Asian Journal of Endoscopic Surgery最新文献_第7页

Short-Term and Long-Term Outcomes of Laparoscopic Local Resection of the Stomach Using the “Lift-And-Cut Method” for Gastric Gastrointestinal Stromal Tumors 腹腔镜胃局部切除术“提切法”治疗胃肠道间质瘤的近期和远期疗效

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-28 DOI: 10.1111/ases.70198

Shun Akiyama, Norihiro Shimoike, Seiichiro Kanaya, Shinya Yoshida, Tomoaki Okada, Akira Mori, Hisahiro Hosogi

Introduction

In laparoscopic local resection of the stomach for gastric gastrointestinal stromal tumors (GISTs), wedge resection and laparoscopic and endoscopic cooperative surgery (LECS) are commonly employed. However, wedge resection can result in excessive removal of gastric tissue, leading to postoperative deformity, while LECS carries risks such as surgical site infection, intra-abdominal abscess, and potential tumor cell seeding due to gastric lumen opening. To overcome these limitations, we developed the “lift-and-cut method,” a minimally invasive surgery (MIS) designed to minimize gastric resection without opening the gastric lumen. This study reports the short- and long-term outcomes of patients treated with this approach.

Methods

We retrospectively reviewed consecutive cases of gastric GIST treated with the “lift-and-cut method” between June 2011 and May 2024.

Results

A total of 80 patients underwent the “lift-and-cut method”. The median operative time was 107 min (interquartile range [IQR], 77–141 min), with no intraoperative blood loss (IQR, 0–0 g). The median postoperative hospital stay was 7 days (IQR, 6–8 days). One patient experienced a postoperative urinary tract infection. According to the modified Fletcher classification, tumor risk levels were very low (n = 9), low (n = 49), intermediate (n = 14), and high (n = 8). After a median follow-up of 60.0 months (IQR, 24.0–89.3 months), one patient died of recurrence, and another from an unrelated cause.

Conclusion

The “lift-and-cut method” appears to be a safe and effective minimally invasive option for gastric GIST, offering favorable short- and long-term outcomes while minimizing tissue resection and avoiding gastric lumen entry.

在腹腔镜胃局部切除术治疗胃肠道间质瘤（gist）中，通常采用楔形切除术和腹腔镜内镜联合手术（LECS）。然而，楔形切除会导致过多的胃组织切除，导致术后畸形，而LECS存在手术部位感染、腹腔内脓肿、胃腔开放可能导致肿瘤细胞播散等风险。为了克服这些限制，我们开发了“提切法”，这是一种微创手术（MIS），旨在最大限度地减少胃切除而不打开胃管。这项研究报告了用这种方法治疗的患者的短期和长期结果。方法回顾性分析2011年6月至2024年5月间采用“提切法”治疗的连续胃间质瘤病例。结果80例患者均采用“提切法”。中位手术时间为107 min（四分位间距[IQR]， 77 ~ 141 min），无术中出血量（IQR, 0 ~ 0 g）。术后中位住院时间为7天（IQR， 6-8天）。1例患者术后尿路感染。根据改良的Fletcher分级，肿瘤危险级别分为极低（n = 9）、低（n = 49）、中（n = 14）和高（n = 8）。中位随访60.0个月（IQR, 24.0-89.3个月）后，1例患者死于复发，另1例死于无关原因。结论“提切法”是一种安全有效的胃间质瘤微创治疗方法，在减少组织切除和避免胃腔进入的同时，具有良好的短期和长期预后。

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引用次数: 0

Anatomy on the Border Expert Consensus Meeting: Current Status and Future Perspectives of Three-Dimensional Image Reconstruction and Immersive Technologies in Liver Surgery 边界解剖学专家共识会议：肝脏外科三维图像重建和沉浸式技术的现状和未来展望

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-27 DOI: 10.1111/ases.70182

Daisuke Asano, Yujin Kudo, Satoshi Kobayashi, Toshiya Abe, Kenoki Ohuchida, Keiichi Akahoshi, Go Wakabayashi, Kimihiro Shimizu, Mingyon Mun, Hisashi Iwata, Atsushi Takenaka, Tomonori Habuchi, Minoru Tanabe, Tomoharu Yoshizumi, Daisuke Ban, Norihiko Ikeda, Masatoshi Eto, Yuko Kitagawa, Masafumi Nakamura

Introduction

The Japan Society for Endoscopic Surgery organized the Anatomy on the Border Expert Consensus Meeting in 2024 to foster cross-disciplinary discussions. One of the themes, on parenchymal organs, brought together liver, lung, and kidney specialists to jointly discuss the current status and future perspectives of three-dimensional image reconstruction and augmented/virtual/mixed reality technologies in surgery. This report summarizes the results of these discussions in relation to liver surgery.

