In the world of telesurgery, network latency can cause serious problems - disrupting operations and potentially endangering patients' lives. The wider use of telechurgical systems and their better availability also make them more vulnerable to potential cyberbullying. Blockchain technology can provide solutions to these and other application problems by securing telesurgical systems, while still being available to surgeons in multiple locations.

Telesurgery involves the use of automated or robotic systems that allow surgeons to operate patients remotely without having to be in the operating room. Although widespread, especially in areas such as gastrointestinal surgery, network congestion remains a major problem and an obstacle to its wider recovery. It's easy to see why - when playing video games, network clutter can be a problem, but performing an operation can have dangerous consequences.

Resolve the network latency issue

The advent of next-generation networks and 5G technology has made surgical robots more common in operating theatres. 5G technology provides a more reliable and faster Internet connection, making telesurgery systems more reliable, without worrying about reducing network speed during operations. While the low-latency 5G network infrastructure has solved some important connectivity issues, other issues have become more pronounced. For example, the fact that these systems are now used by many more surgeons from different locations raises issues of security, privacy and interoperability.

Widely cited research published by researchers at the University of Washington first drew attention to the risk of potential cyber attacks in 2015. Research has shown that it is possible for a malicious third party to break into a telosurgical system and compromise a remote connection made by a surgeon during surgery. As a result, the system may lock up so that it does not work. This raises concerns about telesurgery in a critical moment. Since then, innovators in these automated systems have been looking for ways to improve security.

Blockchain to the rescue

Blockchain technology, which is widely used in the banking sector to secure online transactions and facilitate the purchase and sale of cryptocurrencies, uses a distributed and decentralized system that is secure. The application of this technology to telesurgical systems can provide many benefits. For example, traditional telechurgery systems are centralized, making it difficult for many surgeons to use different patient data sharing systems without the involvement of a facilitator. In addition to delaying surgery, the use of an intermediary is an unnecessary security risk. Thanks to its decentralized blockchain functionality as a distributed ledger technology, it eliminates the need for an intermediary and improves the overall security of the system.

Use "smart contracts" to verify the surgeon's identity

The use of blockchain technology in telesurgery can also help verify a surgeon's identity through a "smart contract." A smart contract is a self-starting program stored in a blockchain that requires the user to achieve a specific predefined behaviour before using the system. This process means that the validity of the surgeon's identity, qualifications and experience can be verified before being checked by a surgical robot.

While many researchers have recognized the benefits that blockchain can bring to telosurgical systems, some other problems remain unresolved and more research and development activities are needed to find solutions.

For example, while network latency is largely addressed by 5G, the consensus mechanism required by blockchain technology to facilitate the use of an automated system may take some time. For example, Bitcoin's "proof of work" consensus mechanism takes an average of 10 minutes to add a new block to a blockchain, which seems like a long time given how it can delay the start of an operation. Although there are other faster consensus mechanisms, such as stake proof, each has disadvantages - for example, stake proof can be weak if one party has a large share of the blockchain's characteristics.

The perspective of patenting

The use of blockchain technology in telesurgery is still in its infancy. The Gartner Hype Cycle for Blockchain 2021 shows that many aspects of blockchain technology that are most useful in telesurgical applications, such as authentication and zero knowledge, are still in the early stages of development. Many R&D activities appear to take place within academic research departments, which may mean that there is a high risk of early publication before patent protection is considered.

This kind of early detection can make technological innovation unpatentable. While many universities have moved to the benefits that commercialization can bring, some may not think that way and lose financial consequences.

At present, there do not appear to be many patent activities specifically focused on the use of blockchain in telesurgery. However, some common blockchain patents may be broad enough to cover telosurgery applications and should be well considered by potential developers. They should also keep in mind that some patent applications may be filed recently, which means that they will not be published until after 18 months and their plans to commercialize innovations may fail.

Innovators exploring ways to leverage their blockchain technology in telesurgery should consider their IP strategies carefully. For example, it may be prudent to file several patent applications early to gain broad protection and stay ahead of all possible competition.

With a pandemic affecting work practices across the healthcare sector, the use of telesurgical systems is expected to grow and expand into new areas of practice. Blockchain technology can play an important role in ensuring that these systems simultaneously improve efficiency and improve patient outcomes.