La robotic telesurgery In a matter of years, it has gone from being a one-off demonstration for medical conferences to becoming a tool with real-world clinical use in Spain. A [system/medium] has already been activated between Barcelona and Las Palmas de Gran Canaria. stable clinical program which allows urology patients to be operated on thousands of kilometers away without having to leave their island.
This project permanently connects the Puigvert Foundation, in Barcelona, with the San Roque University HospitalIn Las Palmas de Gran Canaria, using a specific communications infrastructure and a state-of-the-art robotic surgery system. The goal is not to put on a technological "show," but to consolidate a reproducible model that can bring highly complex surgery to areas far from major healthcare centers.
A pioneering clinical program in Europe
The initiative has been presented as the First structured clinical program for robotic telesurgery between Barcelona and the Canary Islands and one of the first in Europe conceived as a stable healthcare network, not as an isolated trial. It is led by the urologist Alberto Breda, deputy director of the Urology Service and head of the Urological Oncology Unit of the Puigvert Foundation, as well as president of the Robotic Surgery Section of the European Society of Urology (ERUS).
From the Catalan capital, Breda sits in a robotic console Equipped with joystick-type controls and a three-dimensional viewer, she directs the robot's arms located in the operating room in Gran Canaria. At the other end of the connection, the robotic surgeon Pablo Juarez del DagoThe director of the GUA-Urointec urological group coordinates the surgical environment and assumes direct control if any technical or clinical incident occurs.
The program connects the two hospitals at a distance of about 3.000 kilometers away through an infrastructure developed by Edge Medical, based on a dedicated high-capacity line between Barcelona and Las Palmas. It's not about sharing a commercial network, but about having an exclusive circuit designed to ensure stability and safety in every intervention.
According to those in charge, the key to the qualitative leap lies in the fact that telesurgery It is integrated into routine healthcare activities. from both centers. It's not a one-off photo op, but a working model that is repeated, measured, and perfected, with protocols, specific training, and a legal and organizational framework developed over more than a year and a half.
This is how it works at 3.000 kilometers: technology, latency and security
In practice, the procedure is very similar to conventional robotic surgery. The surgeon in Barcelona does not touch the patientInstead, he stands in front of the console, looks through binoculars, and moves the joysticks that control the robotic arms located next to the operating table in the Canary Islands. The difference is that these movements are sent through the dedicated network that connects the two hospitals.
One of the critical factors is the latencyThat is, the time it takes for the command to travel from the surgeon's hand to the robot's arm. In this program, the recorded average latency is... between 30 and 70 milliseconds, a fraction of a second virtually imperceptible to the human brain and well below the threshold of about 200 milliseconds beyond which accuracy could be compromised.
Breda had already tested this technology in more extreme scenarios: in 2024 it carried out a transcontinental partial nephrectomy between Bordeaux and Beijingwhere latency reached approximately 132 milliseconds. That experience was considered a global milestone in telesurgery and served as a proof of concept. The current step goes even further: bringing that capability into routine clinical practice of a European healthcare system and demonstrate that it can operate in this way continuously.
To reinforce security, the two centers are connected by a private cable installed specifically for this purpose. It is not shared with other services nor left to the whims of network congestion. Furthermore, in the Canary Islands operating room there is always a highly qualified local team, led by Juárez del Dago, prepared to take over immediately in case of connection failure or unforeseen medical event.
This “double guarantee” is based on coordination between the remote surgeon and the local surgeon: while one operates the robot remotely, the other can intervene with another robot, laparoscopy, or open surgery if the situation requires it. As the team itself summarizes, the patient does not receive less supervision, but more: “four eyes instead of two” controlling its operation.
More than a dozen complex urological operations
The program between Barcelona and the Canary Islands has not been limited to a single demonstration. In the first three weeks of February According to various sources, between 10 and 11 urological interventions of varying complexity were performed on patients from the Canary Islands, all of them directed in real time from the Puigvert Foundation.
The cases involved include adenomectomies for benign prostatic hyperplasia, partial nephrectomies, radical prostatectomies and resections of retroperitoneal masses. Some patients presented with particularly delicate pathologies, such as a renal cell carcinoma located near the colon or a metastasis following complex kidney surgery.
According to data provided by the Barcelona and Las Palmas teams, All patients have been discharged and recover without significant complications after surgery. The clinical results are considered comparable to those obtained with in-person robotic surgery at referral centers, reinforcing the idea that physical distance does not necessarily translate into worse results if the technology and organization are adequate.
Some patients recount the experience with surprise and, at the same time, with calm. One patient who had a kidney tumor removed describes the feeling upon entering the operating room as if he were in the cockpit of a spaceship, but emphasizes that the presence of the local team And his trust in the surgeons made him feel safe, even though the specialist operating the robot was thousands of kilometers away.
