Intelligent Surgery最新文献

{"title":"Robot-assisted radical resection of perihilar cholangiocarcinoma with bovine pericardial patch venoplasty","authors":"Xuan Zhang,&nbsp;Jimin Dai,&nbsp;Xianglong Tan,&nbsp;Yang Wang,&nbsp;Minggen Hu,&nbsp;Rong Liu","doi":"10.1016/j.isurg.2026.10.001","DOIUrl":"10.1016/j.isurg.2026.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>To report the feasibility and technical details of robot-assisted radical resection of perihilar cholangiocarcinoma with portal vein wedge resection and bovine pericardial patch venoplasty.</div></div><div><h3>Methods</h3><div>A 59-year-old woman with obstructive jaundice was diagnosed preoperatively with Bismuth-Corlette type IIIb perihilar cholangiocarcinoma, with involvement of the left portal vein and portal vein confluence. According to the institutional vascular involvement classification, the lesion was categorized as PV2/HA0. Following percutaneous transhepatic biliary drainage and three-dimensional liver volumetric assessment, the patient underwent entirely robotic regional lymphadenectomy, extended left hepatectomy with caudate lobectomy, extrahepatic bile duct resection, portal vein wedge resection, bovine pericardial patch venoplasty, and intracorporeal Roux-en-Y hepaticojejunostomy with two biliary-enteric anastomoses.</div></div><div><h3>Results</h3><div>Intraoperative exploration demonstrated biliary extension consistent with Bismuth-Corlette type IV disease. The procedure was completed entirely robotically without conversion. The operative time was 550 min, including 25 min of robotic docking. Parenchymal transection, portal vein reconstruction, and biliary reconstruction required 69, 20, and 58 min, respectively. The total portal vein clamping time was 71 min. Estimated blood loss was 500 mL, and the patient received 2 units of packed red blood cells and 1.9 units of fresh frozen plasma. Histopathological examination confirmed moderately differentiated adenocarcinoma invading the full thickness of bile duct wall, adjacent liver parenchyma, perineural tissues and the lateral wall of the portal vein. All surgical margins were negative, confirming an R0 resection. Five of the 9 examined regional lymph nodes showed metastatic involvement. The final pathological stage was pT3N2M0, corresponding to stage IVA according to the AJCC 8th edition. Postoperative Doppler ultrasonography and contrast-enhanced computed tomography confirmed portal vein patency. A controlled bile leak classified as an International Study Group of Liver Surgery grade B bile leak and Clavien-Dindo grade II complication, resolved with conservative management within 3 weeks.</div></div><div><h3>Conclusion</h3><div>Robot-assisted radical resection of perihilar cholangiocarcinoma with bovine pericardial patch venoplasty is technically feasible in selected patients. Given the complexity of hilar dissection, vascular repair, and biliary reconstruction, this approach should be limited to high-volume hepatobiliary centers with extensive robotic and vascular experience.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 79-86"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199306","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":"Application of single-port robotic systems in gynecologic vNOTES surgery","authors":"Chunhua Zhang ,&nbsp;Qian Huang ,&nbsp;Xiaojie Hu ,&nbsp;Yunxia Chen ,&nbsp;Yaxiong Xu ,&nbsp;Ranxin Zhang ,&nbsp;Xiaoming Guan","doi":"10.1016/j.isurg.2026.01.001","DOIUrl":"10.1016/j.isurg.2026.01.001","url":null,"abstract":"<div><div>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) for the treatment of gynecologic diseases offers advantages such minimal invasiveness, low surgical complication rates, and faster postoperative recovery. It also achieves a true “scarless” cosmetic outcome and represents a key direction in the development of modern surgery. The latest generation of single-port (SP) surgical robots deploy one electronic endoscope and three robotic surgical instruments through a single mechanical port, allowing high-definition visualization, a wide range of motion and restoration of the surgical triangulation. These characteristics reduce surgical difficulty and improve precision. Robotic-assisted single-port vNOTES (RSP-vNOTES) allows surgeons to perform intricate surgical procedures within confined anatomical spaces, expands surgical indications, enhances surgical precision and outcomes, and instates a new era of minimally invasive gynecologic surgery.