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PURPOSE: Eye gaze tracking and pupillometry are evolving areas within the field of tele-robotic surgery, particularly in the context of estimating cognitive load (CL). However, this is a recent field, and current solutions for gaze and pupil tracking in robotic surgery require assessment. Considering the necessity of stable pupillometry signals for reliable cognitive load estimation, we compare the accuracy of three eye trackers, including head and console-mounted designs. METHODS: We conducted a user study with the da Vinci Research Kit (dVRK), to compare the three designs. We collected eye tracking and dVRK video data while participants observed nine markers distributed over the dVRK screen. We compute and analyze pupil detection stability and gaze prediction accuracy for the three designs. RESULTS: Head-worn devices present better stability and accuracy of gaze prediction and pupil detection compared to console-mounted systems. Tracking stability along the field of view varies between trackers, with gaze predictions detected at invalid zones of the image with high confidence. CONCLUSION: While head-worn solutions show benefits in confidence and stability, our results demonstrate the need to improve eye tacker performance regarding pupil detection, stability, and gaze accuracy in tele-robotic scenarios.

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PURPOSE: Gaze tracking and pupillometry are established proxies for cognitive load, giving insights into a user's mental effort. In tele-robotic surgery, knowing a user's cognitive load can inspire novel human-machine interaction designs, fostering contextual surgical assistance systems and personalized training programs. While pupillometry-based methods for estimating cognitive effort have been proposed, their application in surgery is limited by the pupil's sensitivity to brightness changes, which can mask pupil's response to cognitive load. Thus, methods considering pupil and brightness conditions are essential for detecting cognitive effort in unconstrained scenarios. METHODS: To contend with this challenge, we introduce a personalized pupil response model integrating pupil and brightness-based features. Discrepancies between predicted and measured pupil diameter indicate dilations due to non-brightness-related sources, i.e., cognitive effort. Combined with gaze entropy, it can detect cognitive load using a random forest classifier. To test our model, we perform a user study with the da Vinci Research Kit, where 17 users perform pick-and-place tasks in addition to auditory tasks known to generate cognitive effort responses. RESULTS: We compare our method to two baselines (BCPD and CPD), demonstrating favorable performance in varying brightness conditions. Our method achieves an average true positive rate of 0.78, outperforming the baselines (0.57 and 0.64). CONCLUSION: We present a personalized brightness-aware model for cognitive effort detection able to operate under unconstrained brightness conditions, comparing favorably to competing approaches, contributing to the advancement of cognitive effort detection in tele-robotic surgery. Future work will consider alternative learning strategies, handling the difficult positive-unlabeled scenario in user studies, where only some positive and no negative events are reliably known.

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PURPOSE: To evaluate the feasibility and safety of percutaneous puncture guided by a 5th generation mobile communication technology (5G)-based telerobotic ultrasound system in phantom and animal experiments. MATERIALS AND METHODS: In the phantom experiment, 10 simulated lesions were punctured, once at each of two angles for each lesion, under the guidance of a telerobotic ultrasound system and ultrasound-guided freehand puncture. Student's t test was used to compare the two methods in terms of puncture accuracy, total operation duration, and puncture duration. In the animal experiment, under the guidance of the telerobotic ultrasound system, an 18G puncture needle was used to puncture 3 target steel beads in the liver, right kidney, and right gluteal muscle, respectively. The animal experiment had no freehand ultrasound-guided control group. After puncture, a CT scan was performed to verify the position of the puncture needle in relation to the target, and the complications and puncture duration, etc., were recorded. RESULTS: In the phantom experiment, the mean accuracies of puncture under telerobotic ultrasound guidance and conventional ultrasound guidance were 1.8 ± 0.3 mm and 1.6 ± 0.3 mm (P = 0.09), respectively; therefore, there was no significant difference in the accuracy of the two guide methods. In the animal experiment, the first-attempt puncture success (the needle tip close to the target) rate was 93%. Polypnea occurred during one puncture. No other intraoperative or postoperative complications were observed. CONCLUSION: Puncture guided by a 5G-based telerobotic ultrasound system has shown good feasibility and safety in phantom and animal experiments.

