Parties involved in the robot-assisted surgery process should sign a consent form designed for this type of treatment, and the patient and physician should be the only parties who must choose this therapeutic method and not another [2,5]. Once consent has been given, it legally constitutes a convention or treaty that sets out the rights and obligations of the parties concerned [10]. The use of telesurgery, telementoring and robotic surgery has led to the globalization of surgery, overcoming geographical and political barriers and boundaries, but various economic, legal and ethical issues have arisen [2]. Objective: With the rapid introduction of revolutionary technologies into surgical practice, such as computer-assisted robotic surgery, complexity in various aspects, including medical, legal and ethical, will increase exponentially. Our goal was to highlight the important legal and ethical implications arising from the application of robotic surgery. Citation: Saceanu SM, Angelescu C, Valeriu S, Patrascu A (2015) Telesurgery and robotic surgery: ethical and legal aspect. J Community Med Health Educ 5: 355. doi: 10.4172/2161-0711.1000355 Telemedicine in general, and robot-assisted surgery in particular, are characterized by certain ethical principles and obligations so that physicians of different specialties can bring their expertise in situations where they cannot interact directly with their patients [1]. American College of Obstetricians and Gynecologists Ethics Committee.

Committee Opinion 510: Ethical means for physicians to market a practice. www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Ethics/Ethical-Ways-for-Physicians-to-Market-a-Practice. Retrieved 8 July 2014. Since their first application, telesurgery and robot-assisted surgery have been increasingly used in medicine. Because of the many benefits they offer.[3] Legal and ethical aspects should confirm the validation of medical qualifications and specialist accreditations and harmonize standards of practice to avoid restricting patient access to telemedicine and robotic surgery services [4]. Surgical instruments have become increasingly complex and error-prone. This is certainly the case with complex robotic surgery systems that contain multiple components. Communication between the patient`s surgeon docking arms, camera and console is critical to the success of surgery as well as patient safety, and system failure at any of these critical nodes could harm the patient. The responsibility for preventing this damage rests with the surgeon using the robot. It must report a malfunction of the robotic equipment to the manufacturer, hospital risk management and, in the event of serious adverse events, the Food and Drug Administration (FDA). Failure to do so is a violation of the surgeon`s ethical duty [4]. This requirement is particularly important in light of the FDA`s recent warning letter to Intuitive Surgical, Inc., manufacturer of a robotic system, in which the company is responsible for delaying reports of technical problems that could have harmed patients [5].

In telemedicine or robot-assisted surgery, the ethical principles of medical practice remain the same and include the right to confidentiality, device security, data collection and storage [1]. Robotic surgery was originally developed by the NATO Department to provide surgical assistance to soldiers directly on the battlefield [1]. Phil Green was the first in California to complete a system consisting of two cameras and a telerobot, a system attached to an operating table on the battlefield [2]. The cameras transmitted images of the operation to a computer at a distance, from where a surgeon controlled the surgical telerobot [1]. Medical centers that provide telesurgery services must employ a specialist in the treated pathology who will treat intra- and postoperative complications. In addition, medical centers and physicians must have insurance covering robot-assisted surgery and telesurgery services [4,10]. To ensure better communication and patient trust in their physician, telesurgery should be performed whenever possible after a prior relationship has been established between the two parties. It is recognized that this is not always possible [2,10]. Barry K. Plan for long-term success with a robotic surgery program. Intuitively surgical.

www.intuitivesurgical.com/support/reimbursement-white-paper-kathryn-barry-en-870526.pdf. Retrieved 24 August 2014. Dr. Spillman completed Intuitive Surgical, Inc.`s first robotic surgery training course online and in person, performing robotic surgery in her gynecologic oncology practice. She has also taught robotic surgery for gynecologic oncology fellows and residents at the University of Colorado. Telesurgery is defined as any surgical procedure performed by a surgeon or surgical team at any distance from the patient and the theater.[6] This new diagnostic and treatment technique is a branch of telemedicine in which medical information is used in a location other than that of the patient via telecommunications and electronic devices to ensure high-quality medical care [5,7]. When Isaac Asimov wrote his famous novel I, Robot [1], he introduced the world to three laws of robotics.