Singapore and Japan have joined forces in a pioneering telesurgery trial spanning over 5,000 kilometers. This preclinical surgery trial involves clinician-scientists from the National University of Singapore’s (NUS) Yong Loo Lin School of Medicine and the National University Hospital (NUH), in partnership with Fujita Health University (FHU) in Japan.
In a demonstration of medical technology, robotic arms in an operating room in Nagoya, Japan, are performing a complex laparoscopic surgical procedure with astonishing precision. However, what sets this scenario apart is that the surgical team in Nagoya is not in control of these robotic arms. Instead, surgeons located over 5,000 kilometers away at Singapore’s National University Hospital, affiliated with NUS Medicine, are orchestrating the robotic arms remotely.
This collaboration represents a fusion of technology and medical expertise, as clinician-scientists from both Singapore and Japan venture into the realm of robotic telesurgery, utilizing recent advancements in advanced surgical robots and network telecommunication technology.
The trial, which took place from 9 to 11 October 2023, leveraged Japan’s first surgical robot. Clinician-scientists from NUH and NUS Medicine remotely performed a gastrectomy (a stomach surgery performed for cancer) from a surgeon cockpit in Singapore. The surgeons’ movements were transmitted, directed, and replicated by a robotic operation unit located in Japan, all facilitated by a dedicated international fiber-optic network. The surgery was conducted on a simulated organ.
This collaboration follows a Memorandum of Understanding (MOU) signed in August 2023 between NUS Medicine and FHU, a prominent Japanese university known for its strong research focus on robotic surgery and telesurgery. The MOU aims to strengthen academic partnerships through collaborative projects, including remote surgical experiments, as well as student exchange programs.
The two leading gastric surgeons in Singapore, Professor Jimmy So from the Department of Surgery at NUS Medicine and Senior Consultant in the Department of Surgery at NUH, along with Assistant Professor Kim Guowei from the Department of Surgery at NUS Medicine and Consultant in the Department of Surgery at NUH, were at the forefront of the demonstration. In Japan, the surgical team was led by Professor Ichiro Uyama and Professor Koichi Suda from Fujita Health University.
This project aims to assess, clarify, and address potential challenges associated with remote surgeries. The preclinical trial includes a series of complex gastrectomy procedures conducted by both teams, with the objective of demonstrating that long-distance robotic telesurgery for technically demanding procedures can be safely conducted using a robotic system connected by high-speed fiber-optic communication.
While robotic surgery is not a new concept in Singapore, this collaboration represents a significant step toward making remote surgeries a viable option for patients in the near future. Professor Jimmy So, who led the surgical team in Singapore, emphasized, “Remote telesurgery offers immense potential to enhance global access to specialized care, reduce travel and wait times for patients, minimize health risks during emergencies and pandemics, and foster training and collaboration among medical professionals worldwide. It also contributes to improved surgical expertise for complex cases, particularly benefiting underserved areas.”
During public health crises, such as global pandemics, remote telesurgery can help minimize the risk of disease transmission between patients, healthcare workers, and surgical teams, as surgeons can perform procedures from a safe location, reducing the potential for infection spread. Additionally, telesurgery promotes tele-mentoring and distance learning in medical education, allowing medical students and young doctors to learn surgical techniques and skills from instructors and medical experts worldwide, regardless of their location.
Assistant Professor Kim Guowei added, “In partnering with our Japanese colleagues, we hope to advance and unlock the potential of telesurgery for patients and doctors alike. This continuous exchange of knowledge, advanced surgical techniques, and best practices across borders contributes to improving surgical expertise and outcomes.”