Anna Ureña, Nestor I. Quiroga, Marc Boada, Xavier Michavila, Irene Botias, Angela Guirao, Rudith Guzman, Andrea Calderon, Laureano Molins, Maria Jose Arguis, Ricard Navarro-Ripoll, Ricard Ramos
Background
Minimally invasive approaches such as video-assisted (VATS) and robotic-assisted thoracoscopic surgery (RATS) offer less traumatic alternatives for the treatment of lung cancer. This study compares the early postoperative inflammatory response and complication rates between both techniques in patients undergoing lung resection for non-small cell lung cancer (NSCLC).
Methods
A retrospective review was conducted on patients between 2022 and 2023. Inflammatory markers, including lymphocytes, monocytes, neutrophils, platelets, and derived ratios (PLR, NLR), were analysed.
Results
RATS was associated with significantly higher postoperative inflammatory markers (PLR, p = 0.007; NLR, p = 0.019) and greater perioperative variation (ΔPLR and ΔNLR, p = 0.028). However, no significant association was found between surgical technique or inflammation and the incidence of postoperative complications or persistent air leak (PAL).
Conclusions
RATS induces a stronger early inflammatory response than VATS, but this does not associate with a higher rate of complications or PAL.
背景：视频辅助胸腔镜手术（VATS）和机器人辅助胸腔镜手术（RATS）等微创方法为肺癌治疗提供了创伤较小的选择。本研究比较了两种技术在非小细胞肺癌（NSCLC）患者肺切除术后早期的炎症反应和并发症发生率。方法：对2022 ~ 2023年患者进行回顾性分析。分析炎症标志物，包括淋巴细胞、单核细胞、中性粒细胞、血小板和衍生比率（PLR、NLR）。结果：大鼠术后炎症指标显著增高（PLR, p = 0.007； NLR, p = 0.019），围手术期差异显著（ΔPLR和ΔNLR， p = 0.028）。然而，没有发现手术技术或炎症与术后并发症或持续性漏气（PAL）的发生率有显著关联。结论：大鼠诱导的早期炎症反应比VATS更强，但这与更高的并发症发生率或PAL无关。
{"title":"Influence of Robotic and Thoracoscopic Surgery on Early Postoperative Systemic Inflammatory Response in Patients With Surgically Treated Lung Cancer—Preliminary Results","authors":"Anna Ureña, Nestor I. Quiroga, Marc Boada, Xavier Michavila, Irene Botias, Angela Guirao, Rudith Guzman, Andrea Calderon, Laureano Molins, Maria Jose Arguis, Ricard Navarro-Ripoll, Ricard Ramos","doi":"10.1002/rcs.70132","DOIUrl":"10.1002/rcs.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Minimally invasive approaches such as video-assisted (VATS) and robotic-assisted thoracoscopic surgery (RATS) offer less traumatic alternatives for the treatment of lung cancer. This study compares the early postoperative inflammatory response and complication rates between both techniques in patients undergoing lung resection for non-small cell lung cancer (NSCLC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted on patients between 2022 and 2023. Inflammatory markers, including lymphocytes, monocytes, neutrophils, platelets, and derived ratios (PLR, NLR), were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RATS was associated with significantly higher postoperative inflammatory markers (PLR, <i>p</i> = 0.007; NLR, <i>p</i> = 0.019) and greater perioperative variation (ΔPLR and ΔNLR, <i>p</i> = 0.028). However, no significant association was found between surgical technique or inflammation and the incidence of postoperative complications or persistent air leak (PAL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RATS induces a stronger early inflammatory response than VATS, but this does not associate with a higher rate of complications or PAL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aman Ladak, Johannes O. Bonatti, Roger J. Hajjar, Alaaeldin A. Shalaby, Cameron N. Riviere
Background
HeartPrinter is a flexible parallel wire robot that adheres to the beating heart with vacuum suction at three bases. An injector head actuated by cables delivers gene therapy injections within the bounds of the bases. To deploy onto the epicardium, an introducer mechanism is required. On the heart, the robot's workspace and anatomical model registration to its pose are needed.
Methods
We present HeartPrinter's components and introducer mechanism, and assess them on an artificial beating heart. We evaluate accuracy for position determination of the bases and registering a three-dimensional heart scan.
Results
The introducer mechanism successfully positioned HeartPrinter, and the bases adhered to the beating heart. The base positions and registration were calculated accurately with errors under 4 and 2 mm.
