Nephrology and Urology (AINU) in Hyderabad, remotely performed a robotic ureteric reimplant procedure on a Hyderabad patient diagnosed with lower ureteric stricture while he was physically present at Tongji Hospital in Wuhan. The patient was prepared for the surgery by the team in Hyderabad, then Dr. Ghouse took over and controlled the robotic system in real time from Wuhan using a high-speed internet connection.
Three components
Explaining how the surgery worked, Dr. Ghouse said robotic surgery is a form of telesurgery. “There are three components of any robotic system — a patient cart attached to the patient, an image cart that processes and displays the visuals, and then there is the surgeon’s console where the surgeon sits and operates,” he explained.
He further added that even in a normal robotic surgery setup, the surgeon does not physically stand over the patient performing the procedure directly. “Now we are just extending that concept across very large distances,” he said.
Dr Syed Mohammed Ghouse operating the MedBot robotic console in Wuhan during the real-time robotic surgery performed on a Hyderabad patient over 3,000 km away | Photo Credit: Special Arrangement
During the procedure, Dr. Ghouse operated from the console in Wuhan while a trained surgical assistant remained beside the patient in Hyderabad. Through continuous two-way communication, the team coordinated every step of the surgery in real time. “Because of the bidirectional communication, you can continuously speak to the assistant who is there beside the patient and they respond instantly. It feels as if everyone is present in the same OT,” he said.
The surgery was performed using the MedBot robotic platform developed by Chinese company MicroPort. According to Dr. Ghouse, the same robotic system has already been introduced in India and is available at AINU institutes.
Internet connection
One of the most critical elements enabling remote robotic surgery is stable internet connectivity. The procedure requires broadband speeds of around 30 to 50 Mbps to ensure smooth transmission of live surgical visuals and robotic commands. On concerns regarding possible internet failure during surgery, Dr. Ghouse said multiple safeguards are built into the system. “There is always redundancy. Usually there are two or three leased lines connected simultaneously. If one fails, another automatically takes over,” he said.
Even in the unlikely event of a complete communication breakdown, patient safety mechanisms remain in place. “There will always be a surgical assistant near the patient who can immediately take over if required,” he added.
The patient recovered quickly after the surgery and was discharged on the same day. Dr. Ghouse returned to Hyderabad from Wuhan.
