Abstract

Background

Despite growing interest in telesurgery, empirical evidence from low- and middle-income countries, including Nigeria, remains limited. This study assessed awareness, perceptions of benefits and barriers, and readiness for telesurgery among medical students at Ambrose Alli University and medical doctors at Irrua Specialist Teaching Hospital, Nigeria.

Methods

A cross-sectional mixed-methods design was used. The survey included 390 respondents: 280 clinical-year medical students and 110 doctors. Four focus group discussions involving 23 participants were analysed.

Results

Among respondents, 80.5% had heard of telesurgery, but only 10.5% had received formal training in robotic surgery or telesurgery. Awareness was higher among doctors than students (93.6% versus 75.4%; p < .001). Most respondents believed telesurgery could improve access to specialist care (68.7%) and could be safe with adequate infrastructure and protocols (73.3%). Only 22.1% rated institutional readiness as moderate or higher, while 55.6% considered their institutions not at all ready. A total of 52.3% were definitely willing to undertake training. Key implementation barriers were unreliable electricity (70.0%), poor internet connectivity (62.1%), and equipment costs (50.5%). Qualitative discussions reinforced concerns about infrastructure, training and regulatory preparedness.

Conclusion

Awareness of telesurgery was high, but formal training, practical exposure and institutional readiness remained limited. The authors recommend phased implementation involving education, telementoring, infrastructure development and appropriate regulation.

Keywords: telesurgery; telemedicine; awareness; readiness; medical students; Nigeria

Key Research Findings

These figures describe the surveyed participants and should not be interpreted as nationally representative estimates.

Study Design and Methods

The research was conducted at Ambrose Alli University, Ekpoma, and Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria. The study used a cross-sectional survey alongside separate focus group discussions with medical students and doctors. Data collection was undertaken during 2026.

• Quantitative sample: 280 clinical-year medical students and 110 doctors (n = 390).
• Qualitative sample: four focus group discussions with 23 participants (11 students and 12 doctors).
• Recruitment: stratified convenience sampling for the survey and purposive sampling for focus groups.
• Analysis: descriptive statistics, group comparisons with appropriate categorical tests and Holm-adjusted sensitivity analysis; framework thematic analysis for focus group transcripts.
• Theoretical framework: Technology Acceptance Model (TAM).

Interpretation and Implications

The findings identify a substantial gap between awareness of telesurgery and the infrastructure, training and governance needed to implement it. Respondents frequently recognised potential benefits for specialist access and education, while expressing concerns about electricity, network reliability, costs, clinical safety and medicolegal responsibility.

The authors propose a phased pathway that prioritises education, practical simulation, telementoring, resilient infrastructure and regulatory safeguards before full telesurgery implementation. As the study was cross-sectional, relied on self-reported responses and was conducted at two institutions in one state, causal conclusions and broad national generalisations are not warranted.

Authors and Institutional Affiliations

Matthew Ayomide Abiodun^1,2*; Precious Ikhianose Aitanun¹; Favour Osemengbe Akhere³; Chinemezu Chizaram Ogbonna⁴; Adebusola Adenike Owokole^2,5,6,7.

1. Department of Medicine and Surgery, Ambrose Alli University, Ekpoma, Edo State, Nigeria.
2. The Operating Room Global (TORG).
3. Department of Nursing Science, Irrua Specialist Teaching Hospital College of Nursing, Irrua, Edo State, Nigeria.
4. Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
5. The Robotic Global Surgical Society (TROGSS).
6. University of Limerick (UL), Limerick, Ireland.
7. UL Hospitals, Ireland.

*Corresponding author: Matthew Ayomide Abiodun · [email protected]

Ethics and Publication Declarations

Ethical approval

Approval was granted by the Irrua Specialist Teaching Hospital Health Research Ethics Committee (ISTH-HREC), reference ISTH/HREC/20262402/857, with approval covering 13 March 2026 to 12 March 2027. The manuscript reports informed consent and measures to protect participant confidentiality.

Funding

No external funding was received; the research was funded by the researchers.

Conflicts of interest

The authors declared no conflicts of interest.

Data availability

De-identified supporting data may be requested from the corresponding author, subject to ethical and data-protection requirements.

Author contributions (CRediT)

Matthew Ayomide Abiodun: Conceptualization, Methodology, Investigation, Project Administration, Writing – Original Draft. Precious Ikhianose Aitanun: Formal Analysis, Investigation, Writing – Original Draft, Writing – Review & Editing. Favour Osemengbe Akhere: Data Curation, Writing – Review & Editing. Chinemezu Chizaram Ogbonna: Investigation, Writing – Review & Editing. Adebusola Adenike Owokole: Supervision, Methodology, Validation, Writing – Review & Editing.

AI assistance declaration

The manuscript reports the use of Fireflies AI for focus-group recording and transcription, and ChatGPT and Claude for limited literature searches and editorial assistance. The authors state that they verified AI-assisted outputs and retain responsibility for the final manuscript.

Licence

Published as an open-access article under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0).

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