China and Pleven Connected Two Operating Rooms in One Surgery of the Future

Could you introduce yourself to the readers of CareerDailyNews? What is your professional path and when did robotic surgery and remote medical technologies become an important part of your work?

 

Thank you for the opportunity to introduce myself to the readers of CareerDailyNews. I am Prof. Dr. Dobromir Dimitrov, a specialist in surgery, Head of the Oncology Surgery Clinic at "UMBAL Dr. Georgi Stranski" EAD, Pleven, and Rector of the Medical University – Pleven. My professional path is inextricably linked to the development of minimally invasive, oncological, and robotic surgery – fields in which scientific progress and technological innovations continuously expand the possibilities of modern medicine.

 

At the core of my professional philosophy has always been the belief that the true value of technologies is determined not only by their innovativeness but above all by their ability to improve the quality of medical care, to expand the capabilities of the surgeon, and to provide more precise and effective treatment for patients.

 

Over the years, my efforts have been directed towards the introduction and development of modern surgical methods and technologies, among which are robotic interventions, focused ultrasound, and remote surgical mentorship. The accumulated experience gradually turned the idea of surgery without geographical boundaries from a professional interest into a specific goal and a natural continuation of my pursuit to expand the possibilities of modern surgery.

 

Today, I am convinced that the future of medicine will be determined by the increasingly close interaction between human expertise, robotic technologies, and digital connectivity. It is in this combination that I see the potential for a qualitative transformation of modern surgery into a model where highly specialized knowledge, skills, and medical assistance can overcome geographical limitations and reach patients regardless of physical distance.

 

How did this operation between China and Pleven come to fruition? What was its purpose and why does it represent an important step for the development of surgery?

 

The idea arose as a result of our long-standing collaboration with partners from China and our desire to overcome geographical limitations in surgery. After months of thorough preparation, technical testing, and organizational coordination, on October 20, 2026, we performed a remote robotic surgery on a patient in Pleven, controlling the surgical system from Shanghai, China, at a distance of approximately 8000 kilometers.

 

Our goal was to demonstrate that with a reliable technological infrastructure, qualified teams, and guaranteed patient safety, highly specialized surgical interventions can be performed regardless of the physical location of the surgeon.

 

This achievement marks an important step towards a future in which patients will have the opportunity to receive highly specialized surgical assistance from leading specialists around the world, without the need to travel. For me, this is not just a technological success, but a new perspective for the development and accessibility of modern medicine.

 

Could you clarify the roles of the participants? What was your role from China, what was the role of Assoc. Prof. Martin Karamanliev and his team in Pleven, and how did the Chinese specialists get involved? Who performed the surgical actions and who provided remote expert support?

 

During the operation, I was in Shanghai, remotely controlling the robotic surgical system and performing the surgical actions on the patient in Pleven. Assoc. Prof. Dr. Martin Karamanliev and Assoc. Prof. Dr. Polina Marinova led the surgical team on site, ensuring the immediate supervision and safety of the patient. Their role was of crucial importance, as such types of interventions require the presence of experienced and fully prepared surgeons who can take over the surgical intervention if necessary.

 

Our partners from China provided the necessary technological, engineering, and organizational support for the functioning of the robotic system. The realization of the intervention was the result of precise coordination and the joint efforts of surgeons, anesthesiologists, nurses, and technical specialists from both countries.

 

The success of this operation is an achievement of the entire international team and is compelling evidence of the importance of professional interaction, mutual trust, and shared expertise.

 

What technologies made this cooperation between China and Bulgaria possible? What was the role of the robotic system, communication infrastructure, and remote collaboration platform?

The realization of this high-tech intervention became possible thanks to the integration of several key technological solutions, each of which made a significant contribution to the final success.

A key role was played by the robotic surgical system Toumai from the Chinese company Shanghai MicroPort Medbot, which allows for remote control of surgical instruments in real time. The system is the first in Europe to receive CE certification under the European Medical Device Regulation (MDR) for performing robotic tele-surgery. To ensure a reliable connection between Shanghai and Pleven, we used high-speed optical internet infrastructure and a specialized communication platform for transmitting video images and control commands.

During the operation, the communication delay was approximately 180 milliseconds, which allowed for precise execution of surgical movements. Backup communication channels, independent power supply, and protocols for response to potential technical failures were also provided. The preliminary preparation, including multiple tests of connectivity and functionality of the system, was of significant importance.

The successful realization of the intervention is the result of the effective integration of modern technologies, combined with professional expertise and precise coordination of the teams. It is in such achievements that the true potential of innovations is revealed – to expand the possibilities of modern surgery and to open new perspectives for providing high-quality medical assistance, regardless of geographical distance.