Intelligent Surgery最新文献

{"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":"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":"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}

{"title":"Robotic surgery for benign biliary strictures","authors":"Xitao Wang,&nbsp;Jian Tan,&nbsp;Yunfeng Li","doi":"10.1016/j.isurg.2026.03.002","DOIUrl":"10.1016/j.isurg.2026.03.002","url":null,"abstract":"<div><div>Benign biliary strictures (BBS) are ductal narrowings resulting from non-malignant causes, most commonly iatrogenic injuries during cholecystectomy, chronic pancreatitis, and other post-operative complications. While endoscopic and percutaneous interventions are the primary management strategy, surgical reconstruction remains the definitive treatment for refractory cases. This review synthesizes the current understanding of the etiology, diagnosis, and classification of BBS and evaluates the evolving landscape of its management, with a specific focus on the application of robotic surgery for complex biliary reconstruction.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 42-48"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709805","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":"Feasibility analysis of robotic-assisted proximal gastrectomy with anterior esophagogastrostomy combined with stent-supported Toupet fundoplication (RAFT technique)","authors":"Yuqiang Shan","doi":"10.1016/j.isurg.2026.02.002","DOIUrl":"10.1016/j.isurg.2026.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the feasibility and technical points of a novel reconstruction technique following robotic-assisted proximal gastrectomy for gastric cancer, robotic-assisted proximal gastrectomy with anterior esophagogastrostomy combined with stent-supported Toupet fundoplication (RAFT Technique).</div></div><div><h3>Methods</h3><div>A patient diagnosed with esophagogastric junction (EGJ) adenocarcinoma (cT2N0M0) underwent da Vinci robot-assisted proximal gastrectomy. The reconstruction involved an anterior esophagogastric anastomosis combined with a Toupet fundoplication. Postoperative complications and quality of life were monitored and recorded.</div></div><div><h3>Results</h3><div>The procedure was completed successfully. The anastomosis was patent and tension-free, with an estimated intraoperative blood loss of 50 mL. To date, follow-up has revealed no complications such as anastomotic leakage, bleeding, stenosis, or reflux esophagitis, and no tumor recurrence has been observed.</div></div><div><h3>Conclusion</h3><div>The RAFT technique integrates the physiological advantages of anterior esophagogastrostomy with the antireflux efficacy of Toupet fundoplication, while maintaining procedural simplicity by requiring only a single primary anastomosis. Our initial experience confirms its safety and technical feasibility. Further clinical research is warranted to validate these findings.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"9 ","pages":"Pages 31-34"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448646","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 of robot-assisted single-port laparoscopic redo pyeloplasty in children","authors":"Ziqin He ,&nbsp;Chutian Xiao ,&nbsp;Juntao Li ,&nbsp;Yifei Zhang ,&nbsp;Wenwen Zhong ,&nbsp;Jianguang Qiu ,&nbsp;Dejuan Wang","doi":"10.1016/j.isurg.2025.10.002","DOIUrl":"10.1016/j.isurg.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the surgical technique of robot-assisted single-port laparoscopic redo pyeloplasty (RSLRP) in children and to confirm the feasibility of this technique.</div></div><div><h3>Methods</h3><div>A 12-year-3-month-old boy with recurrent ureteropelvic junction obstruction after robot-assisted laparoscopic surgery underwent RSLRP with da Vinci Xi surgical system. The general clinical characteristics, perioperative variables and follow-up outcomes were summarized.</div></div><div><h3>Results</h3><div>The child was allowed to drink water up to 2 ​h before surgery. The operation was successfully performed without conversion to open surgery or intraoperative complications. The total operative time was 215 ​min, including 170 ​min of console time, with an estimated blood loss of 10 ​mL. Oral intake was initiated postoperatively upon awakening from anesthesia, starting with clear fluids and advancing to a regular diet as tolerated, with no signs of aspiration. The postoperative complication was gross hematuria (Clavien-Dindo grade Ⅱ), which was improved after conservative treatment. The postoperative hospital stay was 7 days, with total hospitalization duration of 11 days. The ureteral stent was removed 35 days after surgery. Follow-up ultrasound showed improvement of hydronephrosis compared with the preoperative assessment.</div></div><div><h3>Conclusion</h3><div>The application of the da Vinci Xi surgical system for pediatric RSLRP is safe and feasible. Further studies with larger cohorts and long-term follow-up are warranted to validate the safety and efficacy of RSLRP in the pediatric population.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 125-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415044","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":"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}