Those in charge of the program insist that the success lies not only in completing several operations without incident, but in having managed to make this type of intervention fit into the daily routine of the hospitalFrom patient selection and pre-operative preparation to anesthesia protocols, post-operative recovery, and follow-up.
Decentralize super-specialization and reduce inequalities
Beyond the technological component, one of the project's pillars is its organizational impact. For Breda and Juárez, robotic telesurgery opens the door to decentralize highly specialized work without forcing patients to travel to large cities like Barcelona or Madrid.
In the current healthcare model, when a person with a complex pathology lives in a peripheral area, the usual practice is to refer them to a reference hospitalThis involves travel, accommodation, expenses for families, and often long waiting lists. With a well-designed telesurgery system, the situation is reversed: It is the lead surgeon who “travels” virtually to the hospital where the patient is, keeping him close to his environment and his family.
In this sense, the Canary Islands have become a strategic territoryIts island status, distance from the mainland, and historical difficulty in accessing certain technologies make it an ideal testing ground to demonstrate that Distance ceases to be an obstacle when the appropriate infrastructure is in place. As Juárez del Dago points out, on this occasion "the Canary Islands have been an advantage and not a gap" when it comes to innovation.
The program's proponents point out that this approach can reduce territorial inequalitiesThis applies both between autonomous communities and within the same region. Places far from major healthcare centers, such as rural areas of Catalonia, Aragon, or Castile, could benefit in the future if similar connections are replicated and local teams are formed that can network with highly specialized centers.
In addition to the impact on healthcare, the model reinforces the continuous training of the professionals. Telesurgery is combined with the telementoringExpert surgeons can guide and supervise less experienced colleagues without having to travel for weeks to other hospitals, facilitating the spread of robotic surgery throughout the territory.
A scalable model: from urology to other specialties
For now, the Barcelona-Canary Islands program has focused on the robotic urologyThis specialty has been particularly accustomed to the use of surgical robots since the early 2000s. This facilitates the adoption of the model, as the teams involved have extensive prior experience in on-site robotic surgery.
However, both Breda and Juárez agree that telesurgery It is scalable to other disciplines where the robot is already implemented: gynecologic oncology, general surgery, thoracic surgery, or highly complex procedures in other areas. The requirement is that there be a trained local team and a communications network that guarantees the same standards of precision and safety as in urology.
From a European perspective, Breda uses its position in ERUS to promote further structuring telesurgery clinical programs in different countries. Technically, he says, there are no longer major barriers: robotic systems and communication networks are ready. The main obstacle is bureaucratic and regulatoryespecially when considering remote operation between different healthcare systems and legal frameworks.
In parallel, the debate opens up about the use of Artificial Intelligence in this field. Program managers acknowledge the potential of AI to improve planning, the recognition of anatomical structures, and decision support, but they are clear on one point: the “artistic side” of the surgeon It will remain irreplaceable in complex interventions, and the ultimate responsibility will continue to rest with human professionals.
Looking to the medium term, scenarios are being considered in which the connection between hospitals does not depend solely on physical cables, but can also be carried out remotely. via satelliteThis would further expand the scope of telesurgery, making it viable in disaster situations, conflict zones, or space missions—areas for which the first prototypes were conceived at the end of the last century.
Legal and organizational challenges and future prospects
For this type of program to become established and spread to other hospitals in Spain and Europe, technology alone is not enough. The teams involved emphasize the need to build a stable legal framework that clearly regulates the competencies, responsibilities and coverage when a doctor operates on patients located in another community or even in another country.
The issues to be resolved range from the network security From protecting clinical data to accrediting surgeons, obtaining insurance authorization, and determining who will cover infrastructure costs, these challenges are compounded by the inherent inertia of large healthcare organizations, where implementing new workflows is often slow and requires consensus across multiple departments.
Breda and Juárez insist that the scalability potential is “incredible"If these obstacles are overcome. On the horizon, the program's promoters envision a mesh healthcare network, in which different European hospitals can share specialists through telesurgery, reducing waiting lists and bringing complex procedures closer to patients who today depend on flights and long transfers to be treated.
Meanwhile, the experience between Barcelona and the Canary Islands will continue to accumulate cases and data for at least the next few years, with the intention of demonstrating that this model is not only viable, but also sustainable and useful for both the public and private healthcare systems. If these results continue, Spain could position itself as one of the leading European countries in the effective integration of robotic telesurgery into clinical practice.
The surgical connection between the Puigvert Foundation and the San Roque University Hospital symbolizes a new era in robotic surgery: it demonstrates that Excellence no longer has to depend on the postal code. And that a patient on an island or in a remote area can access the same level of precision and experience as someone who lives next to a large hospital, with the robot and fiber optics as new bridges in the healthcare system.