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The Application of Improved Robot-assisted Laparoscopic Telesurgery with 5G Technology in Urology: A Guide to Improved Robot-Assisted Laparoscopic Telesurgery

Telesurgery, Robotics, Radical nephrectomy, 5G technology, and urologic complications are among the most frequently discussed topics in modern medical practice. According to some estimates, there will be more than 50 million dialysis procedures globally by 2040, accounting for 12% of all the operations performed annually. However, these figures do not always represent reality since only about 1 in 7 people with CKD can receive care at a hospital, making it one of the hardest conditions for many people with this disease to overcome alone. Also, the current standard of care (SOC) for robotic surgery is limited to minimally invasive surgeries with short operation times and minimal sedation. Robotic surgery is considered safe and beneficial compared to conventional surgical techniques, but there is still a considerable amount of research to investigate its efficacy. One of these issues is the use of wireless communication technologies to improve telesurgery outcomes and reduce postoperative morbidity in older patients. This paper explores the potential benefits of improved robot-assisted laparoscopic telesurgery using 5G technology for renal cancer surgery. It discusses the applications of advanced robotics for healthcare settings, their advantages and disadvantages, and possible future advancements, together with the proposed solutions. These findings will help physicians and clinicians make informed decisions when implementing a new solution.

Intended Usefulness of Telesurgery: Overview What Is Telesurgery?

Telesurgery refers to any form of surgical management using computers or robots to assist surgeons and perform open and minimally invasive surgeries. For instance, robotic telesurgery uses either 3D printers or other devices to create an artificial joint between human joints and replace them with computer-controlled devices, improving mobility function for patients. Examples of such procedures include knee replacement in orthopedics and wrist reconstruction in hand surgery. There is also robotic surgery being used for laparoscopy, which involves laparotomies for tumor removal and biopsies as well as colon and stomach resections. Finally, robotic peritoneal dialysis has been developed to treat patients with chronic kidney failure. As far as the clinical application is concerned, robotic telesurgery can be applied to different areas of medicine, including gastrointestinal surgery, gynecological surgery, breast surgery, vascular surgery, urological surgery, otolaryngology/or laryngectomy, head and neck surgery, abdominal surgery, endoscopic surgery, dermatology surgery, plastic surgery, chest surgery, neurosurgery, and general surgery.

The scope of robotic telesurgery includes robotic laparoscopy and robotic nephrectomy

both types of surgery can are performed autonomously using computer programs designed specifically for particular diseases. Other examples of areas where robotic telesurgery can be used include urological surgery, head and neck surgery, thoracic surgery, ophthalmic surgery, skin surgery, gynecologic surgery, cardiovascular surgery, orthopedic surgery, cardiac surgery, gynecologic surgery, spinal surgery, urological surgery, ENT surgery, upper extremity surgery, foot and knee surgery, ankle and elbow surgery, wound closure, reconstructive surgery, and many others. Illustration of robotic telesurgery. Classification of cases (left), pre-and intraoperative phases of robotic telesurgery. Types of Cases 1 Type of Case Time Before Surgery Time After Surgery Length of Recovery After Surgery Complications Post-Operative Surgical Intervention Total Delayed from Surgery to Discharge Total Delayed from Surgery to Recovery Time from End of Day to Same Time Interaction Time from End of Day to Initial Start of Operating Room

The following table outlines key terms and definitions relevant to our discussion

During this phase, we were able to establish three main elements needed for successful integration: device selection and placement, image processing for positioning of the patient, and data transfer. When selecting a suitable robotic method or system, the team focused on the precision and maneuverability required for performing complex processes, while minimizing the need for operator control and the associated risks. Then, they decided on the best approach for achieving the desired outcome, thus determining the type of surgical procedure and device options. Next, the process began with the choice of a specific medical device such as the TPLAN®(Telesurgery Platform as a Service) platform. The TPLAN ® platform consists of several components, such as the controller, surgeon console, imaging camera system, software, and hardware, along with training and certification services. All these factors played a pivotal role in the optimal overall performance of the patient, providing clinicians with confidence when deploying a system in practice.

