Safety and feasibility of robot-assisted remote radical gastrectomy for gastric cancer based on 5G communication technology (FUTURE-04): a prospective, single-arm clinical trial.

BACKGROUND

Telesurgery is gaining traction across surgical specialties. However, its use in radical gastrectomy for gastric cancer remains limited. This study evaluated the safety and feasibility of fifth-generation (5G) robot-assisted remote radical gastrectomy using the Toumai Endoscopic Surgery Robotic System.

METHODS

In this prospective single-center single-arm clinical study, eligible patients underwent 5G remote radical gastrectomy over a distance of 15 km. The primary outcome was the incidence of intraoperative and postoperative complications. Secondary outcomes included surgical completion rate, operative duration, estimated blood loss, number of lymph nodes dissected, time to first flatus and diet, and hospital stay.

RESULTS

Twenty-seven patients were enrolled between September and December 2023. All surgeries were completed successfully, with no conversion and a 100% R0 resection rate. No intraoperative complications occurred. Postoperative complications occurred in 18.5% of patients, with no Clavien-Dindo grade ≥ III. The mean operative time was 192.6 ± 34.8 min, and mean blood loss was 35.9 ± 15.9 mL. Lymph nodes were dissected at an average of 38.4 ± 13.2 lymph nodes. Median time to first flatus and oral intake was 2.0 days, to liquid diet was 4.0 days, and hospital stay was 7.0 days. The 5G network was highly stable, with total delay of 226.2 ± 4.4 ms, round-trip delay of 31.6 ± 3.8 ms, and packet loss < 0.1%.

CONCLUSIONS

The 5G robot-assisted remote radical gastrectomy using the Toumai system is safe and feasible for selected patients with gastric cancer. The integration of 5G and robotics may offer a promising telemedicine approach to surgical oncology.