Conclusions
The introducer mechanism can deploy HeartPrinter on the epicardium, and HeartPrinter's components can operate on the heart. Workspace determination and registration demonstrate feasibility as preliminary concepts.
{"title":"Development of a Flexible Parallel Wire Robot for Epicardial Interventions","authors":"Aman Ladak, Johannes O. Bonatti, Roger J. Hajjar, Alaaeldin A. Shalaby, Cameron N. Riviere","doi":"10.1002/rcs.70130","DOIUrl":"10.1002/rcs.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>HeartPrinter is a flexible parallel wire robot that adheres to the beating heart with vacuum suction at three bases. An injector head actuated by cables delivers gene therapy injections within the bounds of the bases. To deploy onto the epicardium, an introducer mechanism is required. On the heart, the robot's workspace and anatomical model registration to its pose are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present HeartPrinter's components and introducer mechanism, and assess them on an artificial beating heart. We evaluate accuracy for position determination of the bases and registering a three-dimensional heart scan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The introducer mechanism successfully positioned HeartPrinter, and the bases adhered to the beating heart. The base positions and registration were calculated accurately with errors under 4 and 2 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The introducer mechanism can deploy HeartPrinter on the epicardium, and HeartPrinter's components can operate on the heart. Workspace determination and registration demonstrate feasibility as preliminary concepts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pan Song, Cong Huang, Xiang Wang, Jiyu Yang, Yiming Zhang, Zhihua Li, Xinfei Li, Shubo Fan, Hongjian Zhu, Liqun Zhou, Kai Zhang, Kunlin Yang, Xuesong Li
Background
The comparative perioperative outcomes of totally intracorporeal robot-assisted ileal ureteral replacement (TI-RAIUR) versus that of RAIUR with extracorporeal ileal segment preparation (RAIUR-EI) remain undefined. This study pioneers a comparative analysis between these approaches to guide clinical individualised therapy.
Methods
Thirty-four patients who underwent RAIUR (22 via RAIUR-EI and 12 via TI-RAIUR) were included. Baseline characteristics, perioperative outcomes, and follow-up data were systematically compared.
Results
There were no between-group differences in baseline characteristics. The RAIUR-EI approach significantly reduced the reoperation time for initial failed procedures. Both groups achieved 100% 1-year subjective success and stable long-term renal function. The complication rates were statistically similar, although one Clavien–Dindo III incisional hernia occurred in the RAIUR-EI group. In addition, the TI-RAIUR approach demonstrated better aesthetic outcomes.
Conclusions
Both techniques achieve reliable outcomes for long-segment ureteral reconstruction. The RAIUR-EI approach may optimise efficiency in more complex cases, whereas the TI-RAIUR technique results in better aesthetic outcomes.
{"title":"Robot-Assisted Ileal Ureter Replacement: Comparisons Between Totally Intracorporeal and Extracorporeal Ileal Segment Preparation","authors":"Pan Song, Cong Huang, Xiang Wang, Jiyu Yang, Yiming Zhang, Zhihua Li, Xinfei Li, Shubo Fan, Hongjian Zhu, Liqun Zhou, Kai Zhang, Kunlin Yang, Xuesong Li","doi":"10.1002/rcs.70131","DOIUrl":"10.1002/rcs.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The comparative perioperative outcomes of totally intracorporeal robot-assisted ileal ureteral replacement (TI-RAIUR) versus that of RAIUR with extracorporeal ileal segment preparation (RAIUR-EI) remain undefined. This study pioneers a comparative analysis between these approaches to guide clinical individualised therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-four patients who underwent RAIUR (22 via RAIUR-EI and 12 via TI-RAIUR) were included. Baseline characteristics, perioperative outcomes, and follow-up data were systematically compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no between-group differences in baseline characteristics. The RAIUR-EI approach significantly reduced the reoperation time for initial failed procedures. Both groups achieved 100% 1-year subjective success and stable long-term renal function. The complication rates were statistically similar, although one Clavien–Dindo III incisional hernia occurred in the RAIUR-EI group. In addition, the TI-RAIUR approach demonstrated better aesthetic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both techniques achieve reliable outcomes for long-segment ureteral reconstruction. The RAIUR-EI approach may optimise efficiency in more complex cases, whereas the TI-RAIUR technique results in better aesthetic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Zhao, Hui Li, Runbo Liu, Jianhua Zhang, Shunming Hong, Bo Yang
Background
Autonomous robotic surgery has demonstrated its potential for the optimal outcomes. However, vascular interventional surgery (VIS) with flexible catheters and soft tissue raises challenges to autonomous execution of preplanned tasks due to indeterminately changed surgical state.
