Objective To evaluate the safety and feasibility of remote robot-assisted thoracoscopic surgery utilizing 5G technology. Methods Clinical data from five patients who underwent 5G remote robot-assisted thoracoscopic surgery at the Thoracic Surgery Center of Gansu Provincial People's Hospital from May to October 2024 were retrospectively analyzed. Results Finally, five patients were included. There were 2 males and 3 females at median age of 50 (42-63) years. All five surgeries (including 1 patient of lobectomy, 3 patients of partial lung resection and 1 patient of mediastinal lesion resection) were successfully completed without conversion to thoracotomy, complications, or mortality. The median intraoperative signal delay across the patients was 39 (37-42) ms. The median psychological load score for the surgeons was 9 (3-13). The median operation time was 100 (80-122) minutes with a median intraoperative blood loss of 100 (30-200) mL. Catheter drainage lasted a median of 4 (3-5) days, and the median drainage volumes on the first, second, and third postoperative day were 200 (100-300) mL, 150 (60-220) mL, and 80 (30-180) mL, respectively. The median postoperative hospital stay was 4 (3-7) days, and the median pain scores on the third postoperative day were 3 (1-4), 3 (0-3), and 1 (0-3), respectively. Conclusion 5G remote robot-assisted thoracoscopic surgery is safe and effective, with good surgical experience, smooth operation and small intraoperative delay.
Objective To explore the feasibility of 5G remote robot-assisted pulmonary lobectomy through animal experiments. Methods In this research, the Toumai? surgical robot was manipulated remotely by the surgeon in the Control Center of the MedBot Company through the 5G network established by China Telecom, and the experimental pig underwent lobectomy in simulated operating room. Results The animal experiment surgery was successfully completed. The surgeon remotely manipulated the surgical robot to complete the lobectomy of right apical lobe and mediastinal lymph node dissection. The entire animal experiment took about 60 minutes, with an average round-trip network delay of 125 (110-155) ms, and no network interruption or robot malfunction occurred. Conclusion This animal experiment is the first attempt of 5G remote thoracic surgery, which preliminarily proves the feasibility of completing remote lobectomy through the Toumai? surgical robot 5G wireless network connection. The systematic surgical procedure is summarized, which lays a foundation for the subsequent experiments and clinical applications of 5G remote robot-assisted thoracic surgery.
Objective To investigate the accuracy and safety of percutaneous screw fixation for pelvic and acetabular fractures with remote navigation of orthopedic robot based on 5G technology. Methods Between January 2021 and December 2021, 15 patients with pelvic and/or acetabular fractures were treated with percutaneous screws fixation which were placed by remote navigation of orthopedic robot based on 5G technology. There were 8 males and 7 females. The age ranged from 20 to 98 years, with an average of 52.1 years. The causes of trauma included traffic accident injury in 6 cases, falling from height injury in 6 cases, fall injury in 2 cases, and heavy object smashing injury in 1 case. The time from injury to operation ranged from 3 to 32 days, with an average of 10.9 days. There were 8 cases of simple pelvic fractures, 2 simple acetabular fractures, and 5 both pelvic and acetabular fractures. There were 7 cases of pelvic fractures of Tile type B2, 2 type B3, 1 type C1, and 3 type C2; 4 cases of unilateral anterior column fracture of the acetabulum, 2 bilateral anterior column fractures, and 1 anterior wall fracture. CT images within 5 days after operation were collected for screw position assessment. The screw planning time and guidewire placement time were recorded, as well as the presence of intraoperative adverse events and complications within 5 days after operation. Results All patients achieved satisfactory surgical results. A total of 36 percutaneous screws were inserted (20 sacroiliac screws, 6 LC Ⅱ screws, 9 anterior column screws, and 1 acetabular apical screw). In terms of screw position evaluation, 32 screws (88.89%) were excellent and 4 screws (11.11%) were good; there was no screw penetrating cortical bone. The screw planning time ranged from 4 to 15 minutes, with an average of 8.7 minutes. The guidewire placement time ranged from 3 to 10 minutes, with an average of 6.8 minutes. The communication delayed in 2 cases, but the operation progress was not affected, and no serious intraoperative adverse events occurred. No delayed vascular or nerve injury, infection, or other complications occurred within 5 days after operation. No cases need surgical revision. ConclusionThe fixation of pelvic and acetabular fractures by percutaneous screw with remote navigation of orthopedic robot based on 5G technology is accurate, safe, and reliable.