Methods

A questionnaire was distributed to board-certified expert training facilities of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and liver surgeons certified by the Japan Society for Endoscopic Surgery. A systematic review of English language articles published between 2015 and 2024 was also conducted.

Results

Responses were obtained from 86 institutions. The majority (88%) reported routine use of three-dimensional image reconstruction, mainly for preoperative planning (92%) and anatomical understanding (88%). It was rated as very or moderately useful by 99% of respondents. A literature review confirmed the perioperative benefits of this technique. In contrast, augmented/virtual/mixed reality technologies were used in only 16% of the institutions; the majority of these (79%) acknowledged their usefulness, primarily for anatomical understanding and education. The barriers to implementation included cost and data preparation complexity. The educational benefits were supported by data from randomized controlled trials; however, clinical evidence remains limited and inconsistent.

Conclusion

Three-dimensional image reconstruction has become essential in liver surgery. Augmented/virtual/mixed reality technologies, although in the early stages, show promise for surgical education and may eventually contribute to surgical practice as accessibility improves.

日本内窥镜外科学会于2024年组织了边境解剖专家共识会议，以促进跨学科讨论。其中一个主题是实质器官，汇集了肝脏、肺和肾脏专家，共同讨论三维图像重建和增强/虚拟/混合现实技术在外科手术中的现状和未来前景。本报告总结了这些关于肝脏手术的讨论的结果。方法对经日本肝胆胰外科学会认证的专家培训机构和经日本内镜外科学会认证的肝脏外科医生进行问卷调查。对2015年至2024年间发表的英语文章进行了系统回顾。结果共获得86所院校的反馈。大多数（88%）报告常规使用三维图像重建，主要用于术前计划（92%）和解剖理解（88%）。99%的受访者认为它非常有用或一般有用。文献回顾证实了该技术的围手术期益处。相比之下，只有16%的机构使用了增强/虚拟/混合现实技术；其中大多数人（79%）承认它们的用处，主要是用于解剖学的理解和教育。实现的障碍包括成本和数据准备的复杂性。随机对照试验的数据支持了教育效益；然而，临床证据仍然有限且不一致。结论三维图像重建在肝脏外科手术中具有重要意义。增强/虚拟/混合现实技术，虽然在早期阶段，显示出外科教育的前景，并可能最终有助于外科实践的可访问性的提高。

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引用次数: 0

Planarization, Squarization, and Verticalization for Optimal Surgical View Exposure in Laparoscopic Cholecystectomy (With Video) 腹腔镜胆囊切除术中平面化、方形化和垂直化的最佳手术视野暴露（附视频）

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-27 DOI: 10.1111/ases.70192

Hironari Kawai, Shunjin Ryu, Daiki Suzuki, Hyuga Kawakubo, Shunsuke Nakashima, Takehiro Kobayashi, Yuta Imaizumi, Ryusuke Ito

Introduction

Laparoscopic cholecystectomy (Lap-C) is generally considered an entry-level surgical procedure. However, achieving a properly tensioned and well-exposed surgical field tailored to each specific case is not always straightforward. In this study, we demonstrate our surgical field exposure strategy based on three key concepts in Lap-C: planarization, squarization (“square-shaped exposure”), and verticalization.

Materials and Surgical Technique

To verbalize the surgical technique, we first defined the three key concepts—planarization, squarization, and verticalization—in the context of Lap-C. The operative procedure was then divided into four major steps: serosal incision, creation of the critical view of safety, transection of cystic structures, and dissection of the gallbladder bed. Each step was performed with conscious application of these principles to optimize the surgical field.

Discussion

The use of verbalized surgical techniques may facilitate more optimal surgical field exposure and tissue dissection, ultimately contributing to safer laparoscopic cholecystectomy.

