Intelligent Surgery最新文献

{"title":"Successful robotic-assisted liver resection after Yttrium-90 radioembolization in combination with targeted and immunotherapy in unresectable hepatocellular carcinoma:A case report and literature review","authors":"Yewei Zhang ,&nbsp;Zefeng Shen ,&nbsp;Xiao Liang","doi":"10.1016/j.isurg.2025.03.002","DOIUrl":"10.1016/j.isurg.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the clinical data and review the literature on successful robotic-assisted hepatectomy after yttrium-90 microsphere radioembolization (Y⁹⁰-RE) combined with targeted therapy and immunotherapy for advanced unresectable hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed a case of with advanced HCC patient in our center who successfully underwent robotic-assisted hepatectomy after Y⁹⁰-RE combined with targeted therapy and immunotherapy. Additionally, we reviewed the related treatments and summarized the latest advances in domestic and international literature.</div></div><div><h3>Results</h3><div>The patient was a 65-year-old man, who underwent successful robotic-assisted hepatectomy after Y⁹⁰-RE combined with targeted immunotherapy and was confirmed to achieve pathologically complete remission (pCR). Postoperative pathology showed that the tumor was necrotic, and no tumor residue was observed. The patient was followed up for more than six months, and no tumor recurrence was observed.</div></div><div><h3>Conclusion</h3><div>In this case, Y⁹⁰-RE combined with targeted immunotherapy as a preoperative conversion therapy ​option for advanced unresectable HCC was proven to be safe and feasible in this case.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 24-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience of single-incision robotic surgery for lateral suspension of patients with pelvic organ prolapse","authors":"Shiyan Wang ,&nbsp;Yuqi Men ,&nbsp;Lei Gao ,&nbsp;Qianqian Ye ,&nbsp;Yiqin Wang ,&nbsp;Hao Deng ,&nbsp;Xiuli Sun","doi":"10.1016/j.isurg.2025.02.001","DOIUrl":"10.1016/j.isurg.2025.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to describe technical considerations and short-term outcomes from the first reported eight cases of single-incision robotic operation for lateral suspension of patients with pelvic organ prolapse using the SHURUI robotics surgical system (SR-ENS-600, SHURAI compony, Beijing Daxing Biomedical Base).</div></div><div><h3>Methods</h3><div>Eight patients with a body-mass index vary from 20 to 30 ​kg/m² was treated for anterior vaginal prolapse and apical prolapse by single-incision robot-assisted lateral suspension with the SHURUI robotics surgical system between March 2024 and June 2024 in Peking University People's Hospital.</div></div><div><h3>Results</h3><div>The single-incision SHURUI robot-assisted lateral suspension was successfully performed with eight patients who suffered from anterior vaginal prolapse and apical prolapse. The console time among the operation ranged from 192 ​min to 274 ​min, with intraoperative blood loss ranging from 20 ​mL to 100 ​mL. There was no urinary retention after urinary catheter removal. During the postoperative period, no severe adverse events occurred. There was no prolapse recurrence after one month of postoperative follow-up.</div></div><div><h3>Conclusion</h3><div>Single-incision SHURUI robot-assisted lateral suspension was a safe and feasible surgical method for patients with anterior vaginal prolapse and apical prolapse. The study provided a basis for subsequent research and highlighted the need for further clinical trials to verify its superior operative outcomes.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 8-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety evaluation of remote robotic surgery under high latency conditions based on satellite communication","authors":"Gong Zhang ,&nbsp;Lichao Pan ,&nbsp;Xuan Zhang ,&nbsp;Zhaohai Wang ,&nbsp;Zhiqiang Ma ,&nbsp;Chao He ,&nbsp;Zihan Li ,&nbsp;Rong Liu","doi":"10.1016/j.isurg.2025.05.001","DOIUrl":"10.1016/j.isurg.2025.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>To verify the feasibility of geostationary orbit satellite communication in ultra-remote robotic surgery and to construct a remote surgical operation control technology system under high-latency communication conditions.</div></div><div><h3>Methods</h3><div>A large time-delay control method was proposed, including the establishment of the Stability Operation Criteria for Large Time-Delay Remote Robotic Surgery and Generalized-Order Compliant Interaction Control Method. On December 26, 2024, a transregional communication link between Lhasa and Beijing was established via the Asia-Pacific 6D high-throughput satellite (orbital altitude of 36,000 ​km), and two hepatectomies for liver cancer were performed using the Tumai surgical robot system. Core parameters such as end-to-end latency and data packet loss rate were monitored.