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 14-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037823","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 liver resection beyond feasibility: Toward robotic-centered liver surgery","authors":"Awang Danzeng,&nbsp;Bin-hao Zhang","doi":"10.1016/j.isurg.2026.08.001","DOIUrl":"10.1016/j.isurg.2026.08.001","url":null,"abstract":"<div><div>Robotic liver resection (RLR) has progressed beyond technical feasibility and now requires a clearer definition of its clinical value, appropriate indications, and pathway for wider adoption. Conventional laparoscopy remains efficient and reproducible for many low-complexity liver resections; however, robotics may provide added value in anatomically demanding settings, including posterosuperior lesions, deep parenchymal tumors, major vascular-adjacent resections, and selected major hepatectomies. In this Expert Perspective, we argue that the future development of RLR should be guided by procedural complexity, measurable value, and standardized implementation rather than by technological availability alone. The evaluation of RLR should extend beyond conventional perioperative outcomes to include economic value, manpower efficiency, surgeon sustainability, and integration with enhanced recovery after surgery pathways. Broader adoption requires structured training, stable robotic teams, standardized workflows, and auditable outcomes. Looking ahead, image-guided surgery, artificial intelligence-assisted decision-making, and surgeon-supervised autonomy may further support the transition toward robotic-centered minimally invasive liver surgery.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 68-73"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737216","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":"Robotic-assisted surgery for colorectal cancer: Rethinking the transition from minimally invasive technology to intelligent precision surgery","authors":"Mingyu Liu,&nbsp;You Li","doi":"10.1016/j.isurg.2026.07.001","DOIUrl":"10.1016/j.isurg.2026.07.001","url":null,"abstract":"<div><div>Robotic surgery has become an important component of minimally invasive colorectal cancer surgery. Compared with conventional laparoscopy, robotic platforms offer potential advantages in three-dimensional stable visualization, articulated instruments, precise manipulation, and surgeon ergonomics, and may be particularly useful in selected scenarios such as mid-low rectal cancer, narrow pelvis, obesity, post-neoadjuvant fibrosis, and complex pelvic procedures. However, robotic surgery should not be simply regarded as a universal replacement for laparoscopy. Its clinical value should be evaluated comprehensively in terms of patient benefit, indication selection, long-term oncological outcomes, functional recovery, learning curve, and cost-effectiveness. With the development of artificial intelligence, fluorescence imaging, three-dimensional reconstruction, and surgical data science, robotic platforms may evolve from minimally invasive surgical tools into digital interfaces for preoperative planning, intraoperative decision support, and postoperative quality assessment. This review article discusses the clinical positioning, ongoing controversies, intelligent development, and future application strategies of robotic-assisted colorectal cancer surgery, aiming to provide a reference for its standardized, precise, and sustainable use.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 63-67"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148651368","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":"Chinese expert consensus on remote-controlled robot-assisted gynecological surgery (2025 Edition)","authors":"Yuanguang Meng ,&nbsp;Li'an Li ,&nbsp;Nan Wang","doi":"10.1016/j.isurg.2026.03.001","DOIUrl":"10.1016/j.isurg.2026.03.001","url":null,"abstract":"<div><div>Remote-controlled robot-assisted gynecological surgery is an innovative medical model integrating advanced communication technologies with robotic surgery systems. It promotes the equitable distribution of high-quality medical resources and responds to public health emergencies. This article, authored by domestic experts, aims to standardize clinical applications and enhance surgical quality and safety. It reviews the development of remote surgery, details the construction and technical requirements of remote-controlled robot-assisted gynecological surgery systems supported by 5G and other communication technologies, and emphasizes the importance of quality management. This includes equipment access, personnel qualifications, team collaboration, network communication and security, and health economics indicators. The article also offers recommendations for the access and training assessment of remote surgery. Additionally, it elaborates on the operating procedures of remote-controlled robot-assisted gynecological surgery, covering preoperative preparation, surgical steps, postoperative management, and the prevention and treatment of complications and fault response. Finally, it discusses the challenges in the development of this technology, including the iterative upgrading of robotic surgery systems, network security assurance, the realization of full-process remote medical services, and the implementation of remote surgery in special environments. These discussions aim to provide references for the promotion of remote-controlled robot-assisted gynecological surgery in China.