Robotic telesurgery in an austere setting

Introduction Telesurgery has been performed between continents and at multiple sites within the same country. The use of telesurgery has not been tested in the low-resourced, remote, and austere setting. The aim of this study is to determine if telesurgery can be performed intercontinentally from an austere setting with portable equipment. Methods A virtual reality platform was planned to remotely control a robot to perform a surgical task using a mobile satellite internet access in a village that did not have electricity nor cellular coverage. The robot console and internet access equipment were carried in a single backpack down the Pomeroon River in Guyana, 40 miles from the nearest town. Results The surgeon was able to perform a fundamentals of laparoscopic skills test from Guyana to the robot located in Menlo Park, California, USA. The average latency was 18 msec. The robot console was powered by electricity converted from solar energy in the village. Discussion Telesurgery is possible in the austere setting with easily portable equipment.