"5G wireless + wired network"-based multi-console robotic telesurgery: adaptability to complex surgical procedures and diverse network infrastructures-a case report.

Background: Robotic telesurgery enables patients at local hospitals to receive treatment from specialists at distant medical centers, while also facilitating intraoperative multidisciplinary collaboration. Stable and reliable network access is a critical prerequisite for telesurgery. Both traditional wired networks and 5G wireless networks have inherent limitations. This study reports a multi-console robotic telesurgery integrating existing wired networks with 5G technology, aiming to fully exploit the clinical potential of robotic systems in telesurgical settings. Case Description: A 62-year-old female was admitted to Liaoyang City Central Hospital following the detection of a left renal tumor 8 days prior. Abdominopelvic contrast-enhanced computed tomography (CT) revealed a 5.4 cm × 4.6 cm mass in the middle-lower segment of the left kidney, consistent with renal cell carcinoma. Physical examination findings were unremarkable. Robot-assisted remote radical nephrectomy was performed using the domestic Kangduo KD-SR-01 system: the patient cart and one console were positioned in Liaoyang, while two consoles and imaging platforms were located in Peking Union Medical College Hospital in Beijing, approximately 700 km away. The surgery utilized a public 5G wireless network (China Mobile) and 5G customer premise equipment (CPE), which transmitted signals from the consoles and patient cart to the base station, with subsequent relaying to the target destination via the 5G core network. Distributed base stations were deployed to optimize signal quality, reduce latency, and enhance signal stability. The User Datagram Protocol (UDP) was employed for real-time monitoring of latency and packet loss rate. In the event of significant latency or other network abnormalities, the telesurgery was designed to switch to bedside surgery immediately. Three surgeons (two in Beijing, one in Liaoyang) transferred the robotic control authority intraoperatively as clinically required. Stable transmission of 3D surgical video and console control signals was achieved. The surgery was performed successfully without complications. The patient was discharged on postoperative day 4. Conclusions: The "5G wireless + wired network" model applied in this case effectively integrates the advantages of both network types and offers a feasible solution for complex telesurgeries, especially in settings with variable network infrastructure. The multi-console robotic system based on this integrated network model enhances surgical safety and provides technical support for the performance of complex telesurgeries.