</div></div><div><h3>Results</h3><div>The Lhasa-Beijing link established through the Asia-Pacific 6D satellite achieved an average end-to-end latency of 632 ​ms (measured uplink 4.2 Mbps/downlink 3 Mbps), with intraoperative robotic arm pose tracking error &lt;0.5 ​mm (n ​= ​2). Both hepatectomies for liver cancer were successfully completed, with surgery durations of 115–124 ​min, blood loss of 20 ​mL, and patients discharged within 24 ​h post-surgery without severe complications (Clavien-Dindo I level).</div></div><div><h3>Conclusion</h3><div>This study is the first to confirm the safety of geostationary orbit satellite support for human surgery and verifies the feasibility of surgical operation control technology under high-latency conditions.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core elements for a smooth transition from laparoscopic to robotic colorectal surgery","authors":"Shuai Ma,&nbsp;Quanbo Zhou,&nbsp;Weitang Yuan,&nbsp;Yugui Lian","doi":"10.1016/j.isurg.2025.05.004","DOIUrl":"10.1016/j.isurg.2025.05.004","url":null,"abstract":"<div><div>With the widespread adoption of da Vinci robotic system, the volume of robotic colorectal surgeries has witnessed an explosive increase. Studies have shown that robotic surgery outperforms traditional laparoscopy in terms of tumor resection quality, intraoperative blood loss, postoperative recovery, and patient prognosis. This article systematically explores the core elements for transitioning from laparoscopic to robotic colorectal surgery, emphasizing learning curve and case selection as pivotal factors. Learning curve analysis indicates that the proficiency process of robotic surgery can be divided into the exploration period, the stabilization period, and the challenge period. Moreover, previous laparoscopic experience has a limited effect on shortening the learning curve, while case selection and training volume are more crucial. Case selection should quantify the surgical difficulty through preoperative clinical parameters and follow the principle of “from simple to complex”. In the future, it is necessary to establish a standardized training system, and develop surgical difficulty prediction tools to optimize clinical decision-making. This article provides a theoretical and practical framework for the safe and efficient transition of surgical approaches.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 58-62"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Da Vinci Xi robot-assisted resection of a large caudate lobe liver tumor: Case report and technical discussion","authors":"Zhichao Yang,&nbsp;Xinyu Ma,&nbsp;Haitao Yang,&nbsp;Zihao Li,&nbsp;Guangchao Yang,&nbsp;Linqiang Li,&nbsp;Yong Ma","doi":"10.1016/j.isurg.2025.02.002","DOIUrl":"10.1016/j.isurg.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>This study details the surgical process of using the da Vinci Xi surgical robot to resect a large caudate lobe liver tumor. It aims to share technical experience in robot-assisted resection of large tumors in the caudate lobe of the liver.</div></div><div><h3>Objective</h3><div>To provide evidence supporting the feasibility and safety of robot-assisted liver caudate lobe tumor resection.</div></div><div><h3>Methods</h3><div>On August 5, 2024, the First Affiliated Hospital of Harbin Medical University successfully performed a large caudate lobe tumor resection adjacent to the inferior vena cava using the da Vinci Xi robotic system on a 23-year-old male. Surgical time, techniques, intraoperative blood loss, and postoperative recovery were documented and analyzed.</div></div><div><h3>Results</h3><div>The surgery was successfully completed in 195 ​min with an intraoperative blood loss of 200 ​mL, and no severe postoperative adverse events occurred. The patient recovered well under Enhanced Recovery After Surgery (ERAS) protocols and was discharged. Pathological examination confirmed focal nodular hyperplasia of the liver, with the tumor measuring 8 ​× ​5 ​× ​4.5 ​cm.</div></div><div><h3>Conclusion</h3><div>Robot-assisted liver tumor resection with the da Vinci Xi system is a safe and reliable surgical approach for treating large benign tumors of the liver caudate lobe. This study contributes to the clinical application of such surgeries and further confirms their safety and feasibility.