Minimally Invasive Therapy & Allied Technologies最新文献

{"title":"A physical information neural network-based path planning method for flexible needle puncture of soft tissues.","authors":"Li Zheng, Fan Zhang, Yaozong Huang, Deng Qianxue, Liu Weikang","doi":"10.1080/13645706.2026.2616591","DOIUrl":"10.1080/13645706.2026.2616591","url":null,"abstract":"<p><strong>Background: </strong>Flexible needle puncture is a critical minimally invasive technique where path planning accuracy directly impacts clinical outcomes. Traditional finite element methods are computationally complex and inadequate for real-time procedures.</p><p><strong>Methods: </strong>We propose a physics-informed neural network (PINN) approach for soft tissue puncture path planning. PINN models generate puncturable regions where rapidly-exploring random tree star (RRT*) performs path optimization using neural network-derived soft tissue mechanics models, avoiding collision risks. Progressive learning control strategies provide real-time path optimization, ensuring accurate needle targeting.</p><p><strong>Results: </strong>Experimental results demonstrate dynamic puncture path correction with errors <1 mm, meeting clinical requirements. The progressive learning control strategy effectively optimizes path prediction models through data analysis.</p><p><strong>Conclusion: </strong>The combined PINN-RRT* approach addresses modeling complexity, path planning difficulty, real-time adaptability, and expert dependence in traditional puncture techniques, significantly improving safety and efficiency.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"116-124"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroperitoneal sentinel lymph node biopsy using vNOTES in endometrial cancer patients with a BMI ≥ 30 kg/m²: a pilot multicenter case series by the Turkish gynecologic oncology group (TRSGO-SLN12).","authors":"Kemal Gungorduk, Selcuk Erkılınc, Vakkas Korkmaz, Candost Hanedan, Serhan Can Iscan, Varol Gülseren, Salih Taskın, Kemal Ozerkan, Cagatay Taskıran","doi":"10.1080/13645706.2026.2625069","DOIUrl":"10.1080/13645706.2026.2625069","url":null,"abstract":"<p><strong>Aim: </strong>This study evaluated the feasibility and surgical outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for retroperitoneal sentinel lymph node biopsy (SLNB), specifically targeting obese and morbidly obese patients diagnosed with endometrial cancer (EC).</p><p><strong>Methods: </strong>Pathohistological evaluation confirmed the diagnosis of either Grade I or II endometrioid EC in all participants.</p><p><strong>Results: </strong>In total, 31 patients participated in this study. The median age was 56 [43-75] years and the median BMI was 34 [30-54] kg/m2. Near-infrared fluorescence imaging utilizing ICG was implemented in 17 cases (54.8%), while methylene blue dye was used in 14 cases (45.2%). A median, 4 sentinel lymph nodes (SLNs) were excised per patient, with numