The role of robotic telesurgery and telementoring in low- and middle-income countries

Abstract

Robotic surgery alone will not close the surgical gap in low- and middle-income countries. Telesurgery, in which a remote expert directly controls instruments on a local robotic platform, is technically possible but expensive, bandwidth heavy, and does little to strengthen local capacity. In contrast, telementoring uses relatively simple video and audio links to allow experienced surgeons to supervise and guide on site teams, supporting skill acquisition and autonomy using low cost, low bandwidth infrastructure that is already widely available. Its use is expanding across urology, gynaecology, thoracic, cardiac, head and neck, and general surgery. By enhancing accuracy, field of vision and ergonomics for locally based surgeons, and by raising minimally invasive rates beyond those achievable with laparoscopy alone, robotics combined with telementoring offers a more sustainable route to improving access to safe surgery than remote robotic operating.