Methods
We present a novel end-to-end deep learning-based framework of human–robot collaborative navigation for VIS. A surgical Generative Adversarial Networks is employed for real-time local path planning of the catheter tip under variable-vascular-contour environment. A CNNs-based action estimator is proposed for nonlinear mapping from the tip's path to the end's action. A human–robot trust-based shared control model is established for surgical navigation.
Results
The networks are trained by a self-built dataset and experiments are conducted under catheterization room environment. The results show the catheter's action decision accuracy achieves 93.75%. The surgical effectiveness and safety are improved with the proposed method.
Conclusion
This work provides a way to achieve autonomous VIS.
{"title":"A Deep Learning-Based Human–Robot Collaborative Navigation Framework for Vascular Interventional Surgery","authors":"Yan Zhao, Hui Li, Runbo Liu, Jianhua Zhang, Shunming Hong, Bo Yang","doi":"10.1002/rcs.70125","DOIUrl":"10.1002/rcs.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autonomous robotic surgery has demonstrated its potential for the optimal outcomes. However, vascular interventional surgery (VIS) with flexible catheters and soft tissue raises challenges to autonomous execution of preplanned tasks due to indeterminately changed surgical state.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present a novel end-to-end deep learning-based framework of human–robot collaborative navigation for VIS. A surgical Generative Adversarial Networks is employed for real-time local path planning of the catheter tip under variable-vascular-contour environment. A CNNs-based action estimator is proposed for nonlinear mapping from the tip's path to the end's action. A human–robot trust-based shared control model is established for surgical navigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The networks are trained by a self-built dataset and experiments are conducted under catheterization room environment. The results show the catheter's action decision accuracy achieves 93.75%. The surgical effectiveness and safety are improved with the proposed method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This work provides a way to achieve autonomous VIS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chen Su, Shan Lin, Qiaocao Su, Xiaorong Liu, Leyi Wei, Changshun Yang
Background
Gastrointestinal diseases pose a significant global health challenge, and their early screening relies on wireless capsule endoscopy (WCE). However, analysing the massive volume of WCE images is time-consuming and prone to human error. Although deep learning offers solutions, existing systems are often inflexible and technically complex, limiting clinical adoption.
Methods
We propose GI-ScreenNet v2, a multi-backbone network framework based on ensemble and transfer learning. It supports arbitrary backbones through a standardised interface and leverages a cross-attention mechanism to dynamically integrate multi-model features for sophisticated representation learning.
Results
In KvasirV2, GI-ScreenNet v2 achieves 94.87% accuracy, 3.31% higher than traditional methods. This high-performance result enables efficient GI screening and paves the way for practical AI-assisted diagnostics.
Conclusions
We present a unified framework for GI disease detection, with an integrated workflow for dynamic model selection and cross-attention fusion. This design enables efficient integration of novel models and techniques, advancing robust diagnostic systems.
{"title":"GI-ScreenNet v2: A Modular Framework for Gastrointestinal Disease Detection Based on an Integrated Transfer Learning","authors":"Chen Su, Shan Lin, Qiaocao Su, Xiaorong Liu, Leyi Wei, Changshun Yang","doi":"10.1002/rcs.70128","DOIUrl":"10.1002/rcs.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastrointestinal diseases pose a significant global health challenge, and their early screening relies on wireless capsule endoscopy (WCE). However, analysing the massive volume of WCE images is time-consuming and prone to human error. Although deep learning offers solutions, existing systems are often inflexible and technically complex, limiting clinical adoption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We propose GI-ScreenNet v2, a multi-backbone network framework based on ensemble and transfer learning. It supports arbitrary backbones through a standardised interface and leverages a cross-attention mechanism to dynamically integrate multi-model features for sophisticated representation learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In KvasirV2, GI-ScreenNet v2 achieves 94.87% accuracy, 3.31% higher than traditional methods. This high-performance result enables efficient GI screening and paves the way for practical AI-assisted diagnostics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We present a unified framework for GI disease detection, with an integrated workflow for dynamic model selection and cross-attention fusion. This design enables efficient integration of novel models and techniques, advancing robust diagnostic systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Digestive tract cancers are among the most common malignancies worldwide, and early diagnosis greatly improves patient prognosis. For instance, colorectal cancer has a 90% 5-year survival rate at early stages. Endoscopic Submucosal Dissection (ESD) is the standard treatment, but traditional flexible endoscopes pose operational and visual challenges.