腹腔镜胆囊切除术（Lap-C）通常被认为是入门级外科手术。然而，为每个特定病例量身定制合适的张力和充分暴露的手术野并不总是直截了当的。在这项研究中，我们展示了基于Lap-C的三个关键概念的手术野暴露策略：平面化，方形化（“方形暴露”）和垂直化。材料和手术技术为了表达手术技术，我们首先在Lap-C的背景下定义了三个关键概念——平面化、方形化和垂直化。手术过程分为四个主要步骤：浆膜切开、建立安全的关键视图、囊性结构的横断和胆囊床的剥离。每一步都是有意识地应用这些原则来优化手术范围。使用语言化的手术技术可以促进更理想的手术野暴露和组织剥离，最终有助于更安全的腹腔镜胆囊切除术。

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引用次数: 0

Nationwide Expert Survey on Appropriate Bile Duct Transection Line in Adult and Pediatric Congenital Biliary Dilatation Surgery in Japan: AOB Consensus Meeting 日本成人和儿童先天性胆道扩张手术中适当胆管横断线的全国专家调查：AOB共识会议

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-27 DOI: 10.1111/ases.70194

Toshiharu Matsuura, Yoshitaka Kiya, Masahiro Takeda, Hiroki Mori, Takahisa Tainaka, Tetsuya Idichi, So Nakamura, Toshiya Abe, Kohei Nakata, Kenoki Ohuchida, Takao Ohtsuka, Hiroki Ishibashi, Hiroyuki Koga, Hiroo Uchida, Yuichi Nagakawa, Tatsuro Tajiri, Masafumi Nakamura, Yuko Kitagawa

Background

Resection of the extrahepatic bile duct including the gallbladder and the dilated segment, is a widely accepted surgical concept in congenital biliary dilatation (CBD) in both adult and pediatric surgeons. However, owing to the existence of various types of CBD and differences in the extent of dilatation, no consensus has been reached regarding the appropriate resection margins.

Methods

Consensus statements regarding the appropriate surgical margins for both the duodenal and hepatic hilum sides were developed as two clinical questions (CQs) during a multidisciplinary consensus meeting. A comprehensive literature review and expert survey were conducted. Consensus was achieved through a Delphi voting process, with statements approved when ≥ 75% agreement was reached.

Results

In a nationwide expert survey, pediatric institutions resected the bile duct closer to the junction of the pancreatic duct on the duodenal side relative to adult institutions. In contrast, adult institutions aggressively transected higher levels of the hepatic duct on the hilum side. Taking literature reviews into account, the following consensus statement was developed: “The narrow segment is a good landmark to remove closely to the pancreatic junction on the duodenal side and the decision on the resection line on the hepatic hilum side should be dependent on the type of Todani's classification.” This statement achieved a unanimous agreement in the Delphi vote.

Conclusion

It should be noted that there are differences in surgical concepts between adult and pediatric institutions. Further research is needed to determine the long-term outcomes related to the resection line.

切除肝外胆管，包括胆囊和扩张段，是成人和儿童外科医生在先天性胆道扩张（CBD）中广泛接受的手术概念。然而，由于不同类型的CBD的存在和扩张程度的差异，对于合适的切除边缘尚未达成共识。方法在多学科的共识会议上，就十二指肠和肝门侧的合适手术切缘达成共识，作为两个临床问题（CQs）。进行了全面的文献综述和专家调查。通过德尔菲投票程序达成共识，当达成≥75%的一致意见时，声明被批准。结果在一项全国性的专家调查中，相对于成人机构，儿科机构更靠近十二指肠侧胰管交界处切除胆管。相比之下，成人机构积极横切肝门侧较高水平的肝管。综合文献回顾，得出如下共识：“窄段是靠近十二指肠侧胰腺连接处切除的良好标志，肝门侧切除线的决定应取决于Todani分类的类型。”这一声明在德尔菲投票中获得了一致同意。结论成人机构与儿科机构在手术理念上存在差异。需要进一步的研究来确定与切除线相关的长期结果。

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引用次数: 0

Preclinical Evaluation of a New Surgical Hybrid Energy Device Compared to the Conventional Energy Device 一种新型手术混合能量装置与传统能量装置的临床前评价

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-27 DOI: 10.1111/ases.70201

Satoru Matsuda, Kazuhisa Ehara, Hiroyasu Kagawa, Shunsuke Tsukamoto, Kohei Nakata, Mamoru Morimoto, Sayaka Yasui, Jumpei Torikai, Ichiro Uyama

Introduction

Despite the development of surgical instruments combining ultrasonic scissors and an advanced bipolar device, thermal management has still been considered a persistent issue, similar to that in conventional ultrasonic scissors. To address this issue, the next-generation hybrid device (NGHD) with a new tip and handle design has been devised while maintaining the high cutting and sealing performance of combined surgical instruments (THUNDERBEAT Type S, TBS). We compared them in an ex vivo and nonclinical in vivo environment and investigated their perceived clinical usefulness.

