Is remote live urologic surgery a reality? Evidences from a systematic review of the literature
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TOPIC PAPER
Is remote live urologic surgery a reality? Evidences from a systematic review of the literature Domenico Veneziano1,2 · A. Tafuri3,4 · J. Gomez Rivas5 · A. Dourado6 · Z. Okhunov7 · B. K. Somani8 · N. Marino9 · G. Fuchs3 · G. Cacciamani3 · ESUT-YAUWP Group Received: 25 July 2019 / Accepted: 20 October 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Introduction and objectives The possibility of performing remote-surgery has been the goal to achieve, since the early development of the first surgical robotic platforms. This systematic review aims to analyse the state of the art in the field and to provide an overview of the possible growth of this technology. Methods All English language publications on Telementoring and Telesurgery for minimally invasive urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus®, and Web of Science™ databases (up to June 2019). Results Our electronic search identified a total of 124 papers in PubMed, Scopus, and Web of Science. Of these, 81 publications were identified for detailed review, which yielded 22 included in the present systematic review. Our results showed that remote surgery has been under-utilised until today, mostly due to the lack of appropriate telecommunication technologies. Conclusion Remote live surgery is a growing technology that is catalyzing incremental interest. Despite not being yet reliable today on a regular basis in its most advanced applications, thanks to the advent of novel data-transmission technologies, telepresence might become a critical educational methodology, highly impacting the global healthcare system Keywords Live surgery · Telementoring · Teleassistance · Teletraining · Telesurgery · Telepresence · Remote
Introduction * Domenico Veneziano [email protected] 1
Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
2
Department of Urology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
3
USC Institute of Urology and Catherine and Joseph, University of Southern California, Los Angeles, CA, USA
4
Department of Urology, University of Verona, Verona, Italy
5
Department of Urology, Hospital Universitario La Paz, Madrid, Spain
6
Department of Urology, Camargo Cancer Center, Sao Paulo, Brasil
7
Department of Urology, University of California, Irvine, CA, USA
8
University Hospital Southampton NHS Trust, Southampton, UK
9
University of Foggia, Foggia, Italy
With the advent of minimally invasive surgery (MIS), novel sophisticated tools were developed and introduced in everyday practice, which led to losing direct contact with the body of the patient. It happened in favor of higher precision, but required longer and specific learning processes. The adoption of robotic systems started in 1985, with the PUMA 200 industrial robot adapted to CT-guided brain biopsies (Fig. 1), but the first modern real-time
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