Methods
This paper proposes a dual-continuum robotic surgical system based on a cascaded vertebrae design. Kinematic and frictional modelling analyses were conducted to ensure stable operation of the surgical robotic system on a commercial endoscope. In addition, a teleoperation system was developed to enable bimanual ESD procedures.
Results
Experimental validation confirmed the system's workspace, stiffness, hysteresis optimisation, and teleoperation accuracy. In an ex vivo ESD procedure performed on a porcine stomach, the system successfully resected a lesion with a diameter of 20 mm.
Conclusion
This continuum robotic system demonstrates strong clinical potential to enhance ESD performance and reduce procedural difficulty.
{"title":"Design of a Continuum Surgical Robotic System for Bimanual Endoscopic Submucosal Dissection","authors":"Haiyan Hu, Heng Zhang, Zhenhao Chen, Haojie Tian, Shumei Yu, Yong Jiang","doi":"10.1002/rcs.70127","DOIUrl":"10.1002/rcs.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Digestive tract cancers are among the most common malignancies worldwide, and early diagnosis greatly improves patient prognosis. For instance, colorectal cancer has a 90% 5-year survival rate at early stages. Endoscopic Submucosal Dissection (ESD) is the standard treatment, but traditional flexible endoscopes pose operational and visual challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper proposes a dual-continuum robotic surgical system based on a cascaded vertebrae design. Kinematic and frictional modelling analyses were conducted to ensure stable operation of the surgical robotic system on a commercial endoscope. In addition, a teleoperation system was developed to enable bimanual ESD procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Experimental validation confirmed the system's workspace, stiffness, hysteresis optimisation, and teleoperation accuracy. In an ex vivo ESD procedure performed on a porcine stomach, the system successfully resected a lesion with a diameter of 20 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This continuum robotic system demonstrates strong clinical potential to enhance ESD performance and reduce procedural difficulty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Igor Monsellato, Teresa Gatto, Marco Lodin, Celeste Del Basso, Marco Palucci, Federico Sangiuolo, Mariantonietta Alagia, Emanuele Tessitore, Irene Gandini, Fabio Benedetti, Fabio Giannone, Gianluca Cassese, Fabrizio Panaro
Background
Robotic surgery is increasingly adopted for colorectal cancer, but long-term single-surgeon data are limited. This study assessed perioperative, oncologic and economic outcomes of a standardised robotic colorectal programme over 9 years.
Methods
A retrospective cohort of 320 consecutive patients undergoing robotic resection for colorectal malignancy (2016–2025) was analysed. Procedures included right, left, transverse and rectal resections using the da Vinci Si/Xi system. Primary end points were conversion, major complications (Clavien–Dindo ≥ III), 30-day mortality and R0 resection. Secondary outcomes were operative time, length of stay (LOS), reoperation and model-based cost-effectiveness using the Quantify the Impact (QTI) tool.
Results
Conversion occurred in 1.9%, anastomotic leak in 2.2% and mortality in 1%. R0 resection was 99.7%, median LOS 7 [5–10] days, and reoperation 2.5%. QTI estimated savings of €483 versus laparoscopy and €3181 versus open surgery.
Conclusions
A standardised robotic colorectal programme achieved safe, reproducible and economically sustainable outcomes.
