The clinical, scientific and teaching model has been conceived and led by Dr. Alberto Breda, urological surgeon, president of the Robotic Surgery Section of the European Society of Urology (ERUS) and deputy director of the Urology Service of the Fundació Puigvert in Barcelona, with the operational and care implementation in charge of Dr. Pablo Juárez del Dago, robotic surgeon and CEO of GUA-Urointec in Las Palmas de Gran Canaria.
Robotic telesurgery has gone from being a technological demonstration to a real clinical program after 18 months of work, consolidating a pioneering success story between the Puigvert Foundation in Barcelona and the San Roque University Hospital in Las Palmas de Gran Canaria at a distance of 3.000 km.
This program is the starting point for a broader deployment at the national and international level and for the remote training of new generations of urological surgeons.
The first structured clinical program of robotic telesurgery in Europe has been launched in Spain between Barcelona and the Canary Islands, a model conceived and clinically led by Dr. Alberto Breda, urological surgeon, president of the Robotic Surgery Section of the European Society of Urology (ERUS), deputy director of the Urology Service and head of the Urological Oncology Unit of the Puigvert Foundation in Barcelona.
The operational and care implementation of the program in the Canary Islands has been led by Dr. Pablo Juárez del Dago, robotic surgeon and CEO of the GUA-Urointec urological group, whose team has taken over the coordination of the surgical environment and the integration of the model into real hospital practice.
The program connects two hospitals 3.000 km apart using a technological infrastructure developed by Edge Medical, consolidating a stable and reproducible surgical system in a healthcare setting: “It has taken us a year and a half to launch a clinical telesurgery program in Spain and this has been a challenge, but it is now a reality: we can connect two hospitals and perform remote telesurgery,” says Dr. Alberto Breda.
During the first three weeks of February, ten urological procedures of varying complexity were performed on patients from the Canary Islands—four adenomectomies for benign prostatic hyperplasia, two partial nephrectomies, three radical prostatectomies, and one resection of a retroperitoneal mass—carried out in real time from Barcelona by Dr. Alberto Breda with on-site assistance from Dr. Pablo Juárez del Dago and his team. To date, all patients have been discharged and are recovering without complications.
In this regard, Dr. Breda continues, “This program demonstrates that an expert surgeon can make their experience available to other patients with a local team that guarantees maximum safety. That's why the model between Barcelona and the Canary Islands is working: there are great surgeons in both places.”
From the robotic console installed at the Puigvert Foundation in Barcelona, the surgeon operated directly on patients from the Canary Islands in an operating room at the San Roque University Hospital in Las Palmas de Gran Canaria. According to Dr. Breda, “the technical performance was key: the average latency recorded ranged between 30 and 70 milliseconds, much lower than the 132 milliseconds recorded during the transcontinental partial nephrectomy I performed in 2024 between Bordeaux and Beijing,” considered by the scientific community to be a global milestone in telesurgery. This precedent laid the groundwork for the model that is now being implemented in a structured way in the Spanish healthcare system, not as a technological demonstration but as a clinical program in a real hospital setting.
“Telesurgery is no longer an experimental technique, but a natural evolution of robotic surgery,” the expert states. “This program demonstrates that it is possible to establish healthcare networks between hospitals while maintaining the same standards of precision and safety as in-person procedures. Furthermore, it opens the door to reducing unnecessary travel and expanding access to complex procedures performed by experts, both nationally and internationally.”
From surgical strategy to clinical practice: The model developed by Dr. Alberto Breda integrates remote surgical leadership and clinical execution from Barcelona, and in the Canary Islands, the team of the robotic surgeon, Dr. Pablo Juárez del Dago, guarantees operational and care management in the operating room, coordinating the surgical environment, patient preparation, and the integration of the model into routine hospital practice.
“Our challenge wasn’t simply connecting two operating rooms, but rather integrating this model into the actual healthcare system with all the necessary clinical guarantees,” explains Dr. Juárez del Dago. “Telesurgery only makes sense when it translates into a direct benefit for the patient and is seamlessly integrated into the work of the surgical team.” Furthermore, “this type of technology and this way of working will raise the bar for surgical expertise and position the Canary Islands as a technological hub for robotic surgery, where it will be possible to perform surgeries and develop a training and mentoring program for new generations of urologists.”
Infrastructure and institutional collaboration: The Puigvert Foundation It acts as the scientific and training hub of the program, the headquarters of the main surgeon from where the surgical strategy is led and its experience as an international reference center in urology and robotic surgery is contributed.
San Roque University Hospitals This center has been the site where the model has been clinically implemented, adapting the robotic operating room and coordinating the local medical-surgical team. The technological infrastructure has enabled a stable connection between both centers via a dedicated fiber optic network linking Barcelona and the Canary Islands, over 3.000 kilometers apart, guaranteeing the stability and security standards necessary for advanced telesurgery.
