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5G-remote radical prostatectomy under novel robotic systems: a prospective comparative cohort study with local surgeries

Prostate Cancer and Prostatic Diseases (2025)Cite this article

Subjects

Abstract

Background

There is no report upon the remote surgery of radical prostatectomy and comparisons between local surgeries. This study aims to evaluate the feasibility and safety of the innovative remote tele-surgical robotic platforms in performing radical prostatectomy.

Methods

The study comprised 13 patients diagnosed with prostate cancer who underwent remote radical prostatectomy using a 5 G wireless network and the innovative remote robotic systems (Tele-RARP). Additionally, the research involved 31 patients who underwent radical prostatectomy with the local Toumai robotic system (TM-RARP) between October 2022 and April 2024, and 36 patients who underwent radical prostatectomy with the da Vinci Xi platform (Xi-RARP) during the same period under the supervision of the same surgical team. Data on demographics, perioperative factors, clinicopathologic information, and postoperative results were collected for a total of 80 patients.

Results

The completion of 13 Tele-RARP procedures was successful without significant intraoperative or postoperative issues. No instances of intraoperative blood transfusion or surgical conversion were reported. The operation, console, and docking time for both the remote and local surgeries showed minimal differences. Neither local nor remote surgery nor da Vinci Xi surgery exhibited significant variations in terms of blood loss, intraoperative complications, or postoperative prognosis. Both TM-RARP and Tele-RARP presented very manageable task loads.

Conclusions

Performing tele-surgical robotic-assisted radical prostatectomy using the innovative Toumai and Edge robotic surgical systems via a 5 G wireless network is not only feasible but also safe.

Registration number

ChiCTR2400085386, ChiCTR2300077721

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Fig. 1: The Toumai robotic surgical system.
Fig. 2: The tele-surgical Toumai robotic surgical system by 5 G connection.
Fig. 3: Surgical technique of remote radical prostatectomy using the Toumai robotic surgical system connected with 5 G wireless network.

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Data availability

The data sets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. All the people shown in the photographs published here consented to the taking and use of these images.

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Funding

This work was supported by the National Natural Science Foundation of China (82303143 to DP), Zhejiang Provincial Natural Science Foundation (LQ23H160027 to DP), and Science and Technology Department of Zhejiang Province (2024C03198).

Author information

Author notes

  1. These authors contributed equally: Sunyi Ye, Ding Peng, Lixian Zhu.

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China

    Sunyi Ye, Ding Peng, Yi Zhu, Anbang He, Taile Jing, Xiaolin Yao, Ping Wang, Shuo Wang & Dan Xia

  2. Department of Thyroid Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China

    Lixian Zhu

  3. Operating Room Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China

    Shilong Wei, Qianqian Zhao & Jieyin Chen

  4. Department of Urology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian Province, People’s Republic of China

    Yanle Ye, Jingshuang Cai, Jin Zhou & Zhiyang Huang

Authors
  1. Sunyi Ye
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Contributions

Conception and design: DX, SW, and ZYH. Data acquisition: SYY, DP, LXZ, YZ, YLY, JSC, and JZ. Data analysis and interpretation: LXZ, ABH, TLJ, XLY, SLW, QQZ, JYC, and PW. Drafting of the manuscript: SYY, DP, YZ, ABH, TLJ, XLY, SLW, QQZ, and JYC. Critical revision of the manuscript for important intellectual content: YLY, JSC, JZ, PW, DX, SW, and ZYH. Statistical analysis: SYY, DP, YZ, YLY, JSC, JZ, ABH, TLJ, XLY, SLW, QQZ, and JYC. Obtaining funding: DP. Administrative, technical, or material support: SYY, DX, SW, and ZYH. Supervision: PW, DX, SW, and ZYH. Other: None.

Corresponding authors

Correspondence to Zhiyang Huang, Shuo Wang or Dan Xia.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

This prospective clinical study was approved by the Ethics Committee of The First Affiliated Hospital School of Medicine Zhejiang University. All patients provided written informed consent, which included disclosure of surgical risks and explicit permission for the use of intraoperative images (including Fig. 3) in scientific publications. All methods adhered to the relevant guidelines and regulations, including the Declaration of Helsinki and its later amendments or comparable ethical standards.

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Ye, S., Peng, D., Zhu, L. et al. 5G-remote radical prostatectomy under novel robotic systems: a prospective comparative cohort study with local surgeries. Prostate Cancer Prostatic Dis (2025). https://doi.org/10.1038/s41391-025-01004-4

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