First UK Long-Distance Robotic Surgery Connects London Surgeon with Gibraltar Patient

 Key Takeaways:

• A London-based surgeon has performed the UK’s first long-distance robotic cancer surgery on a patient in Gibraltar, marking a major milestone in telesurgery
  
• The procedure demonstrated minimal delay and high precision, suggesting remote surgery could expand access to specialist care in underserved regions
  
• Patients living far from specialist centres may benefit from reduced travel, lower costs and improved continuity of care
  
  
  

A landmark moment in remote surgery

A surgeon based in London has carried out what is believed to be the United Kingdom’s first long-distance robotic surgical procedure, operating on a patient located approximately 1,500 miles (2,400 km) away in Gibraltar.

Professor Prokar Dasgupta, a leading robotic urological surgeon, performed a prostate removal on 62-year-old Paul Buxton. Reflecting on the experience, he said it felt “almost as if I was there”, despite the geographical distance between surgeon and patient.

For Buxton, who is living with prostate cancer, the decision to participate in the procedure was straightforward. He described it as a “no-brainer” and an opportunity to become “part of medical history”.

Expanding access to specialist care

The development of long-distance robotic surgery is seen as a potential solution to longstanding challenges in healthcare access, particularly for people living in remote or underserved regions.

Such approaches could reduce the “vast expense and inconvenience” associated with travelling for specialist treatment, while enabling patients to receive care closer to home.

This milestone builds on previous advances involving UK-based surgical teams. Earlier work included a transatlantic robotic stroke procedure conducted over a distance of 4,000 miles on a cadaver – a body donated to science – which demonstrated that long-distance surgery was technically feasible.

A patient’s perspective

Buxton, originally from Burnham-on-Sea in Somerset, has lived in Gibraltar for four decades. As a British Overseas Territory, Gibraltar has limited healthcare infrastructure, with only one hospital – St Bernard’s Hospital at Europort. Patients requiring more complex care often need to travel abroad, commonly to the United Kingdom for NHS treatment if eligible.

Following his prostate cancer diagnosis shortly after Christmas, Buxton initially expected to join an NHS waiting list. However, he chose instead to take part in the remote surgery trial.

“A lot of people actually said to me: ‘You’re not going to do it, are you?’”

“I thought, I’m giving something back here,” he said.

Buxton also highlighted the practical advantages of the approach:

“If I hadn’t gone for the telesurgery in Gibraltar, then I would have had to have flown to London, I would have had to go on the NHS waiting list, get the procedure done and I would have probably been in London for three weeks.

“So I thought: ‘This is a no-brainer’.

“It is pioneering for Gibraltar, because you don’t need to leave Gibraltar.”

Following the operation on 11 February, he reported a positive recovery, stating he was “really well looked after” and “feeling fantastic”.

How the technology works

The procedure was conducted from The London Clinic using a robotic surgical system equipped with a high-definition 3D camera and four robotic arms. These were controlled remotely via a surgical console.

The connection between London and Gibraltar was enabled through fibre-optic cables, supported by a backup 5G link. The system achieved an extremely low latency, with a delay of just 0.06 seconds, allowing for precise and responsive control.

A surgical team in Gibraltar remained on standby throughout the operation to intervene if necessary, although the connection remained stable for the duration of the procedure.

The operation utilised the Toumai Robotic System and was delivered through a collaboration between The London Clinic and the Gibraltar Health Authority.

Looking ahead: scaling telesurgery

Professor Dasgupta emphasised the broader implications of the innovation:

“This gives us the opportunity to treat patients in remote areas and smaller communities by literally being able to take the best surgeon anywhere.”

The procedure forms part of an initial series of test cases. A second operation involving a 52-year-old patient in Gibraltar was carried out on 4 March, with a further procedure scheduled for 14 March.

The upcoming operation will be live-streamed to 20,000 leading urological surgeons attending the European Association of Urology congress, highlighting the global interest in this emerging field.

Reflecting on the future, Dasgupta added:

“I think it is very, very exciting, the humanitarian benefit is going to be significant.”

Alignment with broader surgical trends

This development sits alongside wider efforts to expand the use of robotic-assisted surgery within the NHS. Current ambitions include scaling up to 500,000 robot-supported operations annually by 2035.

While the NHS is prioritising local access to robotic surgery, advances in telesurgery suggest a complementary pathway – one that could extend specialist expertise beyond physical borders and reshape how surgical care is delivered globally.