Igor Monsellato, Teresa Gatto, Maria Antonietta Alagia, Federico Sangiuolo, Marco Palucci, Celeste del Basso, Martina Girardi, Irene Gandini, Gabriela Del Angel-Millan, Marco Lodin, Fabio Giannone, Gianluca Cassese, Fabrizio Panaro
Background
Robotic total colectomy is a valuable approach for managing complex colorectal diseases. Its role in high-risk patients, especially those with significant comorbidities or synchronous malignancy, remains underreported.
Methods
Two high-risk male patients with familial adenomatous polyposis (FAP), one with synchronous colon cancer, underwent fully robotic total colectomy with intracorporeal ileo-pouch-rectal anastomosis and loop ileostomy using the da Vinci Xi system in 2024. A focused review of the recent literature on robotic colectomy was also conducted.
Results
The mean age was 68 years, and mean BMI was 33.05 kg/m2. One patient had cirrhosis and obesity; the other had severe obesity and psychiatric comorbidity. Both procedures were completed without conversions or complications. Mean console time was 315 min, and mean hospital stay was 11 days.
Conclusions
Fully robotic total colectomy is feasible and safe in high-risk patients. These findings support its expanded role in minimally invasive colorectal surgery.
{"title":"Fully Robotic Total Colectomy in High-Risk Patients and Review of Literature","authors":"Igor Monsellato, Teresa Gatto, Maria Antonietta Alagia, Federico Sangiuolo, Marco Palucci, Celeste del Basso, Martina Girardi, Irene Gandini, Gabriela Del Angel-Millan, Marco Lodin, Fabio Giannone, Gianluca Cassese, Fabrizio Panaro","doi":"10.1002/rcs.70098","DOIUrl":"https://doi.org/10.1002/rcs.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic total colectomy is a valuable approach for managing complex colorectal diseases. Its role in high-risk patients, especially those with significant comorbidities or synchronous malignancy, remains underreported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two high-risk male patients with familial adenomatous polyposis (FAP), one with synchronous colon cancer, underwent fully robotic total colectomy with intracorporeal ileo-pouch-rectal anastomosis and loop ileostomy using the da Vinci Xi system in 2024. A focused review of the recent literature on robotic colectomy was also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 68 years, and mean BMI was 33.05 kg/m<sup>2</sup>. One patient had cirrhosis and obesity; the other had severe obesity and psychiatric comorbidity. Both procedures were completed without conversions or complications. Mean console time was 315 min, and mean hospital stay was 11 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fully robotic total colectomy is feasible and safe in high-risk patients. These findings support its expanded role in minimally invasive colorectal surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869416","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}
Wireless Capsule Endoscopy (WCE) is one of the most advanced medical instruments, which can be used for non-invasive imaging detection of the digestive tract by patients taking microcapsules orally. This advanced technology enables medical professionals to evaluate the abnormal situations in the gastrointestinal tract efficiently, analyse the potential problems strictly, discuss the diagnosis and evaluation comprehensively, and make well-founded treatment decisions.
Methods
A scoping review was undertaken, gathering the most relevant sources, utilising a detailed literature search of medical and academic databases including EMBASE, PubMed, Cochrane, IEEE, Google Scholar, and the Google search engine.
Results
Of the 39 articles reviewed, 12 focused on the mechanical structure of WCE, 17 on intestinal lesion detection, and 10 on intestinal 3D reconstruction techniques. We conducted a thorough analysis of the active mechanical structures specifically designed to meet physiological demands and adapt to the dynamic gastrointestinal environment. Furthermore, we performed a comprehensive comparison and evaluation of various detection algorithms, discussing the characteristics of relevant datasets that significantly impact the diagnostic performance of WCE technologies. Lastly, we reviewed the current state and progress of 3D reconstruction techniques.
Conclusions
WCE can greatly improve the defects of current gastrointestinal examination technology, reduce patient pain, and enrich medical means. However, a large number of software and hardware problems need to be solved before being applied to clinical practice.