Connection between territories: Beyond the technological milestone, the program consolidates a vision of medicine based on cooperation between expert teams, knowledge transfer, and the reduction of territorial inequalities in access to highly specialized surgery.
“The Canary Islands represent a strategic point of connection between Europe, Africa, and America. Developing this program from there demonstrates that highly specialized training should not be concentrated exclusively in major healthcare centers, but rather structured as a network,” concludes Dr. Breda.
About Dr. Alberto Breda: Urologist, expert in urologic oncology and kidney transplantation. Surgeon specializing in robotic surgery and a pioneer in the clinical implementation of telesurgery. Clinical, scientific, and teaching leader of the first clinical program for robotic urologic telesurgery implemented in Spain, between Barcelona and the Canary Islands.
He is currently the Deputy Director of the Urology Department at the Puigvert Foundation, a position he combines with directing the Urologic Oncology Unit and the Renal Transplant Surgical Team. He is the President of the European Robotic Urology Section (ERUS) of the European Association of Urology (EAU 2022-2029). He is also the Deputy Director of the Puigvert Foundation Chair of Urologic Robotic Surgery-UAB, an Associate Professor at the UAB, and an Adjunct Professor of Urology at Mount Sinai Hospital in New York (USA).
In 2024, Dr. Breda performed the world's first transcontinental partial nephrectomy, from Europe (France) to Asia (China) via telesurgery.
In 2022, he performed the first partial kidney nephrectomy in Europe using the HUGO™ robot.
In 2015, he was the first surgeon in Spain to perform a complete robotic kidney transplant from a living donor using the DaVinci robot.
About Dr. Pablo Juárez del Dago: Urologist specializing in robotic surgery of the prostate, kidney, and bladder, as well as laser surgery for the treatment of benign prostatic hyperplasia. Clinical and operational sub-director of the first robotic urological telesurgery clinical program implemented in Spain, covering Barcelona and the Canary Islands.
The CEO of the GUA-UROINTEC urological group is the director of the Robotic Surgery Unit at GUA (Urology and Andrology Clinic) and the director of the Urology Department at San Roque University Hospitals in the Canary Islands. He leads the Technology Working Group of the European Robotic Urology Section (ERUS) of the European Association of Urology (EAU), which focuses on promoting innovation, training, and the democratization of robotic surgery in Europe. He collaborates with international experts such as Dr. Richard Gaston and Dr. Alberto Breda on research projects.
About GUA – UROINTEC: GUA (Urology and Andrology Clinic) is the leading healthcare clinic in urology and andrology in the Canary Islands, with more than 35 years of experience.
UROINTEC, for its part, is a Spanish company founded in 2018 by Dr. Pablo Juárez del Dago, based in Las Palmas de Gran Canaria, specializing in advanced urology services, innovation and technology applied to health.
Together, GUA and UROINTEC promote initiatives that integrate clinical practice, robotics, surgical connectivity, and advanced education, contributing to the technological transformation of the healthcare sector. In addition to its clinical practice, UROINTEC provides urology services to medical centers, clinics, and hospitals, and has strengthened its international presence through agreements with leading technology and medical companies in markets such as the United States and China.
About Fundació Puigvert: It is a monographic health institution in Urology, Nephrology, Andrology and Reproductive Medicine, established in 1961 by Professor Antoni Puigvert Gorro with the aim of being a benchmark of excellence in these specialties.
Currently, as a privately managed, non-profit university hospital, it focuses on the study and medical and surgical treatment of pathologies and dysfunctions of the urinary system and the genital system, standing out especially for its high level of experience in the implementation of robotic surgery applied to Urology and kidney transplants since, in 2005, it became the first hospital in Spain to perform a surgical intervention with a robotic system.
After more than 20 years leading this field, the Puigvert Foundation takes a new step forward with the implementation of robotic telesurgery, following the innovative evolution that reaffirms it as an institution that not only adopts technology, but also anticipates and develops the surgical models of the future.
Thanks to its long history and the value of a highly specialized medical team with extensive medical, surgical, teaching and scientific experience, the Fundació Puigvert is one of the health centers in Europe with the highest volume of specialized care activity and high clinical excellence in Urology, Nephrology, Andrology and Reproductive Medicine.
About San Roque University Hospitals: HUSR With over a hundred years of history as a benchmark for private healthcare in the Canary Islands, it became in 2019 the first private hospital in the archipelago to obtain the University Hospital qualification, a key milestone for medical research, development and innovation.
The group's constant commitment to cutting-edge technology and highly complex medicine places it among the top 50 private hospitals in Spain, according to the 2024 Healthcare Reputation Monitor. This positioning is supported by its presence in prestigious international rankings, such as World's Best Hospitals 2026 – Spain (Newsweek), and by awards such as the 2024 New Medical Economics Award for the best-managed private hospital, which consolidate its leadership in excellent healthcare.
