Impact of data compression and security devices on telesurgery systems

Purpose To evaluate the feasibility of secure telesurgery by assessing the impact of image compression and cybersecurity devices on surgical performance and data transmission. Methods Telesurgical procedures using the hinotori™ surgical robot were performed remotely between Hirosaki and Goshogawara, which are 30 km apart, over a secure line provided by NTT East. Image compression was tested at 120, 80, 60, 40, and 20 Mbps. A surgical specialist operated on artificial organ models. Simulated cyberattacks were introduced to assess the performance of security devices. Results Even at 20 Mbps, there was no significant loss in operability or image quality. Security devices detected simulated attacks and permitted essential robot communications. No visual distortion or operational issues occurred, and only a small delay of ≤ 2 min was introduced. The transmission control protocol (TCP) error rates remained low, with or without security devices (0.00–0.04%). Conclusion Security implementation enables safe telesurgery by detecting cyber threats without impairing surgical performance. This finding supports the practical development of economically and technologically viable telesurgical systems.