With the integration of 5G communication technology and robotic surgical systems, remote robot-assisted thoracic surgery is overcoming geographical barriers, offering an innovative approach to addressing the uneven distribution of medical resources. This study conducted a systematic literature review—using databases such as PubMed and CNKI, with the search period extending up to 2025—incorporating clinical studies, case reports, and review articles to comprehensively evaluate the clinical efficacy and safety of 5G-enabled remote robot-assisted thoracic surgery (5G-RRATS). The analysis also examined current technological limitations and potential future development trajectories. Existing evidence indicates that, given adequate technical support, 5G-RRATS can achieve perioperative outcomes comparable to those of conventional local robotic surgeries across procedures including pulmonary wedge resection, lobectomy, and esophagectomy. Furthermore, it demonstrates potential advantages in minimizing surgical incisions and reducing intraoperative blood loss. Nevertheless, challenges related to network stability, latency control, interdisciplinary collaboration between medical and engineering teams, and legal, regulatory, and ethical considerations continue to hinder widespread clinical adoption. Looking ahead, the emergence of a "one-to-many" remote surgical model, combined with the integration of artificial intelligence and augmented reality technologies, as well as advancements in low-orbit satellite communications, may enable 5G-RRATS to further advance precision and efficiency in thoracic surgery, thereby facilitating equitable access to high-quality care for a broader patient population.
Objective To investigate the effectiveness of 5G remote robotic surgery in the treatment of pelvic fractures. Methods A retrospective analysis was conducted on the clinical data of 160 patients with pelvic fractures admitted between July 2023 and June 2024 who met the selection criteria. Among these patients, 80 underwent internal fixation surgery with the assistance of 5G remote robotic surgery (5G group), while 80 received local robotic surgical assistance (control group). Baseline characteristics, including gender, age, body mass index, disease duration, cause of injury, and fracture classification, were compared between the two groups, and no significant difference was found (P>0.05). The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, maximum residual displacement postoperatively, quality of fracture reduction, incidence of complications, Majeed pelvic function score and classification at last follow-up were recorded and compared between the two groups. Results In the 5G group, 180 screws were implanted during surgery, while 213 screws were implanted in the control group. The 5G group demonstrated significantly reduced intraoperative blood loss and shorter incision length compared to the control group (P<0.05). No significant difference was observed between the two groups in terms of operation time or hospital stay (P>0.05). Radiographic evaluation revealed excellent and good reduction rates of 98.8% (79/80) in the 5G group and 97.5% (78/80) in the control group, while excellent and good screw placement accuracy rates were 98.3% (177/180) in the 5G group and 95.8% (204/213) in the control group. No significant difference was found between the two groups in maximum residual displacement, reduction quality, or screw placement accuracy (P>0.05). All patients were followed up 7-16 months (mean, 11.3 months), with no significant difference in follow-up duration between the groups (P>0.05). No perioperative or follow-up complication, such as wound infection, iatrogenic fractures, iatrogenic neurovascular injury, screw loosening or breakage, or nonunion, were observed in either group. The control group exhibited a worse degree of gait alteration compared to the 5G group (P<0.05), while no significant difference was found in incidences of squatting limitation or persistent pain (P>0.05). At last follow-up, no significant difference was observed between the groups in Majeed pelvic function scores or grading (P>0.05). Conclusion Compared with the local surgery group, 5G remote robotic surgery supported by remote expert technical guidance demonstrated smaller incision lengths, less intraoperative blood loss, and fewer postoperative complications, and was shown to be a precise, minimally invasive, safe, and reliable surgical method.
