Evaluating the Toumai MT‑1000 for urologic surgery: a systematic review and single-arm meta-analysis with remote and on-site experiences.

backgroundThe Toumai MT‑1000 is a next-generation robotic surgical system independently developed in China, equipped with telerobotic functionality via 5G and fiberoptic networks. Although early studies have confirmed its feasibility in various urologic procedures, a systematic evaluation of its perioperative performance, safety, and early oncological outcomes-particularly in remote surgical contexts-has not yet been conducted.

methodsA systematic review and single-arm meta-analysis was conducted according to PRISMA guidelines. Five observational studies published between 2024 and 2025 were included, encompassing 105 patients undergoing procedures such as radical prostatectomy, partial nephrectomy, and nephroureterectomy. Pooled analyses of operative metrics, complication rates, renal function, and surgical margin status were performed. Subgroup analyses and heterogeneity assessments were conducted to identify sources of variability.

resultsThe Toumai system demonstrated acceptable operative times (RARP: 182.6 min; RAPN: 127.1 min) and low complication rates (1 Clavien-Dindo grade ≥ III event). No open conversions occurred, and blood transfusion was needed in only one case. Functional and oncological outcomes were favorable, with preserved renal function (eGFR: 96.02 mL/min/1.73 m²) and low positive surgical margin rates (RAPN: 0%; RARP: 5%). Remote surgeries across distances up to 2700 km were successfully completed with latency consistently below 70 ms. Experimental transcontinental animal studies achieved stable performance at 250 ms.

conclusionThe Toumai MT‑1000 robotic system appears to be a safe and effective platform for urologic surgery, offering promising applications in telesurgery and teleproctoring. Its cost-effectiveness and technical reliability suggest a strong potential for broader adoption, especially in resource-limited or geographically remote settings. Further controlled trials are needed to validate these findings and assess long-term outcomes.