Methods

Ex vivo testing included measurements of cutting speed, posterior thermal spread from the jaw, and lateral thermal spread. The nonclinical in vivo study involved evaluations such as cutting capability while maintaining the tissue layer, and handle ergonomics.

Results

The NGHD demonstrated a significantly faster cutting speed than did TBS (2.41 [2.31–2.50] vs. 3.04 [2.94–3.13] s, p < 0.01) with 5–7 mm arteries, as well as significant improvements in the posterior thermal spread on arteries during activation (5.67 [0–12.84] vs. 84.22 [35.34–133.10] μm, p < 0.01) and lateral thermal spread (2.22 [2.06–2.38] vs. 2.79 [2.55–3.03] mm, p < 0.05). Surgeon assessments indicated more improvements with the NGHD than with TBS, especially regarding cutting while maintaining the tissue layer and handle ergonomics.

Conclusion

The NGHD promoted improvements in thermal management generally associated with TBS and maintained the benefits of combining devices capable of ultrasonic and advanced bipolar output. The NGHD has the potential to support safe and efficient endoscopic procedures, pending further clinical evaluation.

尽管结合超声剪刀和先进的双极装置的手术器械得到了发展，热管理仍然被认为是一个持久的问题，类似于传统的超声剪刀。为了解决这个问题，新一代混合装置（NGHD）采用了新的尖端和手柄设计，同时保持了联合手术器械（THUNDERBEAT Type S， TBS）的高切割和密封性能。我们在离体和非临床的体内环境中比较了它们，并调查了它们的临床用途。方法体外实验包括测量切削速度、下颌后向热扩散和侧向热扩散。非临床的体内研究包括评估，如切割能力，同时保持组织层，并处理人体工程学。结果在5-7 mm动脉中，NGHD的切割速度明显快于TBS (2.41 [2.31-2.50] vs. 3.04 [2.94-3.13] s, p < 0.01)，激活时动脉后侧热扩散（5.67 [0-12.84]vs. 84.22 [35.34-133.10] μm, p < 0.01）和侧侧热扩散（2.22 [2.06-2.38]vs. 2.79 [2.55-3.03] mm, p < 0.05）。外科医生评估表明，NGHD比TBS有更多的改善，特别是在切割时保持组织层和处理人体工程学方面。结论NGHD促进了与TBS相关的热管理的改善，并保持了超声和先进双极输出设备相结合的优势。NGHD有可能支持安全有效的内窥镜手术，有待进一步的临床评估。

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引用次数: 0

Clinical Outcomes of Fusion Robot-Assisted Thoracic Surgery: A Retrospective Analysis With Propensity Score Matching 融合机器人辅助胸外科手术的临床结果：倾向评分匹配的回顾性分析。

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-25 DOI: 10.1111/ases.70193

Yasuaki Kubouchi, Toho Wada, Ryota Yasuda, Yuji Nozaka, Wakako Fujiwara, Shinji Matsui, Yugo Tanaka

Fusion robot-assisted thoracic surgery (fusion RATS) has gained much attention as an alternative to console-only approaches (pure RATS), as during fusion RATS, the bedside assistant performs stapling and actively supports the procedure. This study retrospectively analyzed data from 553 patients who underwent robotic anatomical pulmonary resection with either fusion or pure RATS to compare perioperative outcomes. After 1:2 propensity score matching, 294 patients were included in the analysis. Fusion RATS exhibited substantially shorter operative and console times without an increase in complication rates. Moreover, it allowed for flexible stapler insertion angles, enabling the use of reinforced staplers. Assistant participation in key steps may provide educational benefits and improve adaptability, specifically when integrated robotic staplers are unavailable. Fusion RATS proved to be a practical and safe alternative with additional technical and educational advantages, supporting its broader adoption in thoracic surgery.

