Telerobotic surgery: a comprehensive two-decade evolution and the integration of emerging technologies

Telerobotic surgery has undergone remarkable advances over the past two decades, driven by the integration of sophisticated robotic platforms and modern communication technologies, thereby alleviating many constraints of conventional surgical procedures. Building upon previous studies that focused on individual specialties or specific innovations, this review provides a comprehensive and integrated perspective by tracing the evolution of the field and highlighting applications in gastroenterology, urology, neurology, and cardiology. Landmark achievements include the 2001 transatlantic remote cholecystectomy and the introduction of next-generation platforms such as the Hinotori surgical robot, enabling low-latency remote interventions. Moreover, the integration of advanced technologies such as 5G networks, extended reality (XR), and multi-console surgical systems has enhanced surgical precision, minimized latency, and improved procedural coordination, thereby collectively expanding global access to high-quality care. Despite these achievements, telerobotic surgery continues to face challenges, including high costs, communication delays, cybersecurity vulnerabilities, and unresolved ethical and legal concerns. Nonetheless, emerging solutions such as 6G-enabled communication, advanced haptic feedback systems, and AI-assisted surgical platforms hold promise for addressing these obstacles by refining precision, reducing costs, and broadening the scope of remote interventions. By offering a comprehensive review of these developments, this article underscores the inherently interdisciplinary nature of telerobotic surgery, connecting engineering, communications, and clinical medicine. It also provides strategic insights to overcome current barriers and foster both technological and clinical innovation in surgical care.