ReviewInternational journal of clinical oncology2025
Toward safe clinical deployment of remote robotic surgery in Japan: five-year validation of the hinotori™ system using 5G wireless communication.
Review in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Remote robot-assisted renal surgery: a systematic review and single-arm meta-analysis of real-world evidence.Journal of robotic surgery · 2026Pooled it
- Entry Point Localisation for Percutaneous Surgical Robots Based on Concentric Fiducial Patches and Robust Surface Fitting.The international journal of medical robotics + computer assisted surgery : MRCAS · 2026Article
- Fundamental kinematic indicators predict surgical expertise and clinical outcomes in robot-assisted surgery.NPJ digital medicine · 2026Article
- Effects of Modifying Hinotori Surgical Robot System on the Learning Curve of Robot-Assisted Radical Prostatectomy.International journal of urology : official journal of the Japanese Urological Association · 2026Article
- System-level evaluation of 5G standalone communication infrastructure for robotic telesurgery.International journal of computer assisted radiology and surgery · 2026Article
- Clinical application of robotic telesurgery in the Brazilian public health system: a consecutive case series.Clinics (Sao Paulo, Brazil) · 2026Article
- Hinotori vs. da Vinci: a multi-institutional study on robot-assisted radical prostatectomy outcomes.Journal of robotic surgery · 2026Article
- Feasibility of robotic telesurgery over wired and private 5 G networks within Brazil's public health system (SUS): a pilot study.Clinics (Sao Paulo, Brazil) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Remote robotic-assisted surgery (RRAS), a form of telesurgery, offers a potential solution to Japan's surgeon shortage and regional disparities in care. Despite advances in robotic systems and modern communication technologies, including both 5G wireless and wired networks, clinical adoption remains limited due to regulatory, infrastructural, and institutional barriers. This review consolidates five years (2020-2025) of technical and operational validation of the hinotori™ Surgical Robot System-a domestically developed platform-in alignment with the 2022 Japanese Remote Surgery Guidelines. Based on over 30 remote-session evaluations by Kobe University, Medicaroid, and NTT DOCOMO, we summarize system performance across key domains: communication latency, QoS-based prioritization, VPN redundancy, fail-safe mechanisms, electromagnetic compatibility, human-system interaction, and legal compliance. Under optimized Sub6 5G SA conditions, the system consistently achieved a round-trip latency of approximately 100 ms and stable stereoscopic video transmission, even during simulated 1 Gbps congestion. Safety was ensured through automatic standby, dual-cockpit fallback, and real-time monitoring. Although hinotori™ meets technical and safety criteria, full-scale implementation remains constrained by legal requirements-particularly the mandate for an on-site physician under Article 20 of the Medical Practitioners Act. Supervised telesurgery, where remote surgeons assist on-site teams, is legally permissible and may serve as a transitional model. This review integrates technical findings with policy considerations, proposing a path toward safe, equitable, and sustainable RRAS deployment in Japan. To our knowledge, this is the first comprehensive review aligning domestic telesurgical validation with national policy benchmarks, offering a foundation for future regulation, accreditation, and digital surgical integration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.