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The aim of this paper is to investigate technological advancements made to a robotic tele-ultrasound system for musculoskeletal imaging, the MSK-TIM (Musculoskeletal Telerobotic Imaging Machine). The hardware was enhanced with a force feedback sensor and a new controller was introduced. Software improvements were developed which allowed the operator to access ultrasound functions such as focus, depth, gain, zoom, color, and power Doppler controls. The device was equipped with Wi-Fi network capability which allowed the master and slave stations to be positioned in different locations. A trial assessing the system to scan the wrist was conducted with twelve participants, for a total of twenty-four arms. Both the participants and radiologist reported their experience. The images obtained were determined to be of satisfactory quality for diagnosis. The system improvements resulted in a better user and patient experience for the radiologist and participants. Latency with the VPN configuration was similar to the WLAN in our experiments. This research explores several technologies in medical telerobotics and provides insight into how they should be used in future. This study provides evidence to support larger-scale trials of the MSK-TIM for musculoskeletal imaging.

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OBJECTIVE: Telemedicine can offer services to remote patients regardless of the distance. Fifth-generation (5G) mobile networks may make telemedicine practical because of their low latency. This study aimed to evaluate the feasibility and safety of a novel 5G robot-assisted remote abdominal ultrasound (AUS) telemedicine technology in clinical applications in distant locations. METHODS: We performed 5G-based telerobotic AUS in patients who were located more than 100 km away from the physicians. RESULTS: The telerobotic AUS had a longer examination time than the conditional bedside AUS; however, the complete examination rate was not inferior. None of the volunteers experienced discomfort during the examination and the examination time was acceptable for all. CONCLUSION: Our findings confirm the feasibility and safety of 5G-based telerobotic AUS in clinical practice.

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PURPOSE: To explore the feasibility of a 5G-based telerobotic ultrasound (US) system for providing qualified abdominal US services on a rural island. METHODS: This prospective study involved two medical centers (the tele-radiologist site's hospital and the patient site's hospital) separated by 72 km. Patients underwent 5G-based telerobotic US by tele-radiologists and conventional US by on-site radiologists from September 2020 to March 2021. The clinical feasibility and diagnostic performance of the 5G-based telerobotic abdominal US examination were assessed based on safety, duration, image quality, diagnostic findings, and questionnaires. RESULTS: A total of 401 patients (217 women and 184 men; mean age, 54.96 ± 15.43 years) were enrolled. A total of 90.1% of patients indicated no discomfort with the telerobotic US examination. For the examination duration, telerobotic US took longer than conventional US (12.54 ± 3.20 min vs. 7.23 ± 2.10 min, p = 0.001). For image quality scores, the results of the two methods were similar (4.54 ± 0.63 vs. 4.57 ± 0.61, p = 0.112). No significant differences were found between the two methods in measurements for the aorta, portal vein, gallbladder, kidney (longitudinal diameter), prostate, and uterus; however, telerobotic US underestimated the transverse diameter of the kidney (p < 0.05). A total of 504 positive results, including 31 different diseases, were detected. Among them, 455 cases were identified by the two methods; 17 cases were identified by telerobotic US only; and 32 cases were identified by conventional US only. There was good consistency in the diagnosis of 29 types of disease between the two methods (κ = 0.773-1.000). Furthermore, more than 90% of patients accepted the telerobotic US examination and agreed to pay additional fees in future. CONCLUSION: The 5G-based telerobotic US system can expand access to abdominal US services for patients in rural areas, thereby reducing health care disparities.

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PURPOSE: Vision-threatening diseases (VTDs) are the leading causes of vision loss and blindness. Use of deep learning artificial intelligence (DLAI) in early detection and subspecialty referral is critical to saving vision years and maintaining quality of life. To address this, we propose a comprehensive community-based screening retinal approach that incorporates DLAI to mitigate disparities and address need in an underserved urban community. METHODS: We evaluated two DLAI software designed for 45° retinal image analysis. DLAI was deployed in clinical settings to triage cases for ophthalmic referrals. Functionality was evaluated to propose implementation in a community screening. RESULTS: Our community screenings have incorporated various imaging modalities to improve VTD pick up rate: nonmydriatic color retinal imaging (18%), fundus autofluorescence (AF) (23%), and ocular coherence tomography B and angiography scans (35%). Robotic teleconsultation increased follow-up reached 100%. In clinical settings, DLAI reduced image analysis time (EyeArt™ = under 38 s, SELENA+™ =10.6 s) and highlighted multiple VTDs. High concordance was observed between human graders and DLAI (k = 0.68 in the department of endocrinology and k = 1 in the emergency department). CONCLUSION: Integration of DLAI in our ocular screening protocol can be used to reach underserved communities, especially when traditional health-care access is limited.

