Single-incision robotic chest surgery at a distance: a patient in Bucharest operated on from a console in China

What happened

On the evening of 1 April 2025 (China time), a team at the First Affiliated Hospital of Soochow University in Suzhou removed the right upper lobe of the lung of a patient with lung cancer who was in an operating room in Romania, more than 8,000 km away. According to the Jiangsu Commission of Health, they used a robot developed in China and a 5G connection, after months of preparation and with ethical and administrative approvals from Romania.

Spanish thoracic surgeon Diego González Rivas was at the console in Suzhou, and thoracic surgeon Liviu Mugurel Bosînceanu took part in Bucharest, TVR reported. The case was published in 2026 in the European Journal of Cardio-Thoracic Surgery: the operation took 58 minutes, network delay stayed below 150 milliseconds, there were no complications during surgery, and the patient was discharged on the third day.

What uniportal surgery is

In multiport minimally invasive chest surgery, the surgeon works through several small incisions between the ribs. The uniportal approach uses just one. González Rivas's group performed the world's first uniportal thoracoscopic lobectomy (uniportal VATS) in 2010.

Uniportal robotic-assisted thoracic surgery (U-RATS) applies the same principle with a robot. According to the description published by González Rivas and colleagues, the robotic camera, instruments and staplers enter through a single 3–4 cm incision between the ribs, without spreading them. The team reports the first such operations in September 2021, in Spain, using an adapted da Vinci Xi robot. One advantage they cite: the robot can be undocked quickly and, if needed, the operation converted to thoracoscopy or open surgery. The April 2025 case used a single-port robot with 'serpentine' arms developed in China.

What it means for patients now

• The technique was developed by surgeons experienced in uniportal surgery, and for safety the authors recommend a gradual transition from multiport robotic surgery to the single-incision approach.
• Remote surgery remains an exception for now: it required months of preparation, special approvals and a dedicated network. As a safeguard, the surgeon in the operating room can take over control if needed, González Rivas told TVR.
• Whether a given type of operation is suitable depends on the tumour's stage and location and on the patient's general condition; the decision rests with the medical team that knows the case.

What is still unknown

The publication describes a single case. One case cannot show whether remote operations are as safe as standard ones across many patients, how they will be regulated between countries, or what they cost. The claim that this was the first operation of its kind comes from the teams and authorities involved.