Robotic surgery from miles away: could remote operations match On-Site care?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 18 to 80 years, regardless of sex. * Scheduled to undergo robot-assisted hepatobiliary or pancreatic surgery, limited to hemihepatectomy, liver segmentectomy, local liver resection, cholecystectomy, pancreaticoduodenectomy, or distal pancreatectomy. * Considered to have an indication for surgery and to be suitable for robotic surgery based on preoperative assessment. * No definite contraindication to robotic surgery, laparoscopic surgery, pneumoperitoneum, or general anesthesia. * American Society of Anesthesiologists (ASA) physical status class I to III. * Eastern Cooperative Oncology Group (ECOG) performance status score of 0 to 2. * Expected survival of at least 3 months. * Adequate major organ function, with laboratory test results within 7 days before enrollment meeting the following criteria: white blood cell count at least 2.5 x 10\^9/L, absolute neutrophil count at least 1.5 x 10\^9/L, platelet count at least 75 x 10\^9/L, hemoglobin at least 90 g/L, international normalized ratio no more than 1.5 x upper limit of normal, and serum creatinine no more than 1.5 x upper limit of normal. * For patients undergoing liver surgery, Child-Pugh class A liver function or Child-Pugh class B liver function considered tolerable for surgery, with adequate liver reserve and adequate predicted future liver remnant volume. * For patients undergoing pancreatic surgery, imaging assessment showing resectability by robotic surgery without the need for complex vascular reconstruction. * Willing and able to complete perioperative observation and postoperative follow-up according to the study protocol. * Voluntarily agrees to participate in the study and provides written informed consent. Exclusion Criteria: * Need for combined vascular reconstruction. * Need for two or more major hepatobiliary or pancreatic procedures at the same time, or need for major resection of other organs. * Unable to complete full preoperative assessment, randomization, or remote robotic system preparation. * Considered clearly unsuitable for robotic surgery before the operation. * Preoperative assessment indicating a high probability of conversion to open surgery, or difficulty safely completing the planned procedure using a robotic platform. * Uncorrectable severe coagulation disorder or active bleeding tendency. * Severe dysfunction of the heart, lung, liver, kidney, brain, or other major organs that makes the patient unable to tolerate general anesthesia, pneumoperitoneum, or the planned surgery. * For patients undergoing liver surgery, inadequate liver reserve or inadequate predicted future liver remnant volume for safe surgery. * Uncontrolled severe infection, sepsis, severe malnutrition, or other conditions that significantly increase perioperative risk. * Pregnant or breastfeeding women. * Severe psychiatric, cognitive, or communication disorder that prevents cooperation with the study or follow-up. * Major compliance concerns as judged by the investigator. * Currently participating in another interventional clinical study that may affect endpoint assessment in this study. * Any other condition that, in the opinion of the investigator, makes the patient unsuitable for enrollment.