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 14-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of total mesorectal excision through combined peritoneal and anal approaches in an animal model with Carina™ platform","authors":"Xiang Xia ,&nbsp;Yeqian Zhang ,&nbsp;Jiayi Gu ,&nbsp;Tao Liu ,&nbsp;Chunchao Zhu,&nbsp;Zheng Wang,&nbsp;Zizhen Zhang","doi":"10.1016/j.isurg.2025.03.001","DOIUrl":"10.1016/j.isurg.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study assessed the feasibility of performing hybrid transabdominal and transanal total mesorectal excision using the Carina™ platform in an animal model.</div></div><div><h3>Methods</h3><div>The experiment was conducted in a porcine model, where two experienced surgeons performed simultaneous abdominal and transanal portions of the procedure.</div></div><div><h3>Results</h3><div>The procedure was successfully completed in 123 ​min with minimal blood loss of 15 ​mL. Both teams reached the peritoneal reflection without complications or conversion to laparotomy. The Carina™ platform's modular design enabled precise, flexible manipulation and enhanced surgical visibility, facilitating meticulous dissection in the narrow pelvis.</div></div><div><h3>Conclusion</h3><div>The study validated the use of robotic platforms for complex cases and highlighted the advantages of dual-console, modular robotic surgery.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 19-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcome analysis of Carina™ platform in gastric and colorectal surgery: A single-group target-value clinical trial","authors":"Penghui He ,&nbsp;Feng Xiao ,&nbsp;Yahang Liang ,&nbsp;Dongning Liu ,&nbsp;Jinyuan Duan ,&nbsp;Shanping Ye ,&nbsp;Bo Tang ,&nbsp;Taiyuan Li","doi":"10.1016/j.isurg.2025.05.003","DOIUrl":"10.1016/j.isurg.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the efficiency and safety of the Carina™ Platform (Ronovo Surgical, Shanghai, China) in the field of general surgery, this study reported our preliminary experience.</div></div><div><h3>Methods</h3><div>Twenty-six consecutive patients were scheduled to undergo Carina robot-assisted laparoscopic surgery in our units from December 2023 to July 2024. The factors analyzed were the time required to prepare the patient and the room, total time of surgery, length of specimens, number of lymph nodes retrieved, blood loss, complications, and post-operative results.</div></div><div><h3>Results</h3><div>This robot-assisted laparoscopic surgery system is safe and mature. All of procedures were completed robotically, and there was no conversion to laparotomy. The median operation time was 172.5 ​min (range, 125–375) and the mean (SD) number of lymph nodes retrieved was 24 (9). The median docking time was 10 ​min (range, 6–15). The incidence of surgical complications was 2 out of 26 cases, including one patient with a rectal anastomotic leak and another patient with a wound infection.</div></div><div><h3>Conclusions</h3><div>The use of the Carina modular robotic system in gastric and colorectal surgery has been demonstrated to be both effective and safe. However, the advantages of modular robotic platforms remain to be explored, and further research is needed to assess long-term outcomes.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 53-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the da Vinci X robotic system in extramesocolic resections for locally-advanced colon cancer: A video vignette","authors":"Jagannath Dixit ,&nbsp;Joseph Mathew ,&nbsp;Satya Vijay Chigurupati ,&nbsp;Keshav Murthy MR","doi":"10.1016/j.isurg.2025.04.002","DOIUrl":"10.1016/j.isurg.2025.04.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective:&lt;/h3&gt;&lt;div&gt;To demonstrate the surgical technique for robotic extramesocolic resection using the da Vinci X platform in locally-advanced colon cancer (LACC), highlighting the challenges associated with this approach when the oncological margins of resection extend beyond the mesocolic fascia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods:&lt;/h3&gt;&lt;div&gt;This study, designed as a stepwise demonstration of surgical technique with narrated video footage, was conducted at a tertiary cancer center and teaching hospital in India. The patient was an 86-year-old man with Eastern Cooperative Oncology Group (ECOG) performance score of one, a surgical history of having undergone a laparotomy in the past, a significant family history of colon cancer and no comorbidities, who presented with complaints of bleeding per rectum since 3 months and lower abdominal fullness since 1 month, which on physical examination