Journal of Robotic Surgery最新文献

AI-enhanced robotic hands are rapidly reshaping tumour surgery by merging real-time sensing, precision mechanics, and intelligent decision support, yet current systems still struggle with early lesion detection, limited tactile sensitivity, and inconsistent accuracy across cancer types. This review addresses these gaps by examining how next-generation robotic hands, empowered by multimodal AI, augmented imaging, hybrid guidance, and minimally invasive mechatronics, can improve early tumour localization and safer resections. The study synthesizes insights from urologic, breast, colorectal, gastric, thoracic, and gynecologic oncology to highlight shared trends such as the shift toward personalized robotics, smart biopsy tools, light-mediated theranostics, flexible platforms, and real-time intraoperative analytics. A comparative reading of quantitative and qualitative evidence reveals strong gains in surgical precision and patient outcomes, yet also contradictions regarding cost-effectiveness, reproducibility of AI predictions, and disparity in adoption between high- and low-resource settings. Using a narrative review approach, key findings point to robotic hands with enhanced tactile sensors and AI-driven micro-maneuvering as promising breakthroughs for detecting microtumours, reducing positive margins, and guiding on-table diagnostics. Recommendations emphasize stronger clinical validation, interoperable imaging ecosystems, and ethical design. The implications extend to safer surgeries, shorter recovery, and more equitable cancer care. Limitations include heterogeneous study designs and early-stage prototypes. Future research should explore adaptive learning models, haptic-guided autonomy, and broader trials. Overall, AI-enhanced robotic hands signal a transformative pathway for earlier detection and more precise tumour removal.

Transoral robotic surgery (TORS) has rapidly expanded across oncologic and sleep surgery, yet its global evidence base remains fragmented. Prior bibliometric studies examined generic robotic surgery or TORS subsets without search-optimized, domain-specific mapping. Therefore, this study was designed to construct a comprehensive, data-driven bibliometric map of TORS research. A Scopus-based, multi-step search identified 938 English-language TORS articles. R-Based Bibliometrix and VOSviewer were used to analyze publication and citation trends, countries, institutions, sources, collaboration networks, co-citation structures, keyword co-occurrence, thematic evolution, Bradford's law, and emerging research fronts. From 2005 to 2025, TORS discourse across 197 sources showed 21.2% annual growth, with lower per-article citations recently. The United States dominated volume and citations, followed by Italy, the United Kingdom, South Korea, and Canada. Leading institutions included the University of Pennsylvania, Yonsei University, and North American cancer centers. Collaboration networks showed clustered, US-centered international partnerships and tightly connected author communities. Core journals (Laryngoscope, Head and Neck, European Archives of Oto-Rhino-Laryngology, Journal of Robotic Surgery) concentrated output, consistent with Bradford's Law. Keyword and trend analyses indicated transition from technique-focused terms to HPV-driven oropharyngeal cancer, functional outcomes, and de-escalation. Thematic maps and evolution analyses highlighted TORS and obstructive sleep apnea as motor themes, with niche domains such as base-of-tongue lesions and sialendoscopy. TORS research is rapidly expanding yet geographically concentrated, with evolving focus from technical feasibility toward oncologic, functional, and patient-centered themes, guiding multicenter trials, de-escalation strategies, and precision oncology integration.

Pull-through procedures remain the mainstay of treatment for Hirschsprung disease (HD). While laparoscopic-assisted procedures are widely performed, robotic-assisted Soave pull-through (RSPT) has emerged as a minimally invasive alternative with potential technical advantages. We systematically reviewed the available literature to evaluate the perioperative and functional outcomes of RSPT. PubMed, Embase, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov were systematically searched through February 2025. Eligible studies included pediatric (< 18 years) patients undergoing RSPT. Data were pooled using random-effects models with two heterogeneity estimators to ensure robustness given the small number of included studies. Heterogeneity was assessed using I² and τ² statistics. Primary outcomes included operative time, console time, intraoperative blood loss, and length of stay (LOS). Secondary outcomes included constipation, enterocolitis, and soiling. Study quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool. Six retrospective studies comprising 282 patients were included. Pooled mean operative and console times were 192.2 min (95% CI: 95.2-388.0) and 105.6 min (95% CI: 34.7-321.5), respectively. Mean intraoperative blood loss was 9.8 mL (95% CI: 1.9-49.4), and pooled postoperative LOS was 6.5 days (95% CI: 4.6-9.1). No difference in estimates was observed by estimator models. Postoperative complications were typically mild, manageable conservatively, and improved over time. RSPT appears to be a feasible minimally invasive option for HD, demonstrating low blood loss, short hospital stay, and acceptable functional outcomes, albeit with longer operative times which reflect logistical rather than technical inefficiency. Future adequately powered, higher quality, multicenter trials with standardized outcomes are needed to better define its role relative to established laparoscopic approaches.