Telesurgery: from feasibility to reality: emerging technical and governance challenges

Telesurgery, once considered an experimental concept, is rapidly transitioning to a feasible clinical reality. The growing need for equitable access to surgical expertise across geographical boundaries has driven the development of remote robotic surgery. This review outlines the key enablers and limitations of current telesurgical systems, emphasizing the importance of hybrid infrastructure that integrates low-latency networks, surgical robotics, and reliable data security frameworks. While next-generation connectivity technologies such as 5G and 6G promise improved performance, overreliance on communication bandwidth alone may compromise attention to essential factors, such as system redundancy and fail-safe design. Non-technical barriers, such as ethical accountability, patient safety, data governance, and professional regulation, are equally vital in determining the long-term viability of telesurgery in clinical practice. A balanced approach to both technical robustness and governance frameworks is essential to transition telesurgery from feasibility studies to routine clinical practices.