Influence of network latency and bandwidth on robot-assisted laparoscopic telesurgery: A pre-clinical experiment

Author:

Wang Ye1,Ai Qing1,Shi Taoping2,Gao Yu1,Jiang Bin1,Zhao Wuyi3,Jiang Chengjun3,Liu Guojun1,Zhang Lifeng1,Li Huaikang1,Gao Fan1,Ma Xin1,Li Hongzhao1,Zhang Xu1

Affiliation:

1. Department of Urology, Chinese People’s Liberation Army General Hospital, Beijing 100853, China

2. Department of Urology, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Beijing 100853, China

3. Shenzhen Edge Medical Co., Ltd, Shenzhen, Guangdong 518116, China

Abstract

Abstract Background: Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood. Methods: A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000 km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170 ms to 320 ms and bandwidth from 15–20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons. Results: All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866 min. The operations were completed with latency up to 320 ms and bandwidths as low as 1–5 Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions. Conclusions: This telesurgery system demonstrated safety and reliability. A total of 320 ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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