The Current Status and Limitations of Robotic Telesurgery in India

Robotic telesurgery, or remote robotic-assisted surgery, combines surgical robotics with high-speed telecommunications, allowing surgeons to operate on patients from distant locations. A typical setup includes a master console, patient-side robotic arms, and a high-bandwidth, ultra-low-latency link for transmitting stereoscopic video, audio, and control inputs. This enables surgical precision comparable to in-person procedures while expanding access to specialized expertise across geographical boundaries.

The concept gained global attention in 2001 with Operation Lindbergh—a transatlantic laparoscopic cholecystectomy between New York and Strasbourg, which achieved a latency of 155 ms. Since then, platforms such as the da Vinci® and ROSA® systems have incorporated motion scaling, tremor filtration, enhanced articulation, and immersive visualization. Recent advances—such as 5G URLLC, edge computing, and H.265 compression—have reduced experimental latency to under 50 ms, approaching the seamless threshold for hand–eye coordination.

Clinical applications span urology, general surgery, neurosurgery, and orthopedics, with potential benefits in rural healthcare, disaster response, military medicine, and inter-hospital collaboration without the need for patient transfer.

Recent Milestones

In June 2025, Dr. Vipul Patel’s team at the Global Robotic Institute, Orlando, performed a robotic-assisted radical prostatectomy (RARP) on a patient in Angola while operating from Florida via a fiber-optic link using the advanced MedBot robotic platform from MicroPort MedBot. This U.S. FDA–approved clinical trial marked a landmark in transcontinental telesurgery.

India has also made significant progress with the SSI Mantra, its first indigenously developed telesurgical robot, certified by the CDSCO. In 2024, it completed India’s first human telesurgical trial—a robotic cholecystectomy performed between two sites 5 km apart with no perceptible delay. The Rajiv Gandhi Cancer Institute has since conducted telesurgeries including nephrectomy, cystectomy, and hysterectomy under the leadership of Dr. Sudhir K. Rawal. In the public sector, Dr. Raj Gajbhiye performed India’s first government-funded telesurgery in 2025—from Gurugram to GMCH Nagpur, over 1,000 km—successfully completing a hernia repair and cholecystectomy.

Challenges and Limitations

Despite these advances, several key challenges persist:

• Latency and Network Stability – Surgical safety demands ≤200 ms end-to-end delay, with minimal jitter and packet loss.

• Lack of Haptic Feedback – Current systems rely primarily on visual cues; research into force-reflective and tactile feedback is ongoing.

• Infrastructure Requirements – Symmetric gigabit internet, redundant power, secure VPNs, and specialized maintenance remain costly in resource-limited regions.

• Regulatory and Medicolegal Barriers – Cross-border procedures raise complex issues of licensure, jurisdiction, liability, and compliance with privacy laws (HIPAA, GDPR).

• Cybersecurity Risks – Strong encryption, multi-factor authentication, and real-time intrusion monitoring are essential to ensure patient safety and data security.

Conclusion

Robotic telesurgery is transitioning from an experimental concept to early clinical integration. With continued progress in latency reduction, haptic technology, network reliability, and international regulatory frameworks, it holds the potential to democratize access to advanced surgical care and bridge the urban–rural healthcare divide.