Intelligent Surgery最新文献

{"title":"Clinical application analysis of a novel robotic system for total hysterectomy","authors":"Bingxin Han ,&nbsp;Jun Wang,&nbsp;Jing Na,&nbsp;Shichao Han,&nbsp;Ya Li","doi":"10.1016/j.isurg.2025.03.003","DOIUrl":"10.1016/j.isurg.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to explore the feasibility, safety, and clinical outcomes of a novel robotic-assisted total hysterectomy using the Endoscopic Surgical Robot MT1000 (Shanghai MicroPort Medbot CO., Ltd., Shanghai China). Additionally, it seeks to standardized surgical protocols and establish the learning curve for the surgical team performing the new robotic-assisted total hysterectomy.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 34 cases of robotic-assisted total hysterectomy by using the Endoscopic Surgical Robot MT1000 (novel robotic group) at the Second Affiliated Hospital of Dalian Medical University from 2022 to 2024. These cases were individually compared with 35 cases of da Vinci robotic-assisted total hysterectomy (da Vinci robotic group) and 73 cases of traditional laparoscopic total hysterectomy (traditional laparoscopic group) in pairwise comparisons, all carried out by the same surgical team during the same period. Key indicators such as surgical duration, intraoperative blood loss, and time to first flatus post-surgery were observed. Additionally, the CUSUM method was employed to analyze the learning curve for the new robotic total hysterectomy.</div></div><div><h3>Results</h3><div>The novel robotic system demonstrated significant intraoperative and postoperative differences compared to conventional laparoscopy. Specifically, the novel robotic group exhibited higher intraoperative adhesion scores (mean difference ​= ​0.65; 95% CI [0.08, 1.21]; p ​= ​0.025), reduced intraoperative blood loss (mean difference: −20.27 ​mL; 95% CI [-31.82, −8.71]; p ​&lt; ​0.001), and accelerated postoperative recovery evidenced by a shorter time to first flatus (mean difference: 9.37 ​h; 95% CI [-14.35, −4.39]; p ​&lt; ​0.001), though with prolonged operative time (mean difference ​= ​20.71 ​min; 95% CI [6.34, 35.08]; p ​= ​0.05). In contrast, comparisons between the novel robotic and da Vinci systems showed no statistically significant differences across all parameters (all p ​&gt; ​0.05). Learning curve analysis indicated that both the surgeon and the assistant reached a proficient level after completing 20 surgeries, with no significant differences in surgical metrics across various stages (p ​&gt; ​0.05).</div></div><div><h3>Conclusion</h3><div>The new robotic total hysterectomy offers significant advantages in reducing intraoperative blood loss and promoting postoperative recovery, while also maintaining lower operational costs for both the facility and patients. The surgical team can rapidly master this technology, which can also be applied for remote surgeries via 5G communication, demonstrating good safety and feasibility, and warranting clinical promotion.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 35-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864513","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":"Clinical trial on 15 cases of gynecological surgeries using the Cornerstone laparoscopic robotic surgical system","authors":"Nan Wang ,&nbsp;Li'an Li ,&nbsp;Mingxia Ye ,&nbsp;Zhifeng Yan ,&nbsp;Mingxia Li ,&nbsp;Nina Zhang ,&nbsp;Mingyang Wang ,&nbsp;Yuanguang Meng","doi":"10.1016/j.isurg.2025.04.001","DOIUrl":"10.1016/j.isurg.2025.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of a Chinese robotic surgical system in complex gynecological surgeries.</div></div><div><h3>Methods</h3><div>Fifteen patients with cervical cancer and endometrial cancer who received treatment with a laparoscopic robotic surgical system at the First Medical Center of the PLA General Hospital between June and August 2024 were selected as study subjects. The surgical instrument used was the Cornerstone laparoscopic robotic surgical system (Model: C1000 system) from Shenzhen Cornerstone Technology Co., Ltd. (China). The primary surgical procedures included radical hysterectomy with pelvic lymphadenectomy, with or without para-aortic lymphadenectomy.