Development of Teleoperated Robotic System for Remote Intraocular Microsurgery
Microsurgery has revolutionized modern surgery through its precision and favorable outcomes, but it remains limited by operational difficulty and the scarcity of skilled surgeons. Advances in robotics and communication technology have enabled the development of robotic telesurgery, with the goal of eliminating healthcare disparities. However, insufficiencies regarding system precision, surgical image transmission quality, and operational latency have made remote microsurgery challenging, particularly in intraocular microsurgery. A teleoperated robotic system is presented, featuring micrometer-scale precision and remote center of motion design, to ensure safety and flexibility within the confined operating space of the vitreous cavity. To validate its feasibility and safety, a randomized multicenter study is conducted involving in vivo subretinal injections in 51 pigmented rabbits. Surgeons using teleoperated system achieve nearly twice the first-attempt success rate and significantly fewer surgical complications than manual surgery. Furthermore, the system's versatility is showcased by successfully removing microscale intraocular foreign bodies in 15 porcine eyes and the communication stability is validated in multicenter remote surgeries, including procedures across the Qiongzhou Strait. These findings establish the system's safety, reliability, and versatility for performing remote intraocular procedures, highlighting its potential of remote microsurgery to improve surgical outcomes and broaden access to specialized care.
Authors
- Xinming Zhang (ORCID: https://orcid.org/0000-0002-8136-6834)
- Rihui Song (ORCID: https://orcid.org/0000-0001-9466-2408)
- Yining Huang (ORCID: https://orcid.org/0000-0001-9265-5896)
- Zhangkai Lian (ORCID: https://orcid.org/0000-0002-2551-6471)
- Bingqian Liu (ORCID: https://orcid.org/0000-0001-5710-7210)
- Duoru Lin (ORCID: https://orcid.org/0000-0002-7214-1801)
- Wenben Chen
- Andi Xu (ORCID: https://orcid.org/0009-0007-8466-1074)
- M. Ali Nasseri (ORCID: https://orcid.org/0000-0002-9764-5731)
- Zikai Lin (ORCID: https://orcid.org/0000-0002-0247-8628)
- Ling Jin (ORCID: https://orcid.org/0000-0002-8629-2408)
- Hongli Liang (ORCID: https://orcid.org/0000-0002-0355-8021)
- Pisong Yan (ORCID: https://orcid.org/0000-0001-7713-7791)
- Xiaohang Wu (ORCID: https://orcid.org/0000-0002-9398-4330)
- Haotian Lin (ORCID: https://orcid.org/0000-0003-4672-9721)
- Ruixin Wang (ORCID: https://orcid.org/0000-0002-4395-8492)
- Xingwu Zhong (ORCID: https://orcid.org/0000-0002-1358-6544)
- Yanlin Li (ORCID: https://orcid.org/0000-0002-0754-2561)
- W. F. Mader (ORCID: https://orcid.org/0000-0002-7344-998X)
- Wei Liu (ORCID: https://orcid.org/0000-0002-1727-6738)
- Tao Li (ORCID: https://orcid.org/0000-0001-8064-871X)
- Xiaoyue Wei
- Mingyuan Li (ORCID: https://orcid.org/0000-0002-9371-4613)
- Ruiyang Li (ORCID: https://orcid.org/0000-0002-8870-009X)
- Jinghui Wang (ORCID: https://orcid.org/0000-0001-7379-0267)
- Kun Gao (ORCID: https://orcid.org/0000-0002-4504-3026)
- Kai Huang (ORCID: https://orcid.org/0009-0007-5772-7912)
- Hang Shao (ORCID: https://orcid.org/0009-0008-9619-5506)
- Shida Chen (ORCID: https://orcid.org/0000-0003-0907-0614)
- Zheming Zhang (ORCID: https://orcid.org/0000-0003-1162-9747)
- Jiali Liu (ORCID: https://orcid.org/0009-0004-7210-958X)
Institutions
- Sun Yat-sen University (CN)
- Jiaxing University (CN)
- Hainan Eye Hospital (CN)
- Technical University of Munich (DE)
Publication Details
- Journal
- Advanced Science
- Published
- 2025-11-10
- DOI
- https://doi.org/10.1002/advs.202509849
- Primary Topic
- Soft Robotics and Applications
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- Sun Yat-sen University
- China Postdoctoral Science Foundation
- National Key Research and Development Program of China
- Basic and Applied Basic Research Foundation of Guangdong Province