Feasibility and preliminary safety of urologic telesurgery using Chinese surgical systems: a single-center exploratory case series

PURPOSE: Telesurgery offers a solution to the uneven distribution of surgical resources by enabling telesurgery through surgical robotic systems. This study aimed to describe the technical feasibility and preliminary short-term safety of urologic telesurgery using Chinese surgical systems (CSS). METHODS: This single-center exploratory descriptive case series evaluated urologic telesurgery using CSS between January 2023 and October 2025. A total of 6 consecutive eligible telesurgeries were included: 3 robot-assisted radical prostatectomies (RARP) and 1 robot-assisted partial nephrectomy (RAPN) were performed with the Edge MP1000 (MP1000) system, and 1 RAPN and 1 robot-assisted radical cystectomy (RARC) were performed with the KangDuo SR-2000 (KD-SR-2000) system. Six locally performed RARP cases using the da Vinci Xi (DV-Xi) system during the same study period were retrospectively collected as a limited contextual reference for the RARP subgroup. The primary outcome was technical success, defined as completion without conversion. Secondary descriptive outcomes included perioperative safety events, 30-day Clavien-Dindo complications (CDC), network performance, and, in the RARP subgroup, positive surgical margin (PSM) rate, estimated blood loss (EBL), operative time, suture-per-stitch time, and 4-week urinary continence recovery after catheter removal. RESULTS: All six telesurgeries were completed without intraoperative conversion or major complications. In the RARP subgroup, remote MP1000 procedures were summarized alongside locally performed DV-Xi procedures as a limited contextual reference. PSM rate and early urinary continence recovery showed no obvious unfavorable signal in this small contextual cohort, whereas operative time and suture-per-stitch time were longer, and EBL was numerically higher, in remote procedures. Mean Network round-trip latency for telesurgery ranged from 6.13 ± 0.71 ms (Harbin-Harbin, 2 km) to 54.12 ± 0.58 ms (Harbin-Hangzhou, 2200 km), with no frame loss. CONCLUSION: In this small selected case series, urologic telesurgery using CSS was technically feasible and preliminary safety under stable telecommunication conditions.