Telesurgery: A Systematic Literature Review and Future Directions.

Abstract

To undertake a systematic review of the medical literature on telesurgery, with a key focus on identifying the key technical and nontechnical themes searched in medical articles and to analyze gaps in the current knowledge base on telesurgery. It has now been over 2 decades since the first successful case of telesurgery and since this time, there have been significant technological and telecommunications advancements. A systematic review of the literature was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Details of the protocol for this systematic review were registered on PROSPERO (CRD42024511530). In total, 102 unique references were allocated into 5 categories: technical, cybersecurity, ethical, financial, and regulatory considerations to discuss key themes. The vast majority of references were related to technical considerations, which have demonstrated the feasibility of telesurgery. The nontechnical considerations have a paucity of literature and a lack of guidance on telesurgery which appears to still be the major barriers to telesurgery. Telesurgery presents many interdisciplinary challenges, encompassing both important technical and nontechnical (such as cybersecurity, ethical, financial, and regulatory) considerations. Further research, collaboration between stakeholders, a collaborative community of experts, and the development of comprehensive consensus frameworks are essential steps toward the widespread adoption of telesurgery.