Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Journal of robotic surgery
Safety and feasibility of robotic telesurgery in urological procedures: a systematic review and meta-analysis of clinical data
Robotic telesurgery has emerged as a potential solution to expand access to specialized surgical care; however, clinical evidence remains fragmented across procedures and robotic platforms. We conducted this meta-analysis to assess the feasibility and safety of robotic telesurgery across urological procedures. An electronic search was conducted on PubMed, Scopus, Web of Science (WoS) and the Cochrane Library from inception through April 2026 according to PRISMA guidelines. Clinical studies reporting robotic telesurgery in urology were included regardless of study design. The primary outcome of interest was procedural success, defined as completion without conversion to a local surgeon or an alternative surgical approach. Secondary outcomes included complication rates and round-trip latency (RTL). Nineteen studies involving 164 patients were included. The pooled procedural success rate was 0.92 (95% CI: 0.86-0.96). No conversions to open or laparoscopic surgery were reported across the included studies. The pooled complication rate was 0.12 (95% CI: 0.07-0.20), with events occurring in a limited number of studies. RTL data were available from 14 studies, with a pooled mean latency of 123.30 milliseconds (ms) (95% CI: 81.76-164.83) demonstrating substantial heterogeneity (I² = 99.99%). Robotic telesurgery in urology demonstrates excellent technical feasibility and a favorable short-term safety profile in carefully selected cases. However, variability in network performance and procedure-specific requirements remain important considerations. Further prospective studies with standardized reporting and long-term outcome assessment are needed before widespread clinical adoption can be recommended.
21 July 2026
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The future of surgery in space exploration
Long-duration human space missions expose astronauts to microgravity, creating unprecedented surgical risks in environments where evacuation is impossible and communication delays limit real-time intervention. Understanding the feasibility and requirements of robot-assisted surgery in space is essential to ensure crew survival and mission continuity. A literature review was conducted using PubMed, Scopus, and aerospace medicine databases. Studies on surgical risks in spaceflight, robotic and tele-operated surgical systems, and translational applications were identified and thematically synthesized. Microgravity-induced physiological changes complicate surgical management. Anticipated emergencies include intra-abdominal pathologies, trauma, and craniofacial injuries. Miniaturized robotic systems with tele-mentored and semi-autonomous capabilities demonstrated feasibility in simulated and orbital environments, addressing constraints related to latency, sterility, and limited crew expertise. Translational applications include improved surgical access in remote, military, and low-resource settings on Earth. However, challenges remain in system reliability, training, ethics, and resource constraints. Robotic-assisted surgery represents a mission-critical capability for deep-space exploration and transformation for terrestrial surgical care. Integrated technological, training, and ethical frameworks are required to ensure safe tele-operated surgical interventions in extreme environments, improving global equity in surgical care.
21 July 2026
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Telesurgery and remote surgery research: a bibliometric analysis of scientific growth, collaboration, and thematic evolution
Telesurgery and remote surgery have gained relevance in surgical innovation due to advances in robotics, telepresence, artificial intelligence, and high-speed communication networks. Despite this progress, the global evolution, collaborative structure, and thematic development of this field remain insufficiently characterized. A bibliometric study was conducted using records retrieved from Web of Science. Publications on telesurgery and remote surgery published up to 2025 were included. Bibliographic data were processed and analyzed using the bibliometrix package in R. Bibliometric indicators, citation metrics, country productivity, journal output, author contributions, collaboration networks, and keyword-based thematic patterns were assessed. A total of 476 publications on telesurgery were included, distributed across 290 journals. Scientific production showed sustained growth, with an annual growth rate of 20.59%, a mean document age of 6.06 years, and peak output in 2024. The average citation count was 28.54 citations per document. The United States and China were the leading contributors, with 151 and 120 publications, respectively, and also acted as the main hubs in the international collaboration network. The most cited studies focused on telerobotic systems for minimally invasive surgery, telerobotic neurovascular interventions, and ultra-reliable low-latency communications. Keyword analysis showed a progressive shift from early clinical feasibility and surgical applications toward connectivity, latency, robotic systems, extended reality, blockchain, and artificial intelligence. These trends indicate the transition of telesurgery from a clinically exploratory field to a technology-driven research domain. Telesurgery and remote surgery constitute a rapidly expanding and technologically driven research field. Future progress will require stronger international collaboration, real-world clinical validation, standardized outcome assessment, and strategies to reduce technological inequities across regions.
23 June 2026
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