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 35-41"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147656537","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":"Expert consensus on pancreatic duct (repair) surgery","authors":"Rong Liu,&nbsp;Qu Liu,&nbsp;Zizheng Wang","doi":"10.1016/j.isurg.2025.12.002","DOIUrl":"10.1016/j.isurg.2025.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>To standardize and promote the clinical application of pancreatic duct (repair) surgery for benign and borderline/low-grade malignant pancreatic tumors, improve surgical outcomes and reduce complications, the expert consensus was formulated.</div></div><div><h3>Methods</h3><div>Organized by the Minimally Invasive Surgery Committee and Intelligent Medicine Committee of the Chinese Research Hospital Association, domestic pancreatic surgery experts, based on literature evidence and clinical experience, discussed key topics including pancreatic duct anatomy, the concepts of pancreatic duct (repair) surgery, surgical indications, preoperative evaluation, intraoperative techniques, and postoperative management.</div></div><div><h3>Results</h3><div>The consensus describes the core techniques of pancreatic duct (repair) surgery, such as main pancreatic duct repair, end-to-end pancreatic anastomosis, main pancreatic duct replacement, and local resection of branch-duct intraductal papillary mucinous neoplasm (BD-IPMN). It emphasizes preoperative multimodal imaging assessment, intraoperative ultrasound guidance and minimally invasive approaches. Recommendations include the selection of repair strategies based on the severity of duct injury, the standardized use of pancreatic stents, and the prevention protocols for postoperative pancreatic fistula.</div></div><div><h3>Conclusion</h3><div>Pancreatic duct (repair) surgery restores the continuity of the pancreatic duct, avoids gastrointestinal reconstruction, and reduces postoperative complications. It represents a significant advancement in organ preservation pancreatic surgery. Further studies are needed to verify the long-term efficacy and refine the technical procedures.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 7-13"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885083","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":"Minimally invasive liver resection at Kochi health sciences center: Initiatives and current status","authors":"Motoyasu Tabuchi,&nbsp;Sunao Uemura,&nbsp;Shuta Tamura,&nbsp;Teppei Tokumaru,&nbsp;Takehiro Okabayashi","doi":"10.1016/j.isurg.2026.01.002","DOIUrl":"10.1016/j.isurg.2026.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety and feasibility of robot-assisted hepatectomy (RAH) by comparing its early outcomes at our institution with those of laparoscopic hepatectomy (LH).</div></div><div><h3>Methods</h3><div>Among minimally invasive hepatectomies performed at our institution between 2013 and 2025, 29 cases of RAH (January–September 2025) and 52 cases of LH (January 2013–September 2025) were retrospectively compared in terms of operative time, blood loss, postoperative hospital stay, and complications of Clavien–Dindo grade III or higher. Technical details and procedural innovations were described with representative cases.</div></div><div><h3>Results</h3><div>There were no significant differences in patient background characteristics between the two groups, except for the Iwate difficulty score, which was significantly higher in the RAH group. Blood loss, postoperative hospital stay, and the incidence of complications of grade III or higher were comparable between the groups. Operative time was significantly longer in the RAH group. Four representative cases were presented to illustrate the surgical techniques. In addition, a risk-adjusted CUSUM analysis of console time suggested an initial improvement in console efficiency, with transient upward shifts in selected cases.</div></div><div><h3>Conclusions</h3><div>Even in the early phase of RAH introduction, short-term outcomes equivalent to those of LH were achieved.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 19-25"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187862","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":"Corrigendum regarding missing informed consent and conflict of interest statements in previously published articles","authors":"","doi":"10.1016/j.isurg.2026.05.001","DOIUrl":"10.1016/j.isurg.2026.05.001","url":null,"abstract":"","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Page 49"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995319","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":"Preliminary experience with the domestic Jingfeng single-port robotic system for robot-assisted radical prostatectomy","authors":"Qiangsheng Wang ,&nbsp;Hao Li ,&nbsp;Wenbo Hao ,&nbsp;Andong Cheng ,&nbsp;Feixiang Yang ,&nbsp;Yu Guan ,&nbsp;Sheng Tai ,&nbsp;Jialin Meng ,&nbsp;Chaozhao Liang","doi":"10.1016/j.isurg.2026.02.001","DOIUrl":"10.1016/j.isurg.2026.