title: Robotic pyeloplasty using internet protocol and satellite network-based telesurgery.
abstract: BACKGROUND
  In North America, the urological community has embraced surgical robotic technology in the performance of complex laparoscopic surgery. The performance of complex long-distance telesurgery requires further investigation prior to clinical application.
  
  
  METHODS
  The feasibility of laparoscopic robot-assisted pyeloplasty in a porcine model was assessed using the Zeus robot and the internet protocol virtual private network (IP-VPNe) and satellite links. Eighteen pyeloplasty procedures were performed, using real-time, IP-VPNe and satellite network connection (six of each). Network and objective operative data were collected.
  
  
  RESULTS
  Despite network delays and jitter, it was feasible to perform the pyeloplasty procedure without significant detriment in operative time or surgical results compared with real-time surgery.
  
  
  CONCLUSIONS
  The completion of complex tasks such as robotic pyeloplasty is feasible using both land-line and satellite telesurgery. However, the clinical relevance of telesurgery requires further assessment.
authors.affiliation: Division of Urology, Department of Surgery, University of Western Ontario, London, Ontario, Canada.
authors.forename: C Y
authors.initials: CY
authors.lastname: Nguan
authors.forename: R
authors.initials: R
authors.lastname: Morady
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: D
authors.initials: D
authors.lastname: Harrison
authors.forename: D
authors.initials: D
authors.lastname: Browning
authors.forename: R
authors.initials: R
authors.lastname: Rayman
authors.forename: P P W
authors.initials: PP
authors.lastname: Luke
mesh_terms: D000818:Animals; D002170:Canada; D005240:Feasibility Studies; D020407:Internet; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008328:Man-Machine Systems; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D018531:Spacecraft; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D013552:Swine; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014584:User-Computer Interface