</div></div><div><h3>Results</h3><div>A total of 15 patients were included, with a mean age of 50.80 ​± ​9.21 years and a mean BMI of 24.80 ​± ​2.23 ​kg/m². Diagnoses included eight cases of cervical squamous cell carcinoma, three cases of cervical adenocarcinoma, and four cases of endometrioid carcinoma; three patients received neoadjuvant chemotherapy. Intraoperative blood loss averaged 116.67 ​± ​102.93 ​mL, and the mean operative time was 153.47 ​± ​24.57 ​min. All surgeries were successfully completed without conversion to open surgery or the need for blood transfusion. The mean postoperative pain score was 3.53 ​± ​1.81, and the average length of hospital stay was 10.73 ​± ​4.53 days. All cases had negative surgical margins, achieving a 100% rate of negative resection margins. Complications occurred in two cases (13.3%), both involving ureteral injury. The evaluation of system functionality and performance scored 91.93 ​± ​3.06, operator satisfaction scored 92.93 ​± ​3.10, assistant satisfaction scored 93.40 ​± ​3.07, and the overall evaluation scored 92.74 ​± ​2.27. All cases received excellent satisfaction ratings.</div></div><div><h3>Conclusion</h3><div>This single-arm cohort study on robot-assisted surgery demonstrated the precision and stability of the Chinese robotic surgical system in performing complex gynecological procedures. However, further improvements are needed in the overall stability of the system's control and in reducing acquisition and maintenance costs to enable more patients to benefit from this technology.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"8 ","pages":"Pages 29-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859129","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 duodenum-preserving pancreatic head resection with preoperative three-dimensional visualization and intraoperative real-time indocyanine green fluorescence navigation","authors":"Yaqiang Shu,&nbsp;Chuanfu Li,&nbsp;Bo Liu,&nbsp;Fan Wu,&nbsp;Chao Zhang,&nbsp;Muyu Fu,&nbsp;Xiaohua Lei,&nbsp;Guodong Chen","doi":"10.1016/j.isurg.2024.01.003","DOIUrl":"10.1016/j.isurg.2024.01.003","url":null,"abstract":"<div><p>Duodenum-preserving pancreatic head resection (DPPHR) has been widely used in benign tumors, low-grade malignant tumors of the pancreatic head and chronic pancreatitis. Nevertheless, to date, there has been no report about indocyanine (ICG) fluorescence in robotic DPPHR. This report describes the technique of robotic DPPHR with preoperative three-dimensional reconstruction visualization and intraoperative real-time ICG fluorescence imaging navigation. The results show that the technique is safe and effective for benign masses of the head of the pancreas and may offer a benefit for maintaining the integrity of duodenal blood flow and the biliary system.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 27-29"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676624000036/pdfft?md5=066572f0234d3943e2827bb26f033a29&pid=1-s2.0-S2666676624000036-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139892483","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 surgery in gastrointestinal surgery: History, current status, and challenges","authors":"Yu Liu ,&nbsp;Qingyang Feng ,&nbsp;Jianmin Xu","doi":"10.1016/j.isurg.2024.12.001","DOIUrl":"10.1016/j.isurg.2024.12.001","url":null,"abstract":"<div><div>Robotic surgery has been a part of clinical practice for over 30 years, and in recent years, the continuous emergence of new robotic platforms and technologies has brought about both changes and challenges in the field of gastrointestinal surgery,. providing the possibility for more precise surgery and smaller trauma. The publication of high-quality clinical studies gradually confirms the advantages of robotic surgery in gastrointestinal surgery. Especially in the field of colorectal cancer, the publication of research such as REAL has confirmed that robotic radical resection for rectal cancer has better short-term outcomes than laparoscopy. Although robotic surgery still faces some challenges, such as economic costs and learning curves, the future prospects of robotic technology in colorectal surgery are highly promising.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 101-104"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148477","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":"Safety and feasibility evaluation of a novel robotic surgical system in gynecological surgery application","authors":"Yuanbo Tao ,&nbsp;Jun Wang,&nbsp;ShiChao Han,&nbsp;Jing Na,&nbsp;Ya Li","doi":"10.1016/j.isurg.2024.12.002","DOIUrl":"10.1016/j.isurg.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>The study explores the safety, feasibility, and clinical application value of a novel robotic surgical system which is the Endoscopic Surgical Robot MT1000 (Shanghai MicroPort Medbot Co., Ltd., Shanghai, China) in gynecological surgeries. It aims to preliminarily establish a standardized process for the application of the novel robotic surgical system in gynecological procedures and analyze the learning curve associated with the docking technology of the novel robotic surgical system.