Journal of Robotic Surgery最新文献

Accurate component alignment is critical for successful total knee arthroplasty (TKA). Robotic-assisted TKA improves alignment compared with conventional jigged instrumentation, but requires additional imaging, incisions, consumables, and cost. Augmented reality-assisted TKA (AR-TKA) may offer comparable benefits without these disadvantages. We retrospectively reviewed 116 primary TKAs at a single centre, including 77 conventional jig-based procedures and 39 AR-assisted TKAs performed using the Knee+^® system (Pixee Medical, France). Primary outcomes were component alignment accuracy and reproducibility on standardized radiographs. Secondary outcomes included perioperative blood loss (haemoglobin drop), range of motion, operative time and patient-reported outcome measures (PROMS). AR-TKA improved femoral coronal alignment (90.3° ± 1.7 vs. 91.1° ± 2.1; p = 0.045) and reproducibility (p = 0.002). Femoral component flexion was more accurately achieved (p = 0.005). Tibial coronal alignment and slope did not differ significantly between the two groups. Blood loss was reduced with AR-TKA (Hb drop 13.4 vs. 18.6 g/L; p = 0.001). Postoperative ROM was greater in the AR-TKA group (130.8° vs. 123.5°; p = 0.011). There was no difference in the operative duration (67.9 vs. 72.4 min, p = 0.126). PROMs were favourable in both groups with no significant differences: FJS (72 vs. 66; p = 0.244), HAAS (10.4 vs. 10.6; p = 0.829), OKS (43.6 vs. 43.8; p = 0.803). AR-TKA achieved alignment accuracy and reproducibility comparable to conventional jig-based techniques, with reduced perioperative blood loss and improved postoperative range of motion. PROMS were favourable and comparable to published robotic-assisted series. These findings support AR-TKA as a pragmatic alternative to robotic systems, combining precision with efficiency in routine clinical practice.

The adoption of robotic platforms in bariatric and metabolic surgery has increased steadily, raising important questions regarding how surgeons are trained to safely acquire robotic skills. While structured and competency-based training models are increasingly adopted in other fields of robotic surgery, training approaches in robotic bariatric surgery remain less standardized. A systematic review was conducted in accordance with PRISMA 2020 guidelines to identify studies describing structured training pathways or formal curricula for robotic bariatric surgery. PubMed, Embase, Scopus, and Cochrane Library, were searched from inception without date restrictions. Eligible studies explicitly reported training programs, curricula, or educational pathways for robotic bariatric procedures. Learning curve analyses without a defined curriculum were excluded. Data were synthesized using a structured narrative approach. Five studies met the inclusion criteria. Training models included stepwise intraoperative curricula, simulation-based and proficiency-driven programs, and modular educational interventions. Common components across curricula were simulation training, task decomposition, supervised progression, and defined competency benchmarks. Assessment strategies were heterogeneous and ranged from simulation-based proficiency thresholds to operative participation metrics and subjective workload measures. No study reported standardized certification or long-term competency outcomes. Structured training pathways for robotic bariatric surgery have been described and incorporate elements aimed at supporting safe skill acquisition. However, existing curricula remain heterogeneous and lack standardized assessment frameworks. Future efforts should focus on developing competency-driven and proficiency-based progression training models to support reproducible and safe adoption of robotic bariatric surgery.