Remote Telesurgery Versus Local Minimally Invasive Surgery: A Systematic Review of the Comparative Evidence Base.

BACKGROUND

Remote telesurgery allows surgeons to operate over a distance using robotic systems and advanced networks. This review aims to compare remote telesurgery with local minimally invasive surgery (MIS) regarding patient outcomes and system-level outcomes.

METHODS

A PRISMA-compliant systematic review (PROSPERO CRD42023474196) searched six databases to 1 August 2025 for studies comparing remote telesurgery with local MIS in living patients.

RESULTS

Among 5737 records, one retrospective cohort met the criteria. It compared 5G-enabled remote robotic pelvic fracture surgery (n = 80) with local robotic surgery (n = 80). Remote procedures had lower blood loss (20 vs. 50 mL) and shorter incisions (1.25 vs. 1.5 cm). Operative time did not significantly differ between groups (p = 0.177), and complications, hospital stay, and functional outcomes were similar.

CONCLUSIONS

Comparative data on telesurgery remain limited, and healthcare system benefits are unproven. Future studies should incorporate direct comparisons and systematically evaluate system-level outcomes.