Tele-Robotic Gynaecological Surgeries Using the Indigenous SSI Mantra System: A Case Series

Background: Tele-surgery is an emerging field that combines robotics, telecommunications, and digital imaging to overcome geographical barriers in healthcare delivery. In India, where advanced surgical expertise is concentrated in metropolitan areas, tele-robotic surgery may provide improved access to minimally invasive surgical care. This study evaluates the feasibility and safety of long-distance tele-robotic gynaecological surgery using an indigenous robotic platform. Objective: To assess the technical feasibility, safety, and clinical outcomes of tele-robotic hysterectomy performed using the SSI Mantra 3.0 robotic surgical system. Methods: A retrospective observational case series was conducted from August to October 2025 at Her Health Hospital, Bhopal. Five patients underwent tele-robotic hysterectomy after ethical approval and informed consent. Procedures were performed using the SSI Mantra 3.0 robotic platform, with remote console operation from geographically separated locations. System performance, communication latency, operative parameters, complications, and postoperative recovery were evaluated. Results: All five procedures were completed successfully without conversion, intraoperative complications, or technical failure. The mean patient age was 41 ± 4 years. Mean operative time was 124 minutes, docking time was 8 minutes, and estimated blood loss was 41 ± 10 ml. The tele-surgical communication system demonstrated stable performance with average latency of approximately 20 ms and jitter below 10 ms. No connectivity interruption occurred during any procedure. All patients had uncomplicated recovery, with hospital discharge on postoperative day three and no reported postoperative complications. Conclusion: This preliminary case series demonstrates that long-distance tele-robotic gynaecological surgery using the indigenous SSI Mantra robotic system is feasible and safe. The technology has the potential to expand access to advanced minimally invasive surgery across geographically distant healthcare settings. Larger prospective studies are required to establish broader clinical applicability.