ObjectiveTo explore the application of 5G remote robotic surgery in distal gastrectomy for gastric cancer and evaluate the feasibility and advantages of the “3+2” model “seven-step method”. MethodsThe situations at preoperative, intraoperative and postoperative follow-up of a patient who underwent 5G remote robotic distal gastrectomy for gastric cancer with “3+2” model “seven-step method” in Gansu Provincial People’s Hospital were summarized, and based on our experience of robotic surgery, the application advantages of “3+2” model “seven-step method” in 5G remote robotic distal gastrectomy for gastric cancer was explored. ResultsThe operative time of this case was 190 min, the intraoperative blood loss was 50 mL, the network delay was 43.554 ms, and no intraoperative adverse events occurred. After a one-year follow-up, the patient recovered well, with no complications, good diet and good quality of life. ConclusionsThe “3+2” model “seven-step method” is feasible for 5G remote robotic distal gastrectomy. Further research requires an increased sample size and extended follow-up period.
ObjectiveTo study the contents of CD44 that shared exon variant 5 (CD44v5) in peripheral blood lymphocytes (PBL) of patients with gastric carcinoma and the expression of CD44v5 in tumor tissue and their clinical significance. MethodsThe contents of CD44v5 were determined by FlowCytometry in PBL of 31 patients with gastric carcinoma before surgery and 10 normal controls. Tissue expression of CD44v5 in 33 patients with gastric carcinoma was investigated by immunohistochemistry. ResultsThe contents of CD44v5 were significantly higher in PBL of patients with gastric carcinoma before surgery than those of controls (P＜0.01). Nodepositive gastric cancer patients showed significantly elevated contents of CD44v5 in PBL in comparison with nodenegative gastric cancer (P＜0.01）. Significant correlations were noted between the contents of CD44v5 in PBL of patients with gastric carcinoma before surgery and tumor size, depth of invasion, lymph node metastasis and different the Vnion International Centre Le Cancer (VICC) stages of tumor (P＜0.05). The expression of CD44v5 could be detected in 69.7% of tumor tissue,but was not detected in adjacent normal gastric mucosa. Significant correlations were noted between CD44v5 expression and depth of invasion,and lymph node metastasis.The presence of CD44v5 protein was correlated with the lymph node involvement rate. Conclusion CD44v5 in PBL or tumor tissue may be useful as a metastatic marker. It may be of important clinical value in the diagnosis of metastasis and judgement of development for the patients with gastric cancer.
The plasminogen activator inhibitor-1 (PAI-1) is a candidate gene for stroke based on PAI-1's crucial role in fibrinolytic system. However, association studies have yielded conflicting results regarding the association between PAI-1 polymorphisms and stroke susceptibility. To further elucidate the putative association, we performed a systematic review and meta-analysis to provide a complete picture of the loci investigated for association of PAI-1 polymorphism with stroke risk and to derive a precise estimation. PubMed, Embase, and China National Knowledge Infrastructure (CNKI) databases were searched until June 2015 to identify eligible studies. Forty data sets from 39 studies with a total of 8336 cases and 14,403 controls were included. The most commonly investigated polymorphism was -675 4G/5G, followed by -844 G/A, 11053 T > G, HindIII C/G, and (CA)n. Overall, our meta-analysis provided evidence for the significant association of PAI-1 4G/5G polymorphism with an increased risk of adult but not pediatric ischemic stroke (adult: 4G/4G vs. 4G/5G + 5G/5G, OR = 1.21, 95 % CI = 1.04-1.42). In the subgroup analysis, significant association was detected in Asians (4G/4G vs. 4G/5G + 5G/5G, OR = 1.45, 95 % CI = 1.14-1.85) but not Caucasians. Moreover, we found that -844 G/A but not 11053 T > G polymorphism was associated with an increased risk of ischemic stroke (-844G/A: A/A vs. G/G: OR = 1.32, 95 % CI = 1.01-1.73). A tendency of PAI-1 4G/5G polymorphism towards a decreased risk of hemorrhagic stroke was observed (4G/4G + 4G/5G vs. 5G/5G, OR = 0.77, 95 % CI = 0.59-1.02, P = 0.066). Future well-designed studies in large well-characterized sample size and presenting results stratified by gender, age, and stroke subtype are warranted.