{"title":"A Review on the Current Research Status of Key Areas in Wireless Capsule Endoscopy","authors":"Guangyuan Wang, Na Liu, Huili Zhang, Rongmin Zhang, Xiaofei Sheng, Jinwei Qiao","doi":"10.1002/rcs.70094","DOIUrl":"https://doi.org/10.1002/rcs.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Wireless Capsule Endoscopy (WCE) is one of the most advanced medical instruments, which can be used for non-invasive imaging detection of the digestive tract by patients taking microcapsules orally. This advanced technology enables medical professionals to evaluate the abnormal situations in the gastrointestinal tract efficiently, analyse the potential problems strictly, discuss the diagnosis and evaluation comprehensively, and make well-founded treatment decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was undertaken, gathering the most relevant sources, utilising a detailed literature search of medical and academic databases including EMBASE, PubMed, Cochrane, IEEE, Google Scholar, and the Google search engine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 39 articles reviewed, 12 focused on the mechanical structure of WCE, 17 on intestinal lesion detection, and 10 on intestinal 3D reconstruction techniques. We conducted a thorough analysis of the active mechanical structures specifically designed to meet physiological demands and adapt to the dynamic gastrointestinal environment. Furthermore, we performed a comprehensive comparison and evaluation of various detection algorithms, discussing the characteristics of relevant datasets that significantly impact the diagnostic performance of WCE technologies. Lastly, we reviewed the current state and progress of 3D reconstruction techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WCE can greatly improve the defects of current gastrointestinal examination technology, reduce patient pain, and enrich medical means. However, a large number of software and hardware problems need to be solved before being applied to clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716935","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}
SeongHyeon Won, Chanwoo Kim, Yeonho Ko, Junho Hong, Jisu Jeon, Daehie Hong
Background
Endoscopic Retrograde Cholangiopancreatography (ERCP) and Percutaneous Coronary Intervention (PCI) are minimally invasive procedures that treat diseases with minimal scarring and rapid recovery. However, catheterisation under fluoroscopy exposes medical staff to radiation, and navigating flexible guidewires through complex anatomical pathways requires precise control.
Methods
To address these challenges, we propose a novel insertion robot based on a Chebyshev lambda mechanism that makes a linear grasp path and an arc-shaped quick return path using a single motor. An integrated roll module enables continuous insertion and rotation, yielding a robot with two degrees of freedom.
Results
Experiments show robots can make sufficient insertion force for real procedures, with robot's maximum mean translational and rotational errors of 0.11 mm and 1.47°, respectively. Phantom model tests show its applicability to human anatomy.
Conclusions
The proposed robotic system demonstrated sufficient precision and force for real surgical applications, indicating its potential for clinical use in minimally invasive procedures.
{"title":"Novel Design of a Surgical Tool Insertion Robot Using a Chebyshev Lambda Mechanism","authors":"SeongHyeon Won, Chanwoo Kim, Yeonho Ko, Junho Hong, Jisu Jeon, Daehie Hong","doi":"10.1002/rcs.70095","DOIUrl":"https://doi.org/10.1002/rcs.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endoscopic Retrograde Cholangiopancreatography (ERCP) and Percutaneous Coronary Intervention (PCI) are minimally invasive procedures that treat diseases with minimal scarring and rapid recovery. However, catheterisation under fluoroscopy exposes medical staff to radiation, and navigating flexible guidewires through complex anatomical pathways requires precise control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To address these challenges, we propose a novel insertion robot based on a Chebyshev lambda mechanism that makes a linear grasp path and an arc-shaped quick return path using a single motor. An integrated roll module enables continuous insertion and rotation, yielding a robot with two degrees of freedom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Experiments show robots can make sufficient insertion force for real procedures, with robot's maximum mean translational and rotational errors of 0.11 mm and 1.47°, respectively. Phantom model tests show its applicability to human anatomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed robotic system demonstrated sufficient precision and force for real surgical applications, indicating its potential for clinical use in minimally invasive procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705452","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}
Surgical Robotic Platforms (SRPs) have transformed the way surgeons perform Robot-Assisted Minimally Invasive Surgeries (RMIS). SRPs utilize Computer-Assisted Surgery (CAS) systems to guide surgeons.
Methods
This review paper systematically examines 31 SRPs, analysing their benefits and limitations to provide a comprehensive understanding of their role in RMIS execution. In addition, it proposes the logical classification of SRPs. Furthermore, it presents and validates the hypothesis that the use of SRPs and AI-based CAS enhances clinical outcomes by providing an accurate RMIS execution. Moreover, it proposes a logically structured classification of CAS systems.