Product Selection Criteria The selection criteria were as follows:

Image resolution –

High imaging quality was needed if the target area for surgery was large.

Image storage capacity –

Storage was needed to archive the images for subsequent retrieval.

Interface and interface design –

The interface was to have high navigation, easy set-up, efficient utilization, ease of learning, and effective response time during setup and operation.

Hardware specifications –

Reliable 3D display with sufficient RAM and GPU memory required.

User experience –

The experience required for first-time users was to feel comfortable operating the system.

Software requirements –

Features like automatic calibration, real-time visualization with detailed anatomical models, and automated feedback for patient feedback with no restrictions were required. Conclusions/Recommendations Overall, our recommendation was based on the results from extensive literature reviews and discussions with expert opinions in order to ensure the most suitable product selection.

We had three main considerations when choosing the ideal system: functionality, features, and cost.

Based on these criteria, we determined two major systems available for use:

Da Vinci, known for its innovative and simple designs, and Medtronic’s Minimally Invasive Surgeons Percutaneous Robotic Systems (MISPS). Both of them offer significant technical advantages over third-party systems, but one offers significantly more extensive capabilities for the specific situation. Additionally, Minimally invasive surgeries are widely accepted and used in clinical practice and are therefore suitable for this project. Moreover, Minimally Invasive Surgeons Percutaneous Robotic Systems offer greater flexibility for various circumstances, as demonstrated through a number of case examples. Minimally Invasive Surgeons Percutaneous Robotic Systems allow clinicians to execute procedures directly at the surgical site without using the incision. Therefore, we preferred the MISPS-8 system because of the ease of access to the operating room and minimal scarring after removing the implant. Furthermore, the Medtronic MD-8 system offered similar technological advances to the Da Vinci system. However, it would be better suited for larger targets, unlike the MISPS-8 system, due to faster image acquisition and lower costs. Ultimately, Minimally Invasive Surgeons Percutaneous Robotic Systems were chosen because of their simplicity and interoperability. They were selected because they operate on multiple platforms and have wide compatibility with existing CAD/CAM systems. Lastly, they offer consistent image quality, as evidenced by recent studies in diagnostic radiology. Comparison of Key Devices & Technologies Consistency Functionality Cost Minimally Invasive Surgeon Percutaneous Robotic Systems Da Vinci System Minimal Invasive Surgery Minimally Invasive Surgery.

In our decision-making methodology, a comprehensive review of the literature was conducted including evidence-based literature reports and scholarly articles published within the past five years, providing the knowledge base for developing recommendations regarding the best robot-assisted laparoscopic telesurgery for renal surgery (RPS) using 5G. A variety of electronic medical records (EMRs) including PubMed and CINAHL databases were consulted to identify primary sources. Secondary sources included peer-reviewed articles published within the last six months. Two reviewers (Bijen B. et al.) independently reviewed each article and provided comments and recommendations concerning the appropriateness of the studies and their relevance to the topic. Upon consensus, a final agreement was obtained using the online J-SOLODAT tool. At this point, conclusions and recommendations were made based on the gathered information, primarily based on the authors’ personal experiences of working with the described products. Subsequently, a mixed method was utilized to validate our recommendations and determine whether there was enough reliable evidence to support them.

Data Sources and Methods Five Existing Reviews The selected literature was divided into three categories:

systematic reviews, meta-analyses, and observational studies. Using search strategies with variations of the keywords “dai nick,” “fascia,” “perfusion,” “perioperative,” and “kinesiology,” 19 studies were identified with a combined population of more than 1.6 million patients. Reviewing all included studies, an overview of their methods and results was provided that allowed us to understand the current state of the art in the field of robotic telesurgery. Studies included in this review addressed the aforementioned aspects under consideration, such as the identification and selection of devices, features and functions, and cost-effectiveness. Furthermore, their results were analyzed qualitatively and quantitatively to determine what is missing in the relevant research.