{"title":"Long-Term Single-Surgeon Outcomes of 320 Robotic Colorectal Cancer Resections: Safety, Oncologic Reliability, and Cost-Effectiveness","authors":"Igor Monsellato, Teresa Gatto, Marco Lodin, Celeste Del Basso, Marco Palucci, Federico Sangiuolo, Mariantonietta Alagia, Emanuele Tessitore, Irene Gandini, Fabio Benedetti, Fabio Giannone, Gianluca Cassese, Fabrizio Panaro","doi":"10.1002/rcs.70126","DOIUrl":"10.1002/rcs.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic surgery is increasingly adopted for colorectal cancer, but long-term single-surgeon data are limited. This study assessed perioperative, oncologic and economic outcomes of a standardised robotic colorectal programme over 9 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort of 320 consecutive patients undergoing robotic resection for colorectal malignancy (2016–2025) was analysed. Procedures included right, left, transverse and rectal resections using the da Vinci Si/Xi system. Primary end points were conversion, major complications (Clavien–Dindo ≥ III), 30-day mortality and R0 resection. Secondary outcomes were operative time, length of stay (LOS), reoperation and model-based cost-effectiveness using the Quantify the Impact (QTI) tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Conversion occurred in 1.9%, anastomotic leak in 2.2% and mortality in 1%. R0 resection was 99.7%, median LOS 7 [5–10] days, and reoperation 2.5%. QTI estimated savings of €483 versus laparoscopy and €3181 versus open surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A standardised robotic colorectal programme achieved safe, reproducible and economically sustainable outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander D. Orsi, Simon Coffey, Eric Slotkin, Paramjeet Gill, Andrew Lehman, Jeffrey Lawrence, Christopher Plaskos, John Keggi
Background
This study examines the agreement and error between manual gap assessment, and assessment with a robotic soft-tissue tensioning device in total knee arthroplasty across multiple surgeons.
Methods
517 consecutive robotic-assisted TKAs were retrospectively reviewed across six surgeons following ethics approval. Robotic and manual mediolateral (ML) balance and medial and lateral gaps were compared using Intraclass Correlation Coefficient (ICC). ΔML balance (manual-robotic) was compared between right and left knees.
Results
Manual and robotic ML balance showed poor agreement (ICC = 0.368). Surgeons had low to moderate correlations (ICC range: 0.152–0.633) and significant differences throughout flexion. Four measured greater medial gaps manually and two measured greater lateral gaps compared to robotics. All showed significant ΔML balance differences between the leg sides (p < 0.05), with surgeon-specific variations in gap patterns.
Conclusions
Manual ML balance correlated poorly and differed significantly from robotic assessment, with surgeon-specific variation. Surgeons should appreciate the variability in subjective versus objective gap measurements.
{"title":"Soft Tissue Balance Profiles Differ Between Manual and Robotically Assessed Gaps in Total Knee Arthroplasty","authors":"Alexander D. Orsi, Simon Coffey, Eric Slotkin, Paramjeet Gill, Andrew Lehman, Jeffrey Lawrence, Christopher Plaskos, John Keggi","doi":"10.1002/rcs.70124","DOIUrl":"10.1002/rcs.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examines the agreement and error between manual gap assessment, and assessment with a robotic soft-tissue tensioning device in total knee arthroplasty across multiple surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>517 consecutive robotic-assisted TKAs were retrospectively reviewed across six surgeons following ethics approval. Robotic and manual mediolateral (ML) balance and medial and lateral gaps were compared using Intraclass Correlation Coefficient (ICC). ΔML balance (manual-robotic) was compared between right and left knees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Manual and robotic ML balance showed poor agreement (ICC = 0.368). Surgeons had low to moderate correlations (ICC range: 0.152–0.633) and significant differences throughout flexion. Four measured greater medial gaps manually and two measured greater lateral gaps compared to robotics. All showed significant ΔML balance differences between the leg sides (<i>p</i> < 0.05), with surgeon-specific variations in gap patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Manual ML balance correlated poorly and differed significantly from robotic assessment, with surgeon-specific variation. Surgeons should appreciate the variability in subjective versus objective gap measurements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minimally invasive surgery has revolutionized surgical practice by reducing surgical trauma and enhancing recovery. In this context, the da Vinci SP System represents a major technological advancement. This review aims to report its clinical applications in general surgery, evaluating associated outcomes and potential advantages.
Methods
A systematic search of MEDLINE, Embase and Web-of-Science databases was conducted in accordance with PRISMA guidelines. The study was pre-registered in PROSPERO.
Results
Seventy-six studies involving 1841 patients were included. The most frequently reported procedures were colorectal/transanal surgeries (868) and cholecystectomies (661). Learning-curve analyses for SP colorectal surgery demonstrated performance stabilization after 18–21 cases. Comparative studies showed shorter docking times and reduced hospital stays for SP procedures compared to laparoscopic multiport or single-site robotic approaches.
Conclusion
The da Vinci SP system appears to be a safe and feasible option for various general surgery procedures. Preliminary evidence supports improved perioperative efficiency in specific contexts, though further validation is warranted.