Results
Classification of evaluation parameters identified for the comparison of SRPs is introduced. An overview of 27 video-guided CAS systems and their comparison is presented.
Conclusion
In a single place, this paper combines in-depth discussions of three contemporary areas: SRPs, RMIS, and CAS systems. It discusses the identified challenges and extensive future scope of research in three areas.
{"title":"A Review on Surgical Robotic Platforms Including RMIS, AI-Based CAS Systems, Challenges, and Future Directions","authors":"Rachana S. Oza, Mayuri A. Mehta, Patrick Siarry","doi":"10.1002/rcs.70089","DOIUrl":"https://doi.org/10.1002/rcs.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Surgical Robotic Platforms (SRPs) have transformed the way surgeons perform Robot-Assisted Minimally Invasive Surgeries (RMIS). SRPs utilize Computer-Assisted Surgery (CAS) systems to guide surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review paper systematically examines 31 SRPs, analysing their benefits and limitations to provide a comprehensive understanding of their role in RMIS execution. In addition, it proposes the logical classification of SRPs. Furthermore, it presents and validates the hypothesis that the use of SRPs and AI-based CAS enhances clinical outcomes by providing an accurate RMIS execution. Moreover, it proposes a logically structured classification of CAS systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Classification of evaluation parameters identified for the comparison of SRPs is introduced. An overview of 27 video-guided CAS systems and their comparison is presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a single place, this paper combines in-depth discussions of three contemporary areas: SRPs, RMIS, and CAS systems. It discusses the identified challenges and extensive future scope of research in three areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688096","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}
We report the first case of single-port robotic liver tumour resection in a patient with recurrent hepatocellular carcinoma in the right anterior lobe of the liver.
Methods
A 65-year-old male with recurrent hepatocellular carcinoma in the right anterior lobe underwent robotic liver tumour resection using the EDGE SP1000, a single-port laparoscopic surgical robot. The procedure involved resection of a 2.7-cm-diameter tumour in segment five of the liver via adhesiolysis, partial hepatectomy, suturing, ligation, and an innovative suction technique.
Results
The surgery lasted 120 min with 30 mL of blood loss. The patient's postoperative vital signs were stable. EDGE SP1000 use for robotic liver tumour resection is safe for older patients who require minimally invasive surgery and those with severe abdominal adhesions.
Conclusion
The EDGE SP1000 has superior capabilities that enable precise manipulation within the confined space of the abdomen and allow minimally invasive single-port surgery with aesthetic benefits.
{"title":"Single-Port Robotic Resection of Recurrent Hepatocellular Carcinoma in the Right Anterior Lobe: A Case Report","authors":"Zesheng Jiang, Zhoubin Feng, Yuyan Xu, Jiasheng Qin, Jianan Feng, Haiyan Liu, Zhiping Wang, Luhao Chi, Wenxuan Liu, Lei Cai, Mingxin Pan","doi":"10.1002/rcs.70092","DOIUrl":"https://doi.org/10.1002/rcs.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We report the first case of single-port robotic liver tumour resection in a patient with recurrent hepatocellular carcinoma in the right anterior lobe of the liver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 65-year-old male with recurrent hepatocellular carcinoma in the right anterior lobe underwent robotic liver tumour resection using the EDGE SP1000, a single-port laparoscopic surgical robot. The procedure involved resection of a 2.7-cm-diameter tumour in segment five of the liver via adhesiolysis, partial hepatectomy, suturing, ligation, and an innovative suction technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The surgery lasted 120 min with 30 mL of blood loss. The patient's postoperative vital signs were stable. EDGE SP1000 use for robotic liver tumour resection is safe for older patients who require minimally invasive surgery and those with severe abdominal adhesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The EDGE SP1000 has superior capabilities that enable precise manipulation within the confined space of the abdomen and allow minimally invasive single-port surgery with aesthetic benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624550","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}
Min He, Shuangai Liu, Xiaohui Ma, Jiabin Cai, Xuan Wu, Junqin Mao, Linjie Li, Lifeng Zhang, Meidan Ying, Ziqi He, Ting Tao, Jinhu Wang, Xiang Yan
Background
The purpose of this study was to share our experiences with robot-assisted laparoscopic nephrectomy (RALN) for WT in children and to discuss the technical points and indications.