融合机器人辅助胸外科手术（Fusion RATS）作为单纯控制台方法（纯RATS）的替代方案而受到广泛关注，因为在融合RATS过程中，床边助理进行缝合并积极支持手术。本研究回顾性分析了553例机器人解剖肺切除术患者的数据，比较了融合或纯RATS的围手术期结果。经1:2倾向评分匹配后，294例患者纳入分析。融合大鼠表现出较短的手术时间和控制时间，且并发症发生率未增加。此外，它允许灵活的订书机插入角度，使使用加强订书机。助手参与关键步骤可能会提供教育效益，并提高适应性，特别是在集成机器人订书机不可用的情况下。融合大鼠被证明是一种实用、安全的替代方法，具有额外的技术和教育优势，支持其在胸外科手术中的广泛应用。

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引用次数: 0

Consensus Meeting on the “Anatomy on the Border”: Systematic Thoracic Lymph Node Dissection Procedures for Lung and Esophageal Cancer “边缘解剖”共识会议：系统性胸淋巴结清扫手术治疗肺癌和食管癌。

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-25 DOI: 10.1111/ases.70186

Junji Ichinose, Susumu Shibasaki, Koji Shindo, Yujin Kudo, Toshiya Abe, Kenoki Ohuchida, Hisashi Shinohara, Kazutaka Obama, Masato Watanabe, Kimihiro Shimizu, Hisashi Iwata, Hirokazu Noshiro, Norihiko Ikeda, Masafumi Nakamura, Yuko Kitagawa, Mingyon Mun, Ichiro Uyama, Koichi Suda

Background

This study aimed to explore the commonalities and differences in systematic lymph node dissection between lung and esophageal cancer surgeries.

Methods

A survey comprising 11 questions related to systematic lymph node dissection techniques for both lung and esophageal cancer was conducted across 265 facilities specializing in thoracic and esophageal surgeries. Additionally, a comprehensive search was performed using the MEDLINE database.

Results

Responses were received from 63 facilities specializing in thoracic surgery and 79 facilities specializing in esophageal surgery. Many facilities chose minimally invasive surgery for lung and esophageal cancer. Most thoracic and esophageal surgeons paid attention to the concepts of visceral and vascular sheaths. The results of the survey and literature review revealed the key anatomical structures that define the area of mediastinal lymph node dissection.

Conclusion

This survey and the literature review have clarified the current consensus among thoracic and esophageal surgeons regarding systematic mediastinal lymph node dissection.

背景：本研究旨在探讨肺癌与食管癌手术系统性淋巴结清扫的共性与差异。方法：在265家专门从事胸外科和食管癌手术的机构中进行了一项调查，包括11个与肺癌和食管癌系统淋巴结清扫技术相关的问题。此外，使用MEDLINE数据库进行了全面的搜索。结果：我们收到了来自63家胸外科医院和79家食道外科医院的反馈。许多医院选择微创手术治疗肺癌和食管癌。大多数胸外科和食道外科医生都重视内脏鞘和血管鞘的概念。调查结果和文献回顾揭示了确定纵隔淋巴结清扫区域的关键解剖结构。结论：本调查和文献综述澄清了目前胸外科和食管科医生对系统纵隔淋巴结清扫的共识。

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引用次数: 0

Consensus Meeting of Anatomy on the Border, Appropriate Use and Precautions for ICG in Liver, Lung, and Renal Surgery 边界解剖共识会议，ICG在肝、肺、肾外科的适当使用和注意事项。

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-25 DOI: 10.1111/ases.70175

Junji Ichinose, Shinji Itoh, Shintaro Narita, Daisuke Asano, Yujin Kudo, Toshiya Abe, Kenoki Ohuchida, Keiichi Akahoshi, Go Wakabayashi, Kimihiro Shimizu, Hisashi Iwata, Atsushi Takeneka, Minoru Tanabe, Norihiko Ikeda, Masatoshi Eto, Masafumi Nakamura, Yuko Kitagawa, Tomoharu Yoshizumi, Tomonori Habuchi, Mingyon Mun

Introduction

The liver, lungs, and kidneys are all parenchymal organs and are useful targets for indocyanine green (ICG) fluorescence. We created a consensus statement on the appropriate use and precautions for ICG in liver, lung, and kidney surgery.

Methods

We conducted a comprehensive literature search and questionnaire survey for expert surgeons in each area.