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BACKGROUND: Several recent reports of CorPath GRX vascular robot (Cordinus Vascular Robotics, Natick, MA) use intracranially suggest feasibility of neuroendovascular application. Further use and development is likely. During this progression it is important to understand endovascular robot feasibility principles established in cardiac and peripheral vascular literature which enabled extension intracranially. Identification and discussion of robotic proof of concept principals from sister disciplines may help guide safe and accountable neuroendovascular application. OBJECTIVE: Summarize endovascular robotic feasibility principals established in cardiac and peripheral vascular literature relevant to neuroendovascular application. METHODS: Searches of PubMed, Scopus and Google Scholar were conducted under PRISMA guidelines1 using MeSH search terms. Abstracts were uploaded to Covidence citation review (Covidence, Melbourne, AUS) using RIS format. Pertinent articles underwent full text review and findings are presented in narrative and tabular format. RESULTS: Search terms generated 1642 articles; 177, 265 and 1200 results for PubMed, Scopus and Google Scholar respectively. With duplicates removed, title review identified 176 abstracts. 55 articles were included, 45 from primary review and 10 identified during literature review. As it pertained to endovascular robotic feasibility proof of concept 12 cardiac, 3 peripheral vascular and 5 neuroendovascular studies were identified. CONCLUSIONS: Cardiac and peripheral vascular literature established endovascular robot feasibility and efficacy with equivalent to superior outcomes after short learning curves while reducing radiation exposure >95% for the primary operator. Limitations of cost, lack of haptic integration and coaxial system control continue, but as it stands neuroendovascular robotic implementation is worth continued investigation.

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Background: The MELODY system allows for performing ultrasonography on a patient remotely and has been proposed to assess disease characteristics in the context of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this interventional crossover study was to address the feasibility of the system in children aged 1 to 10 years old. Methods: Children underwent ultrasonography with a telerobotic ultrasound system followed by a second conventional examination by a different sonographer. Results: In total, 38 children were enrolled, and 76 examinations were performed, with 76 scans analyzed. The mean [standard deviation (SD)] age of participants was 5.7 (2.7) years (range, 1-10 years). We found substantial agreement between telerobotic and conventional ultrasonography [κ=0.74 (95% CI: 0.53-0.94), P<0.005]. The mean (SD) duration was longer for telerobotic than conventional examinations [26.0 (2.5) vs. 13.9 (11.2) min, P<0.0001]. Abdominal organs and abnormalities were similarly visualized on telerobotic and conventional ultrasonography. Cardiac echocardiography provided reliable diagnoses, with non-significantly different measurements with both techniques, although the visualization score was significantly higher with conventional than telerobotic ultrasonography (P<0.05). On lung analysis, both examinations identified consolidations and pleural effusion, whereas visualization and total lung score were similar with the 2 techniques. Overall, 45% of parents reported that their children felt less pressure with the telerobotic system. Conclusions: Telerobotic ultrasonography may be effective, feasible, and well-tolerated in children.

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OBJECTIVE: Ultrasound (US) plays an important role in the diagnosis and management of breast diseases; however, effective breast US screening is lacking in rural and remote areas. To alleviate this issue, we prospectively evaluated the clinical availability of 5G-based telerobotic US technology for breast examinations in rural and remote areas. METHODS: Between September 2020 and March 2021, 63 patients underwent conventional and telerobotic US examinations in a rural island (Scenario A), while 20 patients underwent telerobotic US examination in a mobile car located in a remote county (Scenario B) in May 2021. The safety, duration, US image quality, consistency, and acceptability of the 5G-based telerobotic US were assessed. RESULTS: In Scenario A, the average duration of the telerobotic US procedure was longer than that of conventional US (10.3 ± 3.3 min vs. 7.6 ± 3.0 min, p = 0.017), but their average imaging scores were similar (4.86 vs. 4.90, p = 0.159). Two cases of gynecomastia, one of lactation mastitis, and one of postoperative breast effusion were diagnosed and 32 nodules were detected using the two US methods. There was good interobserver agreement between the US features and BI-RADS categories of the identical nodules (ICC = 0.795-1.000). In Scenario B, breast nodules were detected in 65% of the patients using telerobotic US. Its average duration was 10.1 ± 2.3 min, and the average imaging score was 4.85. Overall, 90.4% of the patients were willing to choose telerobotic US in the future, and tele-sonologists were satisfied with 85.5% of the examinations. CONCLUSION: The 5G-based telerobotic US system is feasible for providing effective breast examinations in rural and remote areas.