Methods
Patients with WT undergoing RALN between May 2020 and December 2022 were retrospectively analysed. Patient demographics, operative details, postoperative outcomes and follow-up were recorded.
Results
A total of 10 patients with WT who underwent RALN were enrolled in this study. The tumour diameter at operation was 70.2 ± 26.1 mm. The median tumour-abdominal volume ratio (TAVR) was 6.8% (range, 1.9%–14.8%). RALN was successfully performed in all the 10 patients without conversion, tumour rupture or operative complications. No local recurrence or death occurred during the follow-up period.
Conclusion
RALN for the treatment of WT in children appears to be safe and feasible in selected patients. Robotic surgery offers an effective alternative to laparoscopic surgery, appropriately expanding indications when performed by experienced surgeons.
{"title":"Robot-Assisted Laparoscopic Nephrectomy for Wilms' Tumour in Children","authors":"Min He, Shuangai Liu, Xiaohui Ma, Jiabin Cai, Xuan Wu, Junqin Mao, Linjie Li, Lifeng Zhang, Meidan Ying, Ziqi He, Ting Tao, Jinhu Wang, Xiang Yan","doi":"10.1002/rcs.70088","DOIUrl":"https://doi.org/10.1002/rcs.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this study was to share our experiences with robot-assisted laparoscopic nephrectomy (RALN) for WT in children and to discuss the technical points and indications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with WT undergoing RALN between May 2020 and December 2022 were retrospectively analysed. Patient demographics, operative details, postoperative outcomes and follow-up were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 10 patients with WT who underwent RALN were enrolled in this study. The tumour diameter at operation was 70.2 ± 26.1 mm. The median tumour-abdominal volume ratio (TAVR) was 6.8% (range, 1.9%–14.8%). RALN was successfully performed in all the 10 patients without conversion, tumour rupture or operative complications. No local recurrence or death occurred during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RALN for the treatment of WT in children appears to be safe and feasible in selected patients. Robotic surgery offers an effective alternative to laparoscopic surgery, appropriately expanding indications when performed by experienced surgeons.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598249","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}
Christopher D'Ambrosia, Estella Y. Huang, Nicole H. Goldhaber, Henrik Christensen, Ryan C. Broderick, Lawrence G. Appelbaum
Background
This study tested the measurement of operator physiology during performance on robot-assisted surgery simulations to determine if these signals can identify errors and classify high and low performers.
Methods
57 participants performed digital simulations on da Vinci Xi system. Simulation videos, electrocardiogram (EKG), and electroencephalography (EEG) were analysed using linear mixed effects models.
Results
Relative to non-error intervals, errors elicited significant differences in EKG and EEG measures, including high-frequency power, interbeat interval and ratio of theta-to-alpha EEG power. High and low performers differed significantly in several of these measures, while classification models were accurate for the detection of errors (85.7%) and performance groups (96.3%), and using physiological signals leading up to errors, could accurately predict upcoming errors (85.7%).
Conclusions
Noninvasive recording of physiology can differentiate error from non-error intervals and performance groups, leading to the possibility that online physiology can develop into training or early warning systems.
{"title":"Physiological Detection of Intraoperative Errors During Robot-Assisted Surgery","authors":"Christopher D'Ambrosia, Estella Y. Huang, Nicole H. Goldhaber, Henrik Christensen, Ryan C. Broderick, Lawrence G. Appelbaum","doi":"10.1002/rcs.70090","DOIUrl":"https://doi.org/10.1002/rcs.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study tested the measurement of operator physiology during performance on robot-assisted surgery simulations to determine if these signals can identify errors and classify high and low performers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>57 participants performed digital simulations on da Vinci Xi system. Simulation videos, electrocardiogram (EKG), and electroencephalography (EEG) were analysed using linear mixed effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative to non-error intervals, errors elicited significant differences in EKG and EEG measures, including high-frequency power, interbeat interval and ratio of theta-to-alpha EEG power. High and low performers differed significantly in several of these measures, while classification models were accurate for the detection of errors (85.7%) and performance groups (96.3%), and using physiological signals leading up to errors, could accurately predict upcoming errors (85.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Noninvasive recording of physiology can differentiate error from non-error intervals and performance groups, leading to the possibility that online physiology can develop into training or early warning systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589957","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}
Fabio Ausania, Filippo Landi, Carolina González-Abós, John B. Martinie, Dionisios Vrochides, Matthew Walsh, Shanaz M. Hossain, Steven White, Viswakumar Prabakaran, Laleh G. Melstrom, Yuman Fong, Giovanni Butturini, Laura Bignotto, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Francisco Sanchez-Bueno, Nicola de'Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Alessandro Esposito, Roberto Salvia, Francesca Bazzocchi, Ludovica Esposito, Andrea Pietrabissa, Luigi Pugliese, José Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti
Background
Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP.
