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By Professor Obi Davies-Ekwenna
In July last year I wrote an opinion piece telling readers about a girl called Amina. She was seven years old, from Zamfara, and her grandmother had driven her for days across Nigeria in search of a surgeon. I invented Amina. I didn’t invent the distance. In our country, where you live, it still decides, too often, whether a surgeon reaches you in time.
I asked readers to imagine a surgeon in Lagos operating on a patient hundreds of kilometers away, via a robot. The real question was never whether the machine could do it. The question was whether Nigeria could muster the skills, institutions and discipline to do so safely. Sixteen months later, I can tell you it’s been done. I can also tell you that doing it was the easy part. That’s why I’m writing again. Too often, a new way of healing is pioneered in rich countries, perfected there, and reaches Africa twenty years later, second-hand and already out of date.
Our patients pay for this delay with their lives. We don’t have to accept it. We can be in the room while a technology is still being tested, training our staff and helping write the rules, rather than receiving them. Telesurgery is the test to see if we mean it.
A patient, not a show
On September 19, 2026, I was sitting in front of a robotic console at Redeemer’s Health Village in Mowe, Ogun State. About 500 kilometers away, at Nisa Premier Hospital in Abuja, a patient with kidney cancer lay on the operating table. For parts of that operation, my hands moved instruments inside that Mowe patient.
Alongside the patient in Abuja were Dr Wesley Ekeruo, an expert US-based robotic surgeon, and Dr Lemuch Nabasu, a consultant urologist, leading the Nisa team alongside an expert anesthesia team. They were responsible for the patient every second and could have taken over at any time. This is no small detail. It’s the whole foundation. The operation lasted about three hours.
A satellite link carried the signal, with a mobile network ready as backup. Initial reports say the patient is doing well. These facts matter and they are modest. A good operation does not prove that a technology is safe, better or convenient.
There is a person behind this achievement and I will not put words in that patient’s mouth or turn an anticipated report into a promise. We owe this patient follow-up and honest answers to simple questions. Has technology made the operation safer? Did it save the patient a trip or a bill? Would ordinary care have gone as well? These are questions for patients, not for press releases.
Newspapers called it a first for Nigeria and West Africa. Era. But the robot was the least notable thing in the room. What made that day possible were months of unglamorous work: choosing the right patient, training the local team, testing the connection again and again, deciding who was responsible for what, and planning for failure until the plans became boring.
Three institutions, RoboMed Global, Redeemer’s Health Village and Nisa Premier Hospital, had to work as one.
Three words not to be confused
On October 21, 23, and 24, our teams performed additional robotic surgeries, including a prostatectomy and pyeloplasty, using three different types of remote help. Words matter, because the difference between them is the difference between an honest statement and a false one. Telesurgery means that the surgeon remotely controls the instruments.
Teleproctoring means that a distant expert observes and guides the surgeon to the patient’s bedside. Telementoring means teaching that surgeon, over time, until he or she has mastered the skill. An operation can use more than one. But advice from afar should never be interpreted as control from afar, and I will publicly enforce this rule on my team.
Our goal is not to do more and more remote operations. It is to make the bedside surgeon so capable that help from afar becomes a choice, not a crutch.
Florida is not the finish line
On October 25, Dr. Vipul Patel performed a robotic prostatectomy between two Florida hospitals, about 35 miles apart, with Dr. Marcio Moschovas and a trained team at the bedside. ABC News reported the story. I congratulate them. It was a serious achievement from a serious team. Take note of the dates, though, and allow me a smile.
Nigeria’s operation took place on September 19. Florida’s occurred on October 25, five weeks later. We have a saying at home: Naija no carry last. This time we didn’t. But this is not a competition, and it is not a boast.
The point is that, for once, a Nigerian team and an American team were on the same frontier in the same season, instead of twenty years apart. This is what keeping up means.
The Florida case was handled with a research permit granted by the US regulator. This is permission for study, not approval for daily use. Americans are still measuring outcomes, network failures, cybersecurity and what happens when things go wrong. We should maintain the same seriousness, without pretending that their rules are ours. International experts have already published safety and training guidelines, so Nigeria need not start from a blank page. But we must adapt those standards to our hospitals, our networks and our patients, and write that adaptation ourselves.