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Ophthalmology is one of the most enriched fields, allowing the domain of artificial intelligence to be part of its point of interest in scientific research. The requirement of specialized microscopes and visualization systems presents a challenge to adapting robotics in ocular surgery. Cyber-surgery has been used in other surgical specialties aided by Da Vinci robotic system. This study focuses on the current perspective of using robotics and cyber-surgery in ophthalmology and highlights factors limiting their progression. A review of literature was performed with the aid of Google Scholar, Pubmed, CINAHL, MEDLINE (N.H.S. Evidence), Cochrane, AMed, EMBASE, PsychINFO, SCOPUS, and Web of Science. Keywords: Cybersurgery, Telesurgery, ophthalmology robotics, Da Vinci robotic system, artificial intelligence in ophthalmology, training on robotic surgery, ethics of the use of robots in medicine, legal aspects, and economics of cybersurgery and robotics. 150 abstracts were reviewed for inclusion, and 68 articles focusing on ophthalmology were included for full-text review. Da Vinci Surgical System has been used to perform a pterygium repair in humans and was successful in ex vivo corneal, strabismus, amniotic membrane, and cataract surgery. Gamma Knife enabled effective treatment of uveal melanoma. Robotics used in ophthalmology were: Da Vinci Surgical System, Intraocular Robotic Interventional Surgical System (IRISS), Johns Hopkins Steady-Hand Eye Robot and smart instruments, and Preceyes' B.V. Cybersurgery is an alternative to overcome distance and the shortage of surgeons. However, cost, availability, legislation, and ethics are factors limiting the progression of these fields. Robotic and cybersurgery in ophthalmology are still in their niche. Cost-effective studies are needed to overcome the delay. Technologies, such as 5G and Tactile Internet, are required to help reduce resource scheduling problems in cybersurgery. In addition, prototype development and the integration of artificial intelligence applications could further enhance the safety and precision of ocular surgery.

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Telemedicine is the process of utilizing telecommunications and digital relay to perform, teach, or share medical knowledge. The digital era eased the incorporation of telemedicine to different areas of medical care, including the surgical care of Urologic patient mainly through telementoring, telesurgery, and telerobotics. Over the years, Telemedicine has played an integral part in a physicians' ability to provide high quality medical care to remote patients, as well as serve as an educational tool for trainee physicians, in the form of telementoring. During the COVID-19 pandemic, telemedicine has played a vital role in combatting the health implications of confinements. Challenges of telemedicine implementation include cost, ethical considerations, security, bandwidth, latency, legal, and licensure difficulties. Nevertheless, the future of telemedicine, specifically telementoring, promises several improvements and innovative advancements that aim to bridge the gap in technological divides of urologic care. In this review, we build on what is already known about telemedicine focusing specifically on aspects related to telementoring, telestration, and telesurgery. Furthermore, we discuss its historical role in healthcare with a special emphasis on current and future use in urology.

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PURPOSE: To evaluate the feasibility of a 5G-based telerobotic ultrasound (US) system for thyroid examination on a rural island. METHODS: From September 2020 to March 2021, this prospectively study enrolled a total of 139 patients (average age, 58.6 ± 12.7 years) included 33 males and 106 females, who underwent 5G-based telerobotic thyroid US examination by a tele-doctor at Shanghai Tenth People's Hospital and a conventional thyroid US examination at Chongming Second People's Hospital 84 km away. The clinical feasibility of 5G-based telerobotic US for thyroid examination were evaluated in terms of safety, duration, US image quality, diagnostic results, and questionnaire survey. RESULTS: 92.8% of patients had no examination-related complaints. The average duration of the 5G-based telerobotic US examination was similar as that of conventional US examination (5.57 ± 2.20 min vs. 5.23 ± 2.1 min, P = 0.164). The image quality of telerobotic US correlated well with that of conventional US (4.63 ± 0.60 vs. 4.65 ± 0.61, P = 0.102). There was no significant difference between two types of US examination methods for the diameter measurement of the thyroid, cervical lymph nodes, and thyroid nodules. Two lymphadenopathies and 20 diffuse thyroid diseases were detected in two types of US methods. 124 thyroid nodules were detected by telerobotic US and 127 thyroid nodules were detected by conventional US. Among them, 122 were the same thyroid nodules. In addition, there were good consistency in the US features (component, echogenicity, shape, and calcification) and ACR TI-RADS category of the same thyroid nodules between telerobotic and conventional US examinations (ICC = 0.788-0.863). 85.6% of patients accepted the telerobotic US, and 87.1% were willing to pay extra fee for the telerobotic US. CONCLUSION: The 5G-based telerobotic US system can be a routine diagnostic tool for thyroid examination for patients on a rural island.