Methods
A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches. Perioperative outcomes and factors associated with clinically relevant POPF were analysed using univariate and multivariate methods.
Results
Among 130 patients (57L-SPDP, 73R-SPDP), POPF incidence was significantly lower in the robotic group (15.1% vs. 42.1%; p = 0.001). The Comprehensive Complications Index was also lower (8% vs. 15%; p = 0.002). Laparoscopic approach (OR = 4.0), pancreatic body transection (OR = 2.6), and non-stapler stump closure (OR = 3.2) were independently associated with higher POPF rates.
Discussion
Robotic MI-SPDP reduces POPF in obese patients. Transection at the pancreatic neck and stapler-based closure can improve outcomes.
与开放手术相比，微创保脾远端胰腺切除术（MI-SPDP）提供了更好的结果，机器人技术比腹腔镜技术显示出更好的短期效果，特别是在肥胖患者中。本研究旨在评估手术入路对MI-SPDP肥胖患者术后胰瘘（POPF）发生率的影响。方法回顾性分析来自16个国际中心的肥胖患者，比较机器人（R-SPDP）和腹腔镜（L-SPDP）入路。采用单因素和多因素方法分析围手术期结局和临床相关POPF相关因素。结果在130例患者（57L-SPDP, 73R-SPDP）中，机器人组的POPF发生率显著低于前者(15.1% vs. 42.1%；p = 0.001)。综合并发症指数也较低(8% vs. 15%；p = 0.002)。腹腔镜入路（OR = 4.0）、胰体横断（OR = 2.6）和非吻合器残端闭合（OR = 3.2）与较高的POPF发生率独立相关。机器人MI-SPDP降低肥胖患者的POPF。胰颈横断及吻合器缝合可改善预后。
{"title":"Minimally Invasive Spleen-Preserving Distal Pancreatectomy in Obese Patients: Factors Related to Clinically Relevant Pancreatic Fistula","authors":"Fabio Ausania, Filippo Landi, Carolina González-Abós, John B. Martinie, Dionisios Vrochides, Matthew Walsh, Shanaz M. Hossain, Steven White, Viswakumar Prabakaran, Laleh G. Melstrom, Yuman Fong, Giovanni Butturini, Laura Bignotto, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Francisco Sanchez-Bueno, Nicola de'Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Alessandro Esposito, Roberto Salvia, Francesca Bazzocchi, Ludovica Esposito, Andrea Pietrabissa, Luigi Pugliese, José Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti","doi":"10.1002/rcs.70091","DOIUrl":"https://doi.org/10.1002/rcs.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches. Perioperative outcomes and factors associated with clinically relevant POPF were analysed using univariate and multivariate methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 130 patients (57L-SPDP, 73R-SPDP), POPF incidence was significantly lower in the robotic group (15.1% vs. 42.1%; <i>p</i> = 0.001). The Comprehensive Complications Index was also lower (8% vs. 15%; <i>p</i> = 0.002). Laparoscopic approach (OR = 4.0), pancreatic body transection (OR = 2.6), and non-stapler stump closure (OR = 3.2) were independently associated with higher POPF rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Robotic MI-SPDP reduces POPF in obese patients. Transection at the pancreatic neck and stapler-based closure can improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581876","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}
Eliane Weinbrenner, Mykola Gorbachuk, Kathrin Machetanz, Florian Grimm, Linda Oberle, Sophie S. Wang, Marcos Tatagiba, Georgios Naros
Background
In frame-based stereotaxy, the design of the frame limits trajectory selection, e.g., to the temporal lobe and posterior fossa. We hypothesise that frame-less neuronavigation and robotic technology might have expanded these stereotactic corridors.