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical feasibility and safety of the domestic Jingfeng single-port robotic surgical systems in robot-assisted radical prostatectomy.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on the clinical data of 18 patients who underwent single-port robotic-assisted surgeries at the First Affiliated Hospital of Anhui Medical University from March 1 to May 31, 2025. The procedures included single-port robotic-assisted radical prostatectomy (SP-RARP) (n = 18). The preoperative patient's age, body mass index (BMI), prostate volume, preoperative prostate-specific antigen (PSA), Gleason score, operative time (OT), estimated blood loss (EBL), length of stay (LOS), and duration of catheterization were collected.</div></div><div><h3>Results</h3><div>All 18 patients with SP-RARP successfully completed the operations. The mean age was 67.6 ± 7.9 years, and the mean BMI was 22.76 ± 2.37 kg/m². The median (interquartile range, IQR) preoperative PSA was 8.2 (6.6, 11.4) ng/mL, and the median (IQR) preoperative prostate volume on MRI was 31.3 (22.6, 37.5) cm³. Among the perioperative indicators, the mean OT was 136.83 ± 43.77 min; the median (IQR) EBL was 35.0 (15.0, 77.5) mL; the median (IQR) LOS was 4 (3, 4) days; and the median (IQR) duration of catheterization was 3 (3, 3) days. Only 4 of them used NSAIDs during hospitalization, accounting for 22.2%. The Clavien-Dindo grades of all patients were Grade Ⅰ. No positive postoperative pathologic margins were found in any patients. No conversion to open surgery or serious complications occurred during the perioperative period.</div></div><div><h3>Conclusion</h3><div>Domestic Jingfeng single-port robotic surgical system demonstrate good safety and efficacy in urology, but larger sample size, multicenter, randomized controlled clinical studies are still needed to further validate their effects.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 26-30"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396435","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":"Implementation of 5G ultra-remote robotic-assisted surgery for endometrial cancer staging in China using the Edge surgical robot system: A case report and technical discussion","authors":"Ruinan Song ,&nbsp;Jing Liao ,&nbsp;Juyuan Huang ,&nbsp;Jiahui Zhao ,&nbsp;Yurou Chen ,&nbsp;Jing Cheng ,&nbsp;Qiongying Lv ,&nbsp;Jiaqiang Xiong ,&nbsp;Yuanguang Meng ,&nbsp;Wei Zhang","doi":"10.1016/j.isurg.2025.12.001","DOIUrl":"10.1016/j.isurg.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>The integration of 5G technology into telerobotic surgery is expanding minimally invasive options in gynecologic oncology by enabling high-definition 3D visualization, precise articulation of instruments, and low-latency remote collaboration. This case report describes the use of a domestically developed Chinese surgical robotic system (Edge) to perform comprehensive endometrial cancer staging and shares insights regarding its technical implementation.</div></div><div><h3>Objective</h3><div>To evaluate the feasibility and safety of 5G-supported, robot-assisted endometrial cancer staging surgery using a domestically developed robotic platform.</div></div><div><h3>Methods</h3><div>On August 22, 2025, a remote robotic-assisted endometrial cancer staging procedure was successfully performed on a 63-year-old female patient through collaboration between Zhongnan Hospital of Wuhan University and Chinese PLA General Hospital, utilizing the domestically produced Edge surgical robot. Operative time, technical details, intraoperative blood loss, and postoperative recovery metrics were systematically documented and analyzed.</div></div><div><h3>Results</h3><div>The procedure was completed successfully in 126 min with an estimated blood loss of 30 mL. No severe intraoperative or postoperative complications occurred. The 5G network supported real-time operation seamlessly, with a measured video latency of 19 ​ms and no subjective lag reported. Intraoperative frozen section analysis of four sentinel lymph nodes showed no evidence of metastasis. The patient followed an Enhanced Recovery After Surgery (ERAS) protocol, recovered favorably, and was discharged without incident. Final pathology confirmed G1 endometrial adenocarcinoma. The final pathological staging was FIGO Stage IA.</div></div><div><h3>Conclusion</h3><div>This case demonstrates that a 5G-supported, domestically developed robotic system can safely and effectively facilitate precise pelvic dissection and lymph node evaluation during endometrial cancer staging surgery. The successful execution under real-time remote collaboration highlights the clinical feasibility of this approach. These results support the broader clinical adoption, while also underscoring the importance of optimizing 5G infrastructure, ensuring cybersecurity, and enhancing specialized team training to maximize the potential of telerobotic surgery in gynecologic oncology.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705882","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}