International Telepresence-Assisted Robotic Colorectal Surgery Using the da Vinci 5 System: A Technology Paper on Cross-Border Remote Mentoring.

BACKGROUND

Telepresence enables real-time observation and remote mentoring across distances, potentially accelerating the dissemination of advanced minimally invasive techniques. The da Vinci 5 platform integrates Telepresence within the My Intuitive digital ecosystem, facilitating remote case observation, collaboration, and mentoring.

METHODS

This technology paper reports an international telepresence session in which an expert colorectal robotic surgeon located in Daegu, Republic of Korea, provided real-time remote mentoring during a robot-assisted colorectal procedure performed in Saitama, Japan. A representative clinical implementation involved a patient with rectosigmoid cancer (clinical stage T1bN0M0) and obesity (BMI 30.1 kg/m2). The telepresence-mentored segment focused on the most technically demanding phase: peritoneal incision, dissection around the superior rectal artery (SRA), and vascular handling.

RESULTS

The mentored phase lasted 40 min. During this segment, the remote mentor provided step-by-step guidance on exposure strategy, traction direction, and plane selection. Additionally, console-integrated objective force visualization ("Force Gauge") was used as a shared reference to optimize retraction. The operation was completed without intraoperative complications (operative time: 214 min; estimated blood loss: 5 mL).

CONCLUSION

These findings demonstrate the feasibility of cross-border telepresence mentoring on the da Vinci 5 platform. Coupling remote mentoring with objective intraoperative force feedback may improve shared situational awareness and support safe decision-making during complex robotic colorectal surgery.