Feasibility and safety evaluation of remote robotic surgery under high latency conditions based on satellite communication

Objective: To verify the feasibility of geostationary orbit satellite communication in ultra-remote robotic surgery and to construct a remote surgical operation control technology system under high-latency communication conditions. Methods: A large time-delay control method was proposed, including the establishment of the Stability Operation Criteria for Large Time-Delay Remote Robotic Surgery and Generalized-Order Compliant Interaction Control Method. On December 26, 2024, a transregional communication link between Lhasa and Beijing was established via the Asia-Pacific 6D high-throughput satellite (orbital altitude of 36,000 ​km), and two hepatectomies for liver cancer were performed using the Tumai surgical robot system. Core parameters such as end-to-end latency and data packet loss rate were monitored. Results: The Lhasa-Beijing link established through the Asia-Pacific 6D satellite achieved an average end-to-end latency of 632 ​ms (measured uplink 4.2 Mbps/downlink 3 Mbps), with intraoperative robotic arm pose tracking error <0.5 ​mm (n ​= ​2). Both hepatectomies for liver cancer were successfully completed, with surgery durations of 115–124 ​min, blood loss of 20 ​mL, and patients discharged within 24 ​h post-surgery without severe complications (Clavien-Dindo I level). Conclusion: This study is the first to confirm the safety of geostationary orbit satellite support for human surgery and verifies the feasibility of surgical operation control technology under high-latency conditions.