The question is no longer whether a surgeon’s skill can cross a state line. The question is whether patients get better when this happens and whether we can prove it. The robot is the smallest part If Nigeria learns one thing from these two months, let it be this: telesurgery is not something that can be bought. A robot doesn’t work. A team does it. The surgeon at the bedside, the anesthetist, the nurses, the engineer who keeps the machine alive, and the specialist who keeps the signal alive are not assistants to a distant star surgeon. They are the reason the distant surgeon is allowed to get started. So we have to count. Complications and readmissions. Broken connections and delays. Times when it was necessary to give up control. How the local team performed. What patients said about the experience. Trips avoided. The entire cost. Everything was prepared in advance, checked by independent eyes and followed up long after the discharge photograph. When something fails, it needs to be reported as carefully as when something succeeds.
A camp that races to declare itself first will lose the confidence it needs most. A field that counts its mistakes will earn it.
The turning point that lasts is education
On October 22, we opened the RoboMed Academy at Redeemer’s Health Village, in partnership with the National Postgraduate Medical College of Nigeria and Redeemer’s University. The Minister of Education, Dr. Tunji Alausa, announced that qualified professionals will be supported through TETFund’s local scholarship program. This is a serious commitment. Judge it by places funded, skills tested, and graduates who can teach the next class.
Africa cannot build its surgical future on visiting experts, foreign retention contracts and scholarships open only to those who can afford to leave. Surgeons need simulation and supervised practice. Theater nurses need their own training. Engineers must be able to repair machines here. The greatest product of all this remote technology will be the Nigerian team no longer needing it.
That’s how a region stops being late: not by waiting for a technology to get old and cheap, but by growing people who can use it while it’s still new. What comes next is a choice. None of this will hold up through goodwill alone.
Nigeria will need a shared set of rules for telesurgery: who can operate, how patients give consent, how equipment and connections are controlled, how data is protected, what happens in an emergency, and who responds when things go wrong.
Such rules should be written together, by the government, regulators, professional institutes, hospitals and patients themselves, not issued by any company or institution, including mine. Equally important is the habit of counting. Each center undertaking this work should be willing to register its own cases, report on results and costs, and let independent eyes judge when a pilot project deserves to scale.
A training academy should publish the performance of its graduates. Hospitals should be open about who pays and who benefits. None of this needs a decree. It needs a culture, and cultures are built by the first ones who choose to behave this way before anyone creates them. And we need to keep asking the uncomfortable question. Would this money bring more health to Nigerians if it were spent on basic surgeries where there is none?
Telesurgery cannot replace safe anesthesia, blood, electricity, sterile instruments, or a surgeon at the bedside. It should expand access where it proves its value, never compete with essentials. Keeping up with the world and maintaining trust with our poorest patients are not rival goals.
The test of this work is whether it does both. For Amina, in 2025, I imagined a child to make the distance visible.
In September 2026, a real Nigerian patient underwent an operation that united two cities. In October the work continued, the Academy opened and our colleagues in Florida also reported a milestone. These are beginnings, not verdicts.
Last year I asked if Nigeria was ready. This year we responded, and we responded first. The harder question is whether we can make it safe, sustainable, and available to more people than the few who can already afford it, and whether it will continue to matter after the cameras are gone. Beneath it is the question that every health minister, every college of surgeons and every hospital board in the global south faces: will we keep pace with the world in caring for our people, or will we wait another twenty years?
Amina’s journey was imaginary. The millions who need safe surgery on time are not. Reducing the distance between them and ensuring good care, without sacrificing safety or fairness, is the work that remains. It’s the only job that matters.
ABOUT THE AUTHOR
Professor Obi Davies-Ekwenna, MD, FACS, is Professor of Urology and Transplantation; Founding Partner, President and CEO of RoboMed Global; and an internationally recognized robotic and transplant surgeon. His work focuses on surgical education, equitable access, and strengthening surgical capacity in low-income and underserved settings. Disclosure: The author heads RoboMed Global, a developer of robotic surgery programs, telesurgery initiatives and surgical training in Africa.