{"title":"Application of the Da Vinci Single-Port (SP) Robot in General Surgery: A First Systematic Review","authors":"Antonio Cubisino, Maurice Chazal, Fabrizio Panaro","doi":"10.1002/rcs.70123","DOIUrl":"10.1002/rcs.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Minimally invasive surgery has revolutionized surgical practice by reducing surgical trauma and enhancing recovery. In this context, the da Vinci SP System represents a major technological advancement. This review aims to report its clinical applications in general surgery, evaluating associated outcomes and potential advantages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of MEDLINE, Embase and Web-of-Science databases was conducted in accordance with PRISMA guidelines. The study was pre-registered in PROSPERO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-six studies involving 1841 patients were included. The most frequently reported procedures were colorectal/transanal surgeries (868) and cholecystectomies (661). Learning-curve analyses for SP colorectal surgery demonstrated performance stabilization after 18–21 cases. Comparative studies showed shorter docking times and reduced hospital stays for SP procedures compared to laparoscopic multiport or single-site robotic approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The da Vinci SP system appears to be a safe and feasible option for various general surgery procedures. Preliminary evidence supports improved perioperative efficiency in specific contexts, though further validation is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study compares robotic-assisted pancreatic surgery (R-PS) and laparoscopic pancreatic surgery (L-PS) outcomes in patients with pancreatic malignancies and medium- to high-risk pancreatic fistulas.
Materials and Methods
A retrospective cohort study was conducted at Guangdong Provincial People's Hospital (2021–2023). The primary endpoints were major complications (Clavien-Dindo grade ≥ III) and postoperative morbidity.
Results
200 R-PS and 400 L-PS patients were included, with 163 pairs matched. R-PS showed lower conversion rates (2.5% vs. 17.2%, p < 0.001), less blood loss (119 vs. 179 mL, p = 0.013), and faster function recovery (8.2 vs. 9.6 days, p = 0.038). Postoperatively, R-PS had fewer pancreatic fistulas in malignant (4.1% vs. 32.6%, p < 0.001) and moderate to high-risk cases (8.3% vs. 16.7%, p = 0.026). R-PS benefits are not procedure-specific.
Conclusion
R-PS offers advantages in blood loss, complications, and fistula prevention, suggesting it may be preferable for complex pancreatic surgeries.
背景：本研究比较了机器人辅助胰腺手术（R-PS）和腹腔镜胰腺手术（L-PS）对胰腺恶性肿瘤和中高危胰腺瘘患者的治疗效果。材料与方法：回顾性队列研究于广东省人民医院（2021-2023）进行。主要终点为主要并发症（Clavien-Dindo分级≥III）和术后发病率。结果：纳入R-PS患者200例，L-PS患者400例，配对163对。R-PS的转换率较低（2.5% vs. 17.2%） p结论：R-PS在失血、并发症和瘘预防方面具有优势，提示R-PS可能更适合复杂的胰腺手术。
{"title":"Comparison of Robotic and Laparoscopic Pancreatic Surgery Outcomes: A Retrospective Cohort Study With Propensity Score Matching and Subgroup Analysis of Pancreatic Malignancies and Moderate to High-Risk Pancreatic Fistulas","authors":"Min Yu, Wentao Zhong, Feng Zhang, Weifeng Hong, Yuan Yuan, Changgui Zou, Qing Lin, Rufu Chen","doi":"10.1002/rcs.70117","DOIUrl":"10.1002/rcs.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study compares robotic-assisted pancreatic surgery (R-PS) and laparoscopic pancreatic surgery (L-PS) outcomes in patients with pancreatic malignancies and medium- to high-risk pancreatic fistulas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted at Guangdong Provincial People's Hospital (2021–2023). The primary endpoints were major complications (Clavien-Dindo grade ≥ III) and postoperative morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>200 R-PS and 400 L-PS patients were included, with 163 pairs matched. R-PS showed lower conversion rates (2.5% vs. 17.2%, <i>p</i> < 0.001), less blood loss (119 vs. 179 mL, <i>p</i> = 0.013), and faster function recovery (8.2 vs. 9.6 days, <i>p</i> = 0.038). Postoperatively, R-PS had fewer pancreatic fistulas in malignant (4.1% vs. 32.6%, <i>p</i> < 0.001) and moderate to high-risk cases (8.3% vs. 16.7%, <i>p</i> = 0.026). R-PS benefits are not procedure-specific.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>R-PS offers advantages in blood loss, complications, and fistula prevention, suggesting it may be preferable for complex pancreatic surgeries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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