Enhancing telesurgical safety with predictive digital twin synchronization: a framework for latency compensation in robotic surgery

This study addresses the critical challenge of master-slave latency in robot-assisted telesurgery by introducing a Digital Twin Visual Assistance (DTVA) system. DTVA integrates parametric 3D modeling and virtual endoscopic visualization within a tri-layered architecture to enable real-time bidirectional synchronization. The system was evaluated on a geographically distributed robotic platform using programmable latency emulation. Results demonstrated that DTVA maintained spatial precision within 2 mm error under typical conditions and reduced peg-transfer completion time by 13.6% under 900 ms communication latency while lowering operator workload by 27.2%. Clinical validation through teleoperated radical nephrectomy under 300 ms communication latency confirmed feasibility, with all procedures completed successfully without complications and favorable perioperative outcomes. The study establishes DTVA's capacity to mitigate latency effects and demonstrates preliminary clinical feasibility for telesurgical procedures.