Safety and feasibility of robotic telesurgery in urological procedures: a systematic review and meta-analysis of clinical data.

Robotic telesurgery has emerged as a potential solution to expand access to specialized surgical care; however, clinical evidence remains fragmented across procedures and robotic platforms. We conducted this meta-analysis to assess the feasibility and safety of robotic telesurgery across urological procedures. An electronic search was conducted on PubMed, Scopus, Web of Science (WoS) and the Cochrane Library from inception through April 2026 according to PRISMA guidelines. Clinical studies reporting robotic telesurgery in urology were included regardless of study design. The primary outcome of interest was procedural success, defined as completion without conversion to a local surgeon or an alternative surgical approach. Secondary outcomes included complication rates and round-trip latency (RTL). Nineteen studies involving 164 patients were included. The pooled procedural success rate was 0.92 (95% CI: 0.86-0.96). No conversions to open or laparoscopic surgery were reported across the included studies. The pooled complication rate was 0.12 (95% CI: 0.07-0.20), with events occurring in a limited number of studies. RTL data were available from 14 studies, with a pooled mean latency of 123.30 milliseconds (ms) (95% CI: 81.76-164.83) demonstrating substantial heterogeneity (I² = 99.99%). Robotic telesurgery in urology demonstrates excellent technical feasibility and a favorable short-term safety profile in carefully selected cases. However, variability in network performance and procedure-specific requirements remain important considerations. Further prospective studies with standardized reporting and long-term outcome assessment are needed before widespread clinical adoption can be recommended.