Methods
We analysed 376 frame-based, neuronavigated and robotic brain biopsies. We analysed entry (EP) and target (TP) point coordinates, trajectory lengths (TL) and angles (α1,α2), skin-to-skin time (STS), diagnostic yield and morbidity.
Results
Robotics liberated TP and EP selection, enabling trajectories not applicable with the frame. There was an increased application of lateral trajectories (reducing α1) while decreasing TL. There was a significant STS reduction attributable to a modification of the surgical approach (twist drill vs. burr hole).
Conclusions
Robotics modified trajectory selection and the surgical approach. Duration and invasiveness of brain biopsies were decreased without affecting diagnostic yield or morbidity. This may represent a clinical benefit of robotics compared with frame-based and frame-less stereotaxy.
{"title":"The Silent Transformation of Stereotactic Brain Biopsies After the Introduction of Robotics","authors":"Eliane Weinbrenner, Mykola Gorbachuk, Kathrin Machetanz, Florian Grimm, Linda Oberle, Sophie S. Wang, Marcos Tatagiba, Georgios Naros","doi":"10.1002/rcs.70087","DOIUrl":"https://doi.org/10.1002/rcs.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In frame-based stereotaxy, the design of the frame limits trajectory selection, e.g., to the temporal lobe and posterior fossa. We hypothesise that frame-less neuronavigation and robotic technology might have expanded these stereotactic corridors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed 376 frame-based, neuronavigated and robotic brain biopsies. We analysed entry (EP) and target (TP) point coordinates, trajectory lengths (TL) and angles (<i>α</i><sub>1</sub>,<i>α</i><sub>2</sub>), skin-to-skin time (STS), diagnostic yield and morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Robotics liberated <i>TP</i> and <i>EP</i> selection, enabling trajectories not applicable with the frame. There was an increased application of lateral trajectories (reducing <i>α1</i>) while decreasing <i>TL</i>. There was a significant <i>STS</i> reduction attributable to a modification of the surgical approach (twist drill vs. burr hole).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robotics modified trajectory selection and the surgical approach. Duration and invasiveness of brain biopsies were decreased without affecting diagnostic yield or morbidity. This may represent a clinical benefit of robotics compared with frame-based and frame-less stereotaxy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564134","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}
Accurate detection of surgical instruments is essential for robot-assisted surgery. Existing methods face challenges in both accuracy and real-time performance, limiting their clinical applicability.
Methods
We propose UK-YOLOv10, a novel framework that integrates two innovations: the uni-fusion attention module (UFAM) for enhanced multi-scale feature representation, and the C2fKAN module, which employs KAN convolution to improve classification accuracy and accelerate training.
Results
On the M2CAI16-Tool-Locations dataset, UK-YOLOv10 achieves detection accuracy of 96.7%, an [email protected] of 96.4%, and an [email protected]:0.95 of 0.605, outperforming YOLOv10 by 3%, 2.2% and 3.6%, respectively. Generalisation on COCO2017 resulted in an [email protected]:0.95 of 0.386.
Conclusion
UK-YOLOv10 significantly improves surgical instrument detection and demonstrates strong potential for robot-assisted surgeries.
{"title":"UK-YOLOv10: Deep Learning-Based Detection of Surgical Instruments","authors":"Li Zhang, Guanqun Guo, Wenjie Wang","doi":"10.1002/rcs.70083","DOIUrl":"https://doi.org/10.1002/rcs.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate detection of surgical instruments is essential for robot-assisted surgery. Existing methods face challenges in both accuracy and real-time performance, limiting their clinical applicability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We propose UK-YOLOv10, a novel framework that integrates two innovations: the uni-fusion attention module (UFAM) for enhanced multi-scale feature representation, and the C2fKAN module, which employs KAN convolution to improve classification accuracy and accelerate training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On the M2CAI16-Tool-Locations dataset, UK-YOLOv10 achieves detection accuracy of 96.7%, an [email protected] of 96.4%, and an [email protected]:0.95 of 0.605, outperforming YOLOv10 by 3%, 2.2% and 3.6%, respectively. Generalisation on COCO2017 resulted in an [email protected]:0.95 of 0.386.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UK-YOLOv10 significantly improves surgical instrument detection and demonstrates strong potential for robot-assisted surgeries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492887","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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