</div></div><div><h3>Methods</h3><div>This study conducts a retrospective analysis of the clinical data and recent outcomes of 82 patients who underwent the novel robotic-assisted laparoscopic gynecological surgeries by using the Endoscopic Surgical Robot MT1000 at the Gynecology Department of Dalian Medical University Second Affiliated Hospital from September 2022 to December 2023. It also compares the basic data and perioperative indicators of these patients with those of 82 patients who received da Vinci Si robotic-assisted laparoscopic gynecological surgeries during the same period. The cumulative summation (CUSUM) method is employed to analyze the learning curve associated with the docking technology of the novel robotic surgical system.</div></div><div><h3>Results</h3><div>In this study, all 82 cases of the novel robotic surgery were successfully completed without any conversions to open surgery. The average surgical time was (134.15 ​± ​82.44) min, the average intraoperative blood loss was (29.16 ​± ​29.35) mL, the average time for postoperative bowel motility recovery was (27.0 ​± ​11.5) h, and the average hospital stay after surgery was (3.1 ​± ​1.3) d. There were no statistically significant differences (P ​&gt; ​0.05) in surgical time, the difference in hemoglobin levels before and after surgery, the time of first flatus after surgery, the duration of indwelling catheter, the duration of indwelling drainage tube, and drainage volume at 48 and 72 ​h postoperatively between the two groups. However, there were statistically significant differences in intraoperative blood loss and length of stay after surgery (P ​&lt; ​0.05). The CUSUM learning curve analysis indicated that the surgical team in the operating room became proficient in the docking technology of the novel robotic surgical system by the 34th case, while the bedside assistant mastered it by the 32nd case, achieving overall proficiency by the 33rd case.</div></div><div><h3>Conclusion</h3><div>The novel surgical robot MT1000 is safe and feasible for application in the field of gynecology, demonstrating clinical applicability comparable to the da Vinci Si robotic system. Establishing standardized procedures can reduce preoperative preparation time and shorten the learning curve for the docking technology of the novel robotic surgical system. There is significant potential for the application of the novel robotic surgical system in China.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 105-112"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148483","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":"The application of robotic transanal minimally invasive surgery in rectal surgery","authors":"Guodong Xiao,&nbsp;Bin Huang,&nbsp;Zhengyong Liu,&nbsp;Chunxue Li,&nbsp;Weidong Tong","doi":"10.1016/j.isurg.2024.11.001","DOIUrl":"10.1016/j.isurg.2024.11.001","url":null,"abstract":"<div><div>With its superior ergonomic design, high-definition three-dimensional visual field, mechanical arms that transcend human wrist mobility, and ability to eliminate hand tremors caused by surgeon fatigue, the robotic surgical system introduces unparalleled precision and adaptability into intricate surgical procedures within confined areas, particularly the anorectal region. This makes it a strong competitor to laparoscopic-assisted, minimally invasive transanal surgery. The application of robotic surgery has been successfully demonstrated in the resection of complex rectal tumors, total rectal mesentery resection, and fistula repair. These procedures have resulted in notable improvements in surgical precision, safety, and patients' postoperative quality of life. Despite the continued presence of challenges, including prolonged operation time and high cost, the long-term benefits and positive impact on patients' quality of life have become increasingly evident. This article presents a comprehensive overview of the development of robotic-assisted minimally invasive transanal surgery, its evolving application, and the remaining controversies surrounding its use.</div></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 90-94"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744930","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":"Current status and prospects of minimally invasive hepatobiliary surgery","authors":"Jie Li,&nbsp;Ping Chen","doi":"10.1016/j.isurg.2024.07.001","DOIUrl":"10.1016/j.isurg.2024.07.001","url":null,"abstract":"<div><p>In recent years, minimally invasive surgery has developed rapidly and has become an important means of treating hepatobiliary diseases. The development of minimally invasive surgery includes advancements in surgical instruments, laparoscopic equipment, surgical techniques, and related theories. Currently, most traditional hepatobiliary surgeries can be performed using laparoscopic methods. Minimally invasive surgery is the direction for future surgical development, with goals of becoming more intelligent, compact, and multifunctional. In the future, the continuous integration of artificial intelligence, robotic technology, virtual reality and augmented reality technologies, and remote technologies with medicine will further promote the development of minimally invasive surgery. This article provides a brief overview of the current status and prospects of minimally invasive surgery.