Results

We extracted 11 articles related to the liver, 23 to the lung, and 8 to the kidney. A total of 86 facilities, 50 facilities, and 32 surgeons responded to the questionnaire survey for the liver, lung, kidney, respectively. ICG fluorescence is widely employed for segment delineation of the liver, lung, and kidney and has been reported to exhibit high efficacy. The dosage and timing greatly vary depending on the target organ and administration route. Tumor localization via ICG fluorescence is widely performed in the liver area, with numerous reports highlighting its high efficacy. Contrarily, in the lung and kidney, despite the existence of clinical studies, ICG fluorescence has not been generally performed in clinical practice. There have been no reported complications or adverse experiences related to the use of ICG agents, indicating their safety for clinical use.

Conclusion

This survey, along with a literature review, has elucidated the current consensus of liver, lung, and kidney surgeons regarding ICG fluorescence.

肝、肺和肾都是实质器官，是吲哚菁绿（ICG）荧光的有用靶点。我们就ICG在肝、肺和肾手术中的适当使用和注意事项建立了共识声明。方法：对各区外科专家进行全面的文献检索和问卷调查。结果：提取与肝脏有关的11篇，与肺有关的23篇，与肾有关的8篇。共有86家医院、50家医院和32名外科医生分别对肝、肺、肾进行问卷调查。ICG荧光被广泛应用于肝、肺和肾的分段划定，并且据报道具有很高的疗效。剂量和时间根据靶器官和给药途径而有很大差异。通过ICG荧光定位肿瘤被广泛应用于肝脏区域，许多报道强调了它的高疗效。相反，在肺和肾中，尽管有临床研究，但在临床实践中并未普遍进行ICG荧光检测。未见与使用ICG药物相关的并发症或不良经历的报道，表明其临床使用是安全的。结论：本调查和文献综述阐明了目前肝、肺和肾外科医生对ICG荧光的共识。

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引用次数: 0

Clinical Practice and Survey of Three-Dimensional Images, Virtual Reality, Augmented Reality and Mixed Reality for Robotic-Assisted Surgery in Urology—“Anatomy on the Border” Expert Consensus Meeting 泌尿外科机器人辅助手术的三维影像、虚拟现实、增强现实和混合现实的临床实践与综述——“解剖学的边界”专家共识会议。

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-25 DOI: 10.1111/ases.70189

Satoshi Kobayashi, Daisuke Asano, Yujin Kudo, Shintaro Narita, Shuichi Morizane, Toshiya Abe, Kenoki Ohuchida, Tomonori Habuchi, Atsushi Takenaka, Go Wakabayashi, Tomoharu Yoshizumi, Keiichi Akahoshi, Norihiko Ikeda, Minoru Tanabe, Masafumi Nakamura, Yuko Kitagawa, Masatoshi Eto

Background and Objectives

There have been no nationwide surveys on the effectiveness of 3D images, virtual reality (VR), augmented reality (AR), and mixed reality (MR) in robotic-assisted surgery for urology. This study aimed to conduct a nationwide survey of techniques for laparoscopic and robotic 3D images, VR, AR, and MR in urology, and to propose a consensus on their effectiveness.

Material and Methods

In July 2024, the Japan Society for Endoscopic Surgery conducted an anonymous online survey to evaluate the effectiveness of 3D images, VR, AR, and MR among 44 certified laparoscopic technicians and qualified proctors in robotic surgery.

Results

Thirty-two urologists surveyed reported using 3D imaging for preoperative evaluation (84%) and to understand anatomy (75%), with 97% reporting clinical benefits and 85% indicating that it improved the quality of surgery. This widespread usage and the reported benefits of 3D imaging in urology should reassure the audience about the effectiveness of this technology. VR/AR/MR were primarily used for simulation (19%) and navigation (16%). While 63% expressed interest in these technologies, 51% reported never having used them. Among the barriers to adoption, 25% cited high cost, 24% cited the effort required for data processing, and 14% cited the difficulty of use.

Conclusion

3D images and VR/AR/MR technologies were expected to play a pivotal role in urological robotic surgery. These technologies have the potential to enhance precision and improve outcomes significantly. This study provided a comprehensive overview of the current usage status and challenges associated with these techniques.

