Robotic telesurgery: a real‐world comparison of ground‐ and satellite‐based internet performance

BACKGROUND: Telesurgery was performed with ground vs. satellite networks, and differing satellite bandwidths. METHODS: The networks were compared during internal mammary artery (LIMA) dissection in pigs (n = 8). Length of LIMA dissected and surgical quality (five-point scale) were recorded. Also, satellite bandwidth was decreased (n = 7) to determine a limit for telesurgery. RESULTS: No significant differences existed in LIMA dissection during the ground (4.3 +/- 0.5 cm) and satellite phases (5.4 +/- 1.1 cm; p > 0.05) or in quality of surgery, although latency on satellite was 10 times greater (55 vs. 600 ms). With decreasing satellite bandwidth, surgery was not possible below 3 Mb/s, and quality of surgery was significantly decreased comparing 9 Mb/s (4.38 +/- 0.66/5) to 3 Mb/s (4.10 +/- 0.80/5; p < 0.05). CONCLUSIONS: Satellite communication is a viable telesurgical modality. Satellite bandwidth should be above 5 Mb/s during telesurgery if used primarily or as back-up.