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Unprecedented procedure in SUS connected medical teams in Rondônia and São Paulo through robotics, fiber optics, redundant 5G, and dedicated network, expanding the debate on access to high-complexity oncological surgeries outside major centers.
On Tuesday (June 30), SUS performed the country’s first long-distance robotic oncological telesurgery, in an operation that connected the Hospital do Amor Amazônia, in Porto Velho (RO), to the Hospital de Amor, in Barretos (SP).
Attended by the public network, the patient underwent a procedure to treat malignant neoplasm of the rectum, while teams separated by almost 2,700 kilometers worked in an integrated manner between the surgical center in Rondônia and the São Paulo unit.
The surgery brought together medical robotics, dedicated connection, and coordinated action between on-site and remote professionals, with specialists monitoring the operation in real-time and able to take control of the robotic instruments when necessary.
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In Porto Velho, the team beside the patient was responsible for clinical support, positioning the robotic arms, and providing assistance within the room, maintaining the indispensable physical presence throughout the procedure.
Meanwhile, in Barretos, specialists remotely followed each step, with access to the necessary resources to intervene in the control of surgical instruments whenever the operation’s dynamics required specialized remote action.
How the SUS robotic telesurgery was structured
The operation was monitored by the Minister of Health, Alexandre Padilha, in Brasília, while the Minister of Communications, Frederico de Siqueira Filho, and Secretary Ana Estela Haddad followed the procedure in Barretos.
This coordination between the two ministries occurred because the telesurgery depended simultaneously on high-complexity medical assistance and a communication network prepared for critical health applications.
To enable the surgery, the Ministries of Communications and Health, in partnership with the Hospital de Amor, developed a specific connectivity protocol aimed at real-time communication stability.
The technical structure used in the procedure combined two independent fiber optic connections, 5G redundancy, and a dedicated VPN network, with the aim of reducing instability risks during the operation.
Among the central requirements, latency needed to remain below 100 milliseconds, the interval that measures the time between the command made by the remote surgeon and the robot’s response in the surgical center.
This control was essential for the movements to be executed without delay incompatible with the surgical act, as a remote robotic operation requires precision, predictability, and stable communication between the two units.
On-site team maintained a decisive role in the surgery
Even with remote command, tele-surgery did not eliminate the need for professionals in the surgical center, as direct patient assistance remained concentrated with the team located in Porto Velho.
In practice, the model depended on a clear division of functions, with the on-site team handling immediate care and the specialists from Barretos acting in remote monitoring and control of the instruments.
Before performing the procedure, the teams underwent training and simulations to test response protocols, assess possible communication delays, and prepare contingency measures.
According to the Ministry of Health, the choice of the patient followed the same criteria used in a face-to-face robotic surgery, without altering clinical parameters just because it involved remote operation.
The case gained relevance because it did not occur in a laboratory or simulation environment, but in a patient with a confirmed diagnosis of rectal cancer attended by a philanthropic institution of the SUS.
With the connection between the Amazon and the interior of São Paulo, the procedure demonstrated a concrete application of remote long-distance robotic surgery, without relying on transferring the patient to another state.
High-performance connectivity enters the surgical center
Presented by the federal government as part of a strategy to expand high-complexity technologies in the SUS, the initiative places digital infrastructure at the center of the debate on specialized health.
In May, Alexandre Padilha and Frederico de Siqueira Filho signed a Decentralized Execution Term to create the Brazil High Performance and Security Health Connectivity Network.
Aimed at critical health applications, the network provides for an integrated high-capacity solution between the Hospital de Amor, in Barretos, and the unit in Porto Velho.
According to the Ministry of Health, the project has an initial investment of R$ 2 million and a duration of 30 months, focusing on real-time communication, secure data transmission, and operational reliability.
In this type of surgery, the telecommunications network ceases to be just administrative support for digital health and becomes directly involved in the functioning of the medical procedure.
Image, data, and commands need to circulate with enough stability to allow teams in different cities to act in a coordinated manner, without compromising the security required by an oncological surgery.
Technology can bring patients closer to specialists
The distance between Porto Velho and Barretos reinforces the impact of the experience for regions far from the main medical hubs, especially in treatments that require oncology and high-complexity surgery.
In many situations, public health system patients need to travel to access specialized treatments, which can involve long journeys, logistical costs, and separation from the family network during a delicate phase of care.
For the Ministry of Communications, the surgery demonstrates how the expansion of digital infrastructure can bring specialists closer to patients living far from major reference centers.
In the federal government’s assessment, connectivity can help reduce regional inequalities when applied to more complex health services, provided it is associated with technical protocols and trained teams.
The Hospital de Amor plays a central role in this experience due to its national work in oncology and the free care it provides to public health system patients.
According to data released by the ministries, the institution carried out in 2025 more than 2 million appointments, including consultations, exams, and procedures, reaching more than 613 thousand patients from 2,711 Brazilian municipalities.
In addition to tele-surgery, the Ministry of Health reported that it is expanding robotic surgery in the public health system with the incorporation of robot-assisted radical prostatectomy and robotic systems among the fundable equipment.
The implementation should occur gradually, regionally, and with technical criteria, maintaining the necessary clinical safety logic for high-complexity procedures in the public network.
In the case of the operation between Rondônia and São Paulo, the advancement lies in combining physical presence in the surgical center with specialized remote command, without requiring the patient to leave their state.
Would you agree to be operated on by a team that monitors the procedure from almost 2,700 kilometers away?
