5G Remote Robotic Surgery for Hepatic Echinococcosis in High-Altitude Region

This study aims to evaluate the feasibility and safety of performing radical hepatectomy for hepatic echinococcosis in a high-altitude region (Lhasa, Xizang, 3650m altitude) utilizing the domestic Toumai™ robotic surgical system via 5G network communication.

Hepatic echinococcosis is a significant endemic parasitic disease in high-altitude areas. While radical resection remains the definitive treatment, a disparity in the distribution of expert surgical resources poses challenges to patient access. This prospective study investigates the following:

Technical Feasibility: To validate whether the 5G network performance, specifically regarding latency and image resolution in a high-altitude and long-distance transmission environment, meets the clinical requirements for real-time robotic surgery.

1. Operational Safety: To assess the impact of tele-robotic control on the precision required for complex hepatic procedures, such as managing critical vascular structures and dissecting cystic walls. 2. Clinical Outcomes: To analyze the efficacy and non-inferiority of the tele-robotic approach compared to traditional surgical methods by evaluating perioperative technical metrics and postoperative recovery indices.

By establishing a closed-loop surgical connection between the center (Chengdu) and the remote site (Lhasa), the team will monitor real-time tele-interaction stability. This study includes robust contingency protocols for network instability or mechanical failure to ensure patient safety, providing clinical evidence for the standardization of remote hepatobiliary surgery in underserved regions.

• Surgical Efficiency -Operative Time [Срок оценки: From skin incision to skin closure, assessed up to 24 hours.]
• Intraoperative Safety-Estimated Intraoperative Blood Loss [Срок оценки: From the start of surgery to the completion of the procedure, assessed up to 24 hours.]
• Intraoperative Safety-Intraoperative Blood Transfusion Rate [Срок оценки: From the start of surgery to the completion of the procedure, assessed up to 24 hours.]
• Rate of Conversion to Open or Laparoscopic Surgery [Срок оценки: From the start of the robotic procedure until the completion of the surgery, assessed up to 24 hours.]
• Postoperative Clinical Recovery-Length of Postoperative Hospital Stay [Срок оценки: From date of surgery until the date of hospital discharge, assessed up to 60 days.]
• Postoperative Clinical Recovery-Time to First Postoperative Ambulation [Срок оценки: From the end of surgery until the first documented ambulation, assessed up to 10 days.]
• Incidence of Postoperative Complications (Clavien-Dindo Classification) [Срок оценки: From the end of surgery up to 30 days post-operation.]
• Tele-Robotic System Performance-Incidence of Robotic Device Defects [Срок оценки: From the start of the robotic procedure until the completion of the surgery, assessed up to 24 hours.]
• Tele-Robotic System Communication Quality-Average 5G Network Round-Trip Latency [Срок оценки: Continuously during the surgical procedure (approximately 3 to 6 hours).]
• Surgeon-Perceived Image Quality and Transmission Stability Score [Срок оценки: Assessed once immediately after the completion of the surgery.]
• Total NASA Task Load Index (NASA-TLX) Score [Срок оценки: Within 24 hours after the completion of each surgery.]
• Textbook Outcome in Liver Surgery (TOLS) [Срок оценки: Up to 30 days post-operation.]