A surgeon in Istanbul used robotic technology to remove a kidney tumor from a 34-year-old patient 321 kilometers away in the western province of Balıkesir last week, in what he described as Türkiye’s first remote cancer operation.
Professor Bülent Önal, head of urology at Istanbul University-Cerrahpaşa’s Cerrahpaşa Medical Faculty, controlled robotic arms from an Istanbul console while the patient was at Balıkesir University Medical Faculty. The operation preserved the kidney and removed the entire tumor, making Türkiye the fifth country to perform remote cancer surgery.
Engineers repeatedly tested both hospitals’ network infrastructure and monitored data transmission for delays and fluctuations over 15 days before the operation proceeded, Önal said.
A technical team was on site. Professor Şakir Ongün, Associate Professor Çağdaş Şenel and their teams stood beside the patient, along with a surgeon from Önal’s team, ready to take over immediately if a technical problem occurred.
The required permissions, patient consent and safety conditions were secured before surgery. Önal said patchy mobile reception at Cerrahpaşa had initially made him question how the connection would work, but engineers checked the infrastructure before the decision to operate.
“What matters is not being the first to do something, but taking every precaution to ensure the patient receives the best healthcare,” Önal said.
He described the partial nephrectomy, surgery to remove part of a kidney, as a first within Türkiye’s Group A surgical procedures.
Önal said the method could bring expertise concentrated in big cities to patients elsewhere, reducing travel, accommodation costs and disruption to families’ work. Access to an Istanbul specialist without leaving home could improve equality in healthcare, he said.
It could also strengthen cooperation between surgical teams, allowing doctors in different cities to consult and support each other.
The distance nevertheless removed a personal connection Önal values: seeing patients before surgery, holding their hands, explaining the procedure and reassuring them. He normally speaks to relatives before and after an operation.
“You cannot see the patient or their relatives; you operate at a computer,” he said.
Wider access would require more robotic systems, he said. Using existing equipment efficiently was as important as buying new devices, and discussions on domestic production were underway.
Önal said advances in imaging and targeted treatments could make cancer care less invasive, reducing harm and helping patients continue daily life more comfortably.
The procedure also reflects a shift toward preserving healthy tissue. In the early 2000s, surgeons sometimes made a roughly 20-centimeter incision and removed an entire kidney for a 1-centimeter tumor, Önal said.
