When Paul Buxton was diagnosed with prostate cancer in January, he expected the usual routine for Gibraltar residents needing complex treatment: fly to London, join an NHS waiting list, spend weeks away from home. Instead, the 62-year-old became part of medical history.

On 11 February, Professor Prokar Dasgupta — one of the world's leading robotic urological surgeons — removed Buxton's prostate from a console at The London Clinic, 1,500 miles away. Buxton never left St Bernard's Hospital in Gibraltar.

"A lot of people said to me: 'You're not going to do it, are you?'" Buxton told the BBC. "I thought, I'm giving something back here. This is a no-brainer."

How it works

The operation used the Toumai Robotic System, made by Microport. A robot equipped with a 3D high-definition camera and four surgical arms sat beside Buxton in Gibraltar, while Dasgupta controlled every movement through a console in London.

The two sites were connected by fibre-optic cables — with a backup 5G link — delivering a time lag of just 48 milliseconds. That's less than the blink of an eye, and well within the 100-millisecond threshold that surgeons consider safe for precision work. A local surgical team led by urologists James Allen and Paul Hughes stood by throughout, ready to intervene if the connection dropped. It didn't.

"It felt almost as if I was there," Dasgupta said.

Why it matters

Gibraltar is a British overseas territory with just one hospital. Residents who need specialist surgery typically travel to the UK — at significant personal cost, inconvenience, and delay. Buxton estimated he would have spent three weeks in London had he gone the traditional route.

The implications stretch far beyond Gibraltar. Rural communities across the UK, island territories, and countries with surgeon shortages could all benefit from a model where the world's best specialists operate remotely.

"This gives us the opportunity to treat patients in remote areas and smaller communities by literally being able to take the best surgeon anywhere," Dasgupta said.

The NHS is already investing heavily in robotics, with a target of 500,000 robot-supported operations a year by 2035. Remote surgery could become a natural extension of that ambition — connecting specialist centres with district hospitals that lack certain expertise.

A long time coming

The idea of operating across distances isn't new. The world's first telesurgery took place in 2001, when a team of French surgeons in New York used the ZEUS robotic system to perform a gallbladder removal on a patient in Strasbourg, France — a procedure known as "Operation Lindbergh." That operation had a latency of around 155 milliseconds and relied on a dedicated transatlantic fibre-optic link to make it possible.

Twenty-five years on, the technology has matured dramatically. Networks are faster and more reliable, robotic systems are more refined, and the latency that once threatened surgical precision has shrunk to a fraction of what it was.

UK surgeons have also previously completed a transatlantic robotic stroke procedure on a cadaver over 4,000 miles, proving the technical feasibility at even greater distances.

What comes next

Dasgupta has already performed a second remote procedure — on an unnamed 52-year-old patient on 4 March — and live-streamed a third operation on 14 March to 20,000 urological surgeons at the European Association of Urology congress.

But experts urge caution alongside excitement. Remote surgery still requires a skilled local team for safety, robust network infrastructure, and regulatory frameworks that don't yet exist in most countries. Scaling from a carefully controlled trial to routine practice will take time.

For Paul Buxton, though, the future arrived early. He reported feeling "fantastic" after his operation — and never had to pack a suitcase.

"It is pioneering for Gibraltar," he said, "because you don't need to leave Gibraltar."