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 47-52"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676624000097/pdfft?md5=7ed4b5ac02378f190cc9611520e345f2&pid=1-s2.0-S2666676624000097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838854","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":"Pioneering case: Robot-assisted remote radical distal gastrectomy for gastric cancer based on 5G communication technology","authors":"Honghai Guo ,&nbsp;Yuan Tian ,&nbsp;Jia Shi ,&nbsp;Peigang Yang ,&nbsp;Jiaxuan Yang ,&nbsp;Pingan Ding ,&nbsp;Xuefeng Zhao ,&nbsp;Zhidong Zhang ,&nbsp;Qun Zhao","doi":"10.1016/j.isurg.2024.01.004","DOIUrl":"https://doi.org/10.1016/j.isurg.2024.01.004","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study is to describe technical considerations and short-term outcomes of the first officially published robot-assisted remote radical distal gastrectomy for gastric cancer with 5G technology.</p></div><div><h3>Methods</h3><p>A 51-year-old gastric cancer patient with clinical stage T2N0M0 underwent 5G-enabled robot-assisted remote radical distal gastrectomy on September 11, 2023 ​at the Third Department of Surgery, the Fourth Hospital of Hebei Medical University.</p></div><div><h3>Results</h3><p>The surgery procedure was successfully performed with an average total intraoperative delay of 225 ​ms, average round-trip delay of 30 ​ms and no packet loss rate. The operative time was 140 ​min and intraoperative blood loss was 20 ​ml. The patient was discharged on postoperative day 6 without any postoperative complications.</p></div><div><h3>Conclusion</h3><p>This case has preliminarily verified the feasibility and safety of 5G-enabled robot-assisted remote radical distal gastrectomy for patients with gastric cancer. The initial study fills in the gaps in related fields and lays a solid foundation for subsequent research. To verify its superior operative outcomes, further clinical trials are needed.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 22-26"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676624000048/pdfft?md5=dd5906a351feedaf76cb5365022f1237&pid=1-s2.0-S2666676624000048-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709149","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":"Corrigendum to “RETML-4: Advancements in esophageal cancer surgery with four-arm robotic thoracic esophagectomy with total mediastinal lymphadenectomy” [Intell Surg 7 (2024) 7–11]","authors":"Xuefeng Leng ,&nbsp;Koshiro Ishiyama ,&nbsp;Hiroyuki Daiko","doi":"10.1016/j.isurg.2024.01.002","DOIUrl":"https://doi.org/10.1016/j.isurg.2024.01.002","url":null,"abstract":"","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Page 21"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676624000024/pdfft?md5=ec1a40ab8837228876f29e8268348242&pid=1-s2.0-S2666676624000024-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139653618","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":"Integrating robotic surgery and pharmacotherapy: A dual approach to lung cancer management","authors":"Gnanendra Sai Kumar Nareboina ,&nbsp;Prudhvi Raj Chalapaka","doi":"10.1016/j.isurg.2024.08.002","DOIUrl":"10.1016/j.isurg.2024.08.002","url":null,"abstract":"<div><p>Medication and robotic surgery are new approaches in the treatment of lung cancer. To obtain the goal of radical surgical treatment of the tumor, this effective approach takes advantage of the accuracy of robotic surgical system in combination with the pharmacological strategies that are aimed at achieving the highest therapeutic intervention and the minimal toxic effects.</p><p>Patient selection and survival data are required for desired long-term effects. The success of this method depends on training and learning curves for health care providers. Clinical applications emphasize the necessity of robotic assisted strategies and efficient use of consumables and advanced robotic bronchoscopy. This innovative approach helps to improve the lung cancer treatment by setting a new standard for patient outcomes.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"7 ","pages":"Pages 66-73"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676624000127/pdfft?md5=440c50cce96dbd5d70bf4377a12433da&pid=1-s2.0-S2666676624000127-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149196","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}