Objective: To undertake a systematic review of the medical literature on telesurgery, with a key focus on identifying the key technical and nontechnical themes searched in medical articles and to analyze gaps in the current knowledge base on telesurgery. Background: It has now been over 2 decades since the first successful case of telesurgery and since this time, there have been significant technological and telecommunications advancements. Methods: A systematic review of the literature was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Details of the protocol for this systematic review were registered on PROSPERO (CRD42024511530). Results: In total, 102 unique references were allocated into 5 categories: technical, cybersecurity, ethical, financial, and regulatory considerations to discuss key themes. The vast majority of references were related to technical considerations, which have demonstrated the feasibility of telesurgery. The nontechnical considerations have a paucity of literature and a lack of guidance on telesurgery which appears to still be the major barriers to telesurgery. Conclusions: Telesurgery presents many interdisciplinary challenges, encompassing both important technical and nontechnical (such as cybersecurity, ethical, financial, and regulatory) considerations. Further research, collaboration between stakeholders, a collaborative community of experts, and the development of comprehensive consensus frameworks are essential steps toward the widespread adoption of telesurgery.