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OBJECTIVE: Patients living in many rural and remote areas do not have readily available access to ultrasound services because of a lack of sonographers and radiologists in these communities. The objective of this study was to determine the feasibility of using telerobotic ultrasound to establish a service delivery model to remotely provide access to diagnostic ultrasound in rural and remote communities. METHODS: Telerobotic ultrasound clinics were developed in three remote communities more than 500 km away from our academic medical center. Sonographers remotely performed all ultrasound examinations using telerobotic ultrasound systems, and examinations were subsequently interpreted by radiologists at an academic medical center. Diagnostic performance was assessed by each interpreting radiologist using a standardized reporting form. Patient experience was assessed through quantitative and qualitative analysis of survey responses. Operational challenges and solutions were identified. RESULTS: Eighty-seven telerobotic ultrasound examinations were remotely performed and included in this study, with the most frequent examination types being abdominal (n = 35), first-trimester obstetrical (n = 26), and second-trimester complete obstetrical (n = 12). Across all examination types, 70% of telerobotic ultrasound examinations were sufficient for diagnosis, minimizing travel or reducing wait times for these patients. Ninety-five percent of patients would be willing to have another telerobotic ultrasound examination in the future. Operational challenges were related to technical infrastructure, human resources, and coordination between clinic sites. CONCLUSION: Telerobotic ultrasound can provide access to diagnostic ultrasound services to underserved rural and remote communities without regular ultrasound services, thereby reducing disparities in access to care and improving health equity.

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A key challenge in achieving effective robot teleoperation is minimizing teleoperators' cognitive workload and fatigue. We set out to investigate the extent to which gaze tracking data can reveal how teleoperators interact with a system. In this study, we present an analysis of gaze tracking, captured as participants completed a multi-stage task: grasping and emptying the contents of a jar into a container. The task was repeated with different combinations of visual, haptic, and verbal feedback. Our aim was to determine if teleoperation workload can be inferred by combining the gaze duration, fixation count, task completion time, and complexity of robot motion (measured as the sum of robot joint steps) at different stages of the task. Visual information of the robot workspace was captured using four cameras, positioned to capture the robot workspace from different angles. These camera views (aerial, right, eye-level, and left) were displayed through four quadrants (top-left, top-right, bottom-left, and bottom-right quadrants) of participants' video feedback computer screen, respectively. We found that the gaze duration and the fixation count were highly dependent on the stage of the task and the feedback scenario utilized. The results revealed that combining feedback modalities reduced the cognitive workload (inferred by investigating the correlation between gaze duration, fixation count, task completion time, success or failure of task completion, and robot gripper trajectories), particularly in the task stages that require more precision. There was a significant positive correlation between gaze duration and complexity of robot joint movements. Participants' gaze outside the areas of interest (distractions) was not influenced by feedback scenarios. A learning effect was observed in the use of the controller for all participants as they repeated the task with different feedback combination scenarios. To design a system for teleoperation, applicable in healthcare, we found that the analysis of teleoperators' gaze can help understand how teleoperators interact with the system, hence making it possible to develop the system from the teleoperators' stand point.

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The effective integration of robotic technology and surgical tools has played a vital role in advancing surgical care by enabling telepresence in surgery to provide mentorship and surgical care across long distances in the absence of surgeons. This article describes our experiences with advancing surgical education and innovation through telementoring community surgeons, establishing the world's first telerobotic surgical service, and the integration of Artificial Intelligence and robotics to provide remote surgical care and training.