was determined to be a solitary well-circumscribed fixed mass in the left iliac fossa. On further evaluation, the colonic origin of this mass was confirmed, with colonoscopy revealing a circumferential ulceroproliferative growth extending from 35 to 40 cm of the anal verge, the biopsy of which was reported as a well-differentiated adenocarcinoma. On contrast-enhanced CT of the thorax, abdomen and pelvis, transmural thickening of the distal descending and proximal sigmoid colon causing severe luminal narrowing was evident, with infiltration of the left psoas and abdominal wall musculature, and abutting the left ureter and gonadal vessels, suggestive of LACC. Given the stricturing nature of the primary tumor with features suggestive of impending obstruction, and in the absence of significant locoregional lymphadenopathy or distant metastases, the multidisciplinary tumor board recommended primary surgical resection. A robotic approach was offered, considering the patient’s good performance status, the limited extent of extramesocolic disease, and the anticipated favorable postoperative outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results:&lt;/h3&gt;&lt;div&gt;The patient underwent a robotic anterior resection with extended complete mesocolic or extramesocolic excision. Before the procedure, a staging laparoscopy was performed to exclude peritoneal surface metastases and confirm operability, following which additional robotic ports were inserted, docking performed and the instruments deployed. Early into surgery, contiguous involvement of the retroperitoneal structures seen to abut the tumor on imaging was ruled out, ensuring disease resectability. Despite the lack of haptic feedback, the surgical margins were estimated and an en bloc resection performed based on compensatory visual cues including tissue color and texture, mobility of fascial planes and peritumoral edema, demonstrating the Reverse Braille phenomenon or faux haptic feedback wherein tactile sensation is perceived when vision is greatly enhanced, primarily considered a function of surgeon experience and the acuity of vision i","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 67-69"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic remote left lateral hepatectomy: A 2,600 ​km telesurgical case from Yunnan to Beijing","authors":"Xuan Zhang ,&nbsp;H.S. Boo ,&nbsp;Yuyao Song ,&nbsp;Zhaohai Wang ,&nbsp;Rong Liu","doi":"10.1016/j.isurg.2025.05.002","DOIUrl":"10.1016/j.isurg.2025.05.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To report on a successful case of robotic remote left lateral hepatectomy.</div></div><div><h3>Methods</h3><div>A 56-year-old female patient with a liver hemangioma in the left lateral segment underwent robotic remote left lateral hepatectomy at Chinese People's Liberation Army General Hospital (PLAGH).</div></div><div><h3>Results</h3><div>The surgery lasted 1 ​h and 21 ​min with minimal blood loss and was conducted using a 5G network with a one-way delay of 40 ​ms. The patient was discharged in one day post-surgery. There were no complications, including hemorrhage or bile leakage.</div></div><div><h3>Conclusions</h3><div>This case highlights the potential of telesurgery in hepatic surgeries to improve access to specialized surgery while addressing logistical, ethical and technological challenges.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 63-66"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages and prospects of robotic surgery for colorectal cancer","authors":"Qi Fan,&nbsp;Zhengwei Fu,&nbsp;Dehai Xiong","doi":"10.1016/j.isurg.2025.01.001","DOIUrl":"10.1016/j.isurg.2025.01.001","url":null,"abstract":"<div><div>This paper provides an overview of the development, technical features and current applications of the da Vinci surgical robots in colorectal cancer surgeries and conducts an in-depth analysis of the precision and stability of the da Vinci surgical robots in surgeries, as well as its technical advantages in reducing surgical trauma and accelerating recovery. This paper evaluates the clinical efficacy and safety of da Vinci surgical robotic-assisted surgery through a comparison of partial clinical data with traditional surgical methods, particularly focusing on the economic and social benefits. It fully demonstrates the advantages and application prospects of the da Vinci surgical robots in colorectal surgery, including intelligent precision technology, good clinical outcomes and excellent cost-effectiveness, while also discussing the current challenges and countermeasures.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}