背景和目的：目前还没有关于3D图像、虚拟现实（VR）、增强现实（AR）和混合现实（MR）在泌尿外科机器人辅助手术中的有效性的全国性调查。本研究旨在对泌尿外科的腹腔镜和机器人3D图像、VR、AR和MR技术进行全国性调查，并就其有效性提出共识。材料和方法：2024年7月，日本内窥镜外科学会对44名经过认证的腹腔镜技术人员和合格的机器人手术监考人员进行了一项匿名在线调查，以评估3D图像、VR、AR和MR的有效性。结果：接受调查的32名泌尿科医生报告使用3D成像进行术前评估（84%）和了解解剖学（75%），其中97%报告临床获益，85%表示其提高了手术质量。3D成像在泌尿外科的广泛应用和报道的好处应该让观众对这项技术的有效性放心。VR/AR/MR主要用于模拟（19%）和导航（16%）。虽然63%的人表示对这些技术感兴趣，但51%的人表示从未使用过它们。在采用的障碍中，25%的人提到了高成本，24%的人提到了数据处理所需的努力，14%的人提到了使用困难。结论：3D影像和VR/AR/MR技术有望在泌尿外科机器人手术中发挥关键作用。这些技术有可能显著提高精确度和改善结果。本研究全面概述了这些技术的使用现状和面临的挑战。

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引用次数: 0

The Feasibility of Telerobotic Pancreaticojejunostomy Using a Surgical Robot: A Pilot Study With Commercial Optical Networks 远程机器人胰空肠吻合术的可行性：商业光学网络的初步研究。

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery

Pub Date : 2025-11-23 DOI: 10.1111/ases.70181

Yusuke Wakasa, Kenichi Hakamada, Hajime Morohashi, Kazuki Yokoyama, Yuma Ebihara, Satoshi Hirano, Eiji Oki, Norihiko Ikeda, Akinobu Taketomi, Masaki Mori

Introduction

In recent years, the practical application of remote robotic surgery has become a reality, and is expected to be applied to difficult surgeries. The purpose of this study is to demonstrate whether the pancreaticojejunostomy in a pancreaticoduodenectomy, a difficult surgery, can be performed through a remote surgery-assisted robotic operation, as well as to verify the feasibility of remote surgery-assisted pancreaticojejunostomy.

Methods

Hirosaki city and Goshogawara city (about 30 km) were connected via a commercial communication line using the hinotori surgical robot, and five surgeons performed remote surgery on an artificial organ model for pancreaticojejunostomy. Four local surgeons were instructed remotely. Each procedure was repeated 3–5 times in sets of 8 min, and communication latency, Image Quality Score, System Usability Scale (mSUS), and Robot Usability Score were all evaluated.

Results

The communication latency was stable at less than 12 msec, and there were no problems in performing the surgery. No significant differences were noted in Image Quality Score, System Usability Scale (mSUS), or Robot Usability Score. Pancreaticojejunostomy was performed using the Blumgart anastomosis technique, and all procedures were completed without any issues.

Conclusion

We demonstrated that pancreaticojejunostomy can be performed in a telesurgical environment. This system can be applied to remote surgical guidance and support in the future and it is expected to correct regional disparities in medical care, improve surgical education, and enhance the implementation of remote surgery in society.

近年来，远程机器人手术的实际应用已成为现实，有望应用于难度较大的手术。本研究的目的是验证在胰十二指肠切除术这一难度较大的手术中，是否可以通过远程手术辅助机器人手术进行胰空肠吻合术，验证远程手术辅助胰空肠吻合术的可行性。方法：利用hinotori手术机器人通过商业通信线路连接广崎市和Goshogawara市（约30 km）， 5名外科医生对胰空肠吻合术人工器官模型进行远程手术。四名当地外科医生接受了远程指导。每个过程以8分钟为一组重复3-5次，并对通信延迟、图像质量评分、系统可用性量表（mSUS）和机器人可用性评分进行评估。结果：通信延迟稳定在12 msec以内，手术顺利进行。在图像质量评分、系统可用性量表（mSUS）或机器人可用性评分方面没有显著差异。胰空肠吻合术采用Blumgart吻合技术，所有手术均顺利完成。结论：胰空肠吻合术可以在远端手术环境下进行。该系统可应用于未来的远程手术指导和支持，有望纠正医疗的地区差异，改善外科教育，促进远程手术在社会中的实施。

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引用次数: 0