Urologists perform first remote robot–assisted HIFU for prostate cancer

Urologists from Cleveland Clinic have collaborated across borders to perform the world’s first remotely conducted robot–assisted high-intensity focused ultrasound (HIFU) focal therapy procedure for prostate cancer.¹

Remote operation for the HIFU procedure was conducted by Ruben Olivares, MD, of Cleveland Clinic’s main campus, who was more than 7000 miles away from the procedure that was performed at Cleveland Clinic Abu Dhabi.

Olivares was able to connect remotely to the Focal One System to lead treatment planning from Cleveland Clinic’s main campus in Ohio, in the United States. On-site procedural execution—including positioning the patient, preparing the HIFU system, and starting the procedure—was led by Waleed A. Hassen, MD, MBA, at Cleveland Clinic Abu Dhabi, in the United Arab Emirates.

Ruben Olivares, MD

“We are thrilled to have successfully performed the first-ever transcontinental robotic–assisted focal therapy procedure for prostate cancer by working in tandem with our partners at Cleveland Clinic Abu Dhabi,” said Olivares, a urologist in the Glickman Urological Institute at Cleveland Clinic, in a news release on the procedure.¹ “Here at Cleveland Clinic, we use cutting-edge technology, but unfortunately, it's not available in many places throughout the US and in the world. We look forward to expanding the adoption of the latest alternative minimally invasive options and increasing access for patients throughout the world with this first step."

Overall, the HIFU procedure lasted approximately 1 hour, and no complications were reported. Olivares and Hassen collaborated in real-time during the procedure using shared Focal One system displays and an audio connection.

Waleed A. Hassen, MD, MBA

“There are many ways to treat prostate cancer, and one of the options is HIFU focal therapy. This is proof of principle that we can contour the prostate and design the plan remotely. This milestone is a testament to the power of collaboration and innovation,” said Hassen, who is the department chair of urology at the Surgical Subspecialties Institute at Cleveland Clinic Abu Dhabi. “By leveraging the expertise of our global network, we are not only providing patients with world-class care but also shaping the future of medical education and surgical innovation.”

The remote procedure was the product of nearly 2 years of planning. According to the news release from Cleveland Clinic, this planning included “testing various connectivity networks, working with cybersecurity teams, and navigating legal and ethical frameworks to ensure a secure and reliable process, with patient safety and quality being the primary goals.”

This marks the first time in the world that a procedure like this has been conducted, opening the door for expanded access to urologic care.

Jihad Kaouk, MD, FACS

“We are witnessing the dawn of teletreatment,” said Jihad Kaouk, MD, FACS, enterprise chair of urology at Cleveland Clinic.² “This innovative approach not only allows us to share expertise across Cleveland Clinic’s locations but also expands access to specialized care for patients, no matter where they are. Teletreatment offers a unique opportunity to improve health care delivery, enhance clinical training, and reduce global health disparities, bringing quality care to patients worldwide.”

REFERENCES
1. Cleveland Clinic Abu Dhabi performs world’s first robotic-assisted, transcontinental ultrasound focal therapy procedure for prostate cancer. News release. Cleveland Clinic Abu Dhabi. April 16, 2025. Accessed April 17, 2025. https://www.mediaoffice.abudhabi/en/health/cleveland-clinic-abu-dhabi-performs-worlds-first-robotic-assisted-transcontinental-ultrasound-focal-therapy-procedure-for-prostate-cancer/

2. Cleveland Clinic performs first transcontinental robotic-assisted HIFU focal therapy procedure for prostate cancer. News release. Cleveland Clinic. April 18, 2025. Accessed April 18, 2025. https://consultqd.clevelandclinic.org/cleveland-clinic-leads-first-transcontinental-hifu-procedure-to-treat-prostate-cancer