An Australian surgeon has performed a remote robotic surgery demonstration in China without leaving Sydney, showcasing technology that could one day help regional patients access specialist cancer surgery closer to home.
Assoc. Prof. Ruban Thanigasalam used a console at Sydney’s Chris O’Brien Lifehouse to control a Toumai surgical robot in Shanghai, guiding its instruments as they cut and stitched a demonstration kidney. No patient was involved in the Australian-first demonstration.
“This is groundbreaking surgery,” Thanigasalam told 7NEWS.
“Australia is such a large country and there are many cities and communities that don’t have access to highly trained robotic surgeons.”
He said remote surgery could help bridge that gap, potentially allowing patients to undergo procedures in their home towns rather than travelling to major cities for specialist care.
“Often patients are moving to Sydney to have their operations, but this enables them to stay in their home town and us to potentially operate on them.”
For regional families, the technology could mean fewer long-distance trips, less time away from home and better access to specialist expertise.
The demonstration relied on a network connection that allowed the surgeon in Sydney to control robotic instruments thousands of kilometres away.
Thanigasalam said the team used a 5G network and checked the connection before operating, with a backup connection also available.
“The latency has to be less than 50 milliseconds ideally” to avoid noticing a difference in response speed, he said before the demonstration.
However, the reported latency during the session was 150 milliseconds. Despite this, Thanigasalam said the demonstration went better than expected.
“We were able to operate the robot from Shanghai from here in Sydney which is a distance of 7,500km,” he said.
“I was pleasantly surprised and I’m looking forward to testing this technology further.”
The results demonstrate the system’s potential, but further testing and clinical assessment would be needed before remote surgery could be offered routinely to Australian patients.
The Toumai system has been used in overseas procedures involving patients, including a prostate cancer operation controlled remotely from London while the patient was in Gibraltar, Thanigasalam said.
In Australia, however, hospitals must complete further governance, medico-legal and indemnity checks before introducing the technology into clinical practice.
“We’ve got approval to use the robot, but we have to go through internal governance,” he said, adding that several steps remained before patient procedures could begin.
A second medical team would also need to be present beside the patient, ready to intervene if necessary.
Thanigasalam said he hoped the technology could become available in Australia within the next six months, although its introduction would depend on the required approvals, hospital preparations and funding.
Deploying remote surgical systems across regional hospitals would also require investment in trained staff and reliable network infrastructure.
Beyond performing operations remotely, the technology could help experienced specialists mentor and train surgeons at other hospitals.
“This is a fantastic piece of technology,” Thanigasalam said, highlighting its potential for remote supervision, teaching and professional development.
Thanigasalam is an Associate Professor of Robotic Surgery at the University of Sydney and a urology clinical research lead investigator at the Institute of Academic Surgery at Royal Prince Alfred Hospital.
His research focuses on minimally invasive and robotic surgery for urological cancers. He also co-chairs a postgraduate robotic surgery fellowship training programme involving Concord Hospital, Royal Prince Alfred Hospital and Chris O’Brien Lifehouse.
He has helped train Australian registrars and international surgeons from countries including the Netherlands, France and Ireland. He is also chief co-convener of the Sydney Robotic Summit, a major multidisciplinary robotic surgery conference held every two years.
After completing his medical degree at St George’s Hospital, University of London, Thanigasalam undertook specialist urological training in New South Wales and a two-year fellowship in robotic urological surgery in Paris before returning to Sydney.
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