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Telesurgery, or remote surgery, is widely known as a master-slave technology. It has achieved a milestone in surgical technology and intervention, providing widespread prospects of operating on a patient in a remote area with increased accuracy and precision. It consists of one or more arms controlled by a surgeon and a master controller in a remote area accessing all the information being transferred via a telecommunication system. This paper reviews the present advancements and their benefits and limitations in the field of telesurgery. A handful of operations have been done so far. However, due to time-lag (latency), global networking problems, legal issues and skepticism, and on top of the cost of robotic systems and their affordability have led to the concept of telerobotics and surgery to lag. However, with more information and high speed, 5G networking, which has been in a trial to reduce latency to its minimum, is beneficial. Haptic feedback technology in telesurgery and robotics is another achievement that can be improved; further, this allows the robotic arms to mimic the natural hand movements of the surgeon in the control center so that the master controller can perform surgeries with more dexterity and acuity. Due to coronavirus (COVID-19), this type of surgery approach can reduce the probability of contracting the virus, saving more lives and the future.

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Artificial Gravity generated by Short Arm Human Centrifuges is a promising multi-system countermeasure for physiological deconditioning during long duration space flights. To allow a continuous assessment of cardiovascular hemodynamics during centrifugation, a telerobotic robotic system holding an ultrasound probe has been installed on a Short Arm Human Centrifuge. A feasibility study was conducted to define the use capabilities and limitations of such a novel method. The objective of this study is to estimate the reproducibility and precision of remotely controlled vascular ultrasound assessment under centrifugation by assessing peripheral vascular diameter and wall distension. Four repeated centrifugation runs of 5 min, with 2.4 g at feet level, were performed including a 15 min rest between each run for a group of eight healthy male volunteers. Vascular diameter and distention were assessed for the common carotid artery (CCA) and the femoral artery (FA) by ultrasound imaging using a 10 MHz linear array probe (Mylab1, Esaote). Ultrasound measurements were consecutively performed: a) by an expert user in hand-held mode in standing as well as supine position, b) using the telerobotic arm without centrifugation as baseline and c) using the telerobotic arm during centrifugation. Vascular responses were compared between baseline and under centrifugation. Inter-, intra-registration and group variability have been assessed for hand-held and remotely controlled examination. The results show that intra-registration variability, σ h , was always smaller than inter-registration variability, σ m, that is in turned smaller than the inter-subject variability σ g (σ h < σ m < σ g). Centrifugation caused no significant changes in CCA diameter but a lower carotid distension compared to manual and robotic ultrasound in supine position (p < 0.05). Femoral diameter was significantly decreased in hypergravity compared to robotic sonography without centrifugation. A good reproducibility and precision of the remotely controlled vascular ultrasound assessment under centrifugation could be demonstrated. In conclusion, arterial wall dynamics can be precisely assessed for the CCA and femoral artery during centrifugation using a telerobotic ultrasound measurement system. Potential improvements to further enhance reproducibility and safety of the system are discussed.

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BACKGROUND: Robotic-assisted endovascular surgery enables us to perform interventions from long distances. This study evaluates the workflow and telecommunication requirements of telerobotic peripheral vascular interventions. METHODS: Ten superficial femoral artery cases were performed by the operator being 44 miles away from the interventional suite, with an endovascular robotic system, on a high-fidelity endovascular simulator. Procedural success, technical success, fluoroscopy time, residual stenosis, contrast dose and network delay were registered. Communication success was assessed after each procedure on a scale from 1 (unacceptable) to 5 (ideal). RESULTS: Procedural success and technical success were 100% and 80%, respectively. The mean residual stenosis, fluoroscopy time and contrast dose were 1.7 ± 5.25%, 6.5 ± 1.8 min and 58.8 ± 14.8 ml. The mean network latency was 38.9 ± 3.5 ms. Median communication success scores were 4.5 (min: 4, max: 5) reported by both the operator and the bedside technician on a scale of 1 (unacceptable) to 5 (ideal). CONCLUSION: With a stable network connection and good communication protocol, a high success rate was achieved for remote robotic-assisted peripheral vascular intervention in an ex vivo model.

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Access to sonographers and sonologists is limited in many communities around the world. Telerobotic sonography (robotic ultrasound) is a new technology to increase access to sonography, providing sonographers and sonologists the ability to manipulate an ultrasound probe from a distant location and remotely perform ultrasound examinations. This narrative review discusses the development of telerobotic ultrasound systems, clinical studies evaluating the feasibility and diagnostic accuracy of telerobotic sonography, and emerging use of telerobotic sonography in clinical settings. Telerobotic sonography provides an opportunity to provide real-time ultrasound examinations to underserviced rural and remote communities to increase equity in the delivery of diagnostic imaging.

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