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5G ultra-remote robot-assisted laparoscopic surgery in China



5G communication technology has been applied to several fields in telemedicine, but its effectiveness, safety, and stability in remote laparoscopic telesurgery have not been established. Here, we conducted four ultra-remote laparoscopic surgeries on a swine model under the 5G network. The aim of the study was to investigate the effectiveness, safety, and stability of the 5G network in remote laparoscopic telesurgery.


Four ultra-remote laparoscopic surgeries (network communication distance of nearly 3000 km), including left nephrectomy, partial hepatectomy, cholecystectomy, and cystectomy, were performed on a swine model with a 5G wireless network connection using a domestically produced “MicroHand” surgical robot. The average network delay, operative time, blood loss, and intraoperative complications were recorded.


Four laparoscopic telesurgeries were safely performed through a 5G network, with an average network delay of 264 ms (including a mean round-trip transporting delay of 114 ms and a 1.20% data packet loss ratio). The total operation time was 2 h. The total blood loss was 25 ml, and no complications occurred during the procedures.


Ultra-remote laparoscopic surgery can be performed safely and smoothly with 5G wireless network connection using domestically produced equipment. More importantly, our model can provide insights for promoting the future development of telesurgery, especially in areas where Internet cables are difficult to lay or cannot be laid.

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This work was supported by National Natural Science Foundation of China (81772713, 81972378, 81981260351, 81472411), Qingdao People's Life Science and Technology Project (18-6-1-64-nsh), Major Scientific and Technological Innovation Project of Shandong Province (2019JZZY021002).

Author information




HN designed the research; HN and WG performed the telesurgeries; XY, LL, WJ, ZY, MZ, FX, YJ, BL, and XH assisted the telesurgeries; LZ, ZY, and CW analyzed the data; JZ, YW, and JZ wrote the manuscript; QD, ZL, and HN edited the manuscript; all authors reviewed and approved the manuscript.

Corresponding author

Correspondence to Haitao Niu.

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Jilu Zheng, Yonghua Wang, Jian Zhang, Weidong Guo, Xuecheng Yang, Lei Luo, Wei Jiao, Xiao Hu, Zongyi Yu, Chen Wang, Ling Zhu, Ziyi Yang, Mingxin Zhang, Fei Xie, Yuefeng Jia, Bin Li, Zhiqiang Li, Qian Dong, and Haitao Niu declare that they have no conflicts of interest or financial ties to disclose.

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Zheng, J., Wang, Y., Zhang, J. et al. 5G ultra-remote robot-assisted laparoscopic surgery in China. Surg Endosc 34, 5172–5180 (2020).

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  • 5G network
  • Telesurgery
  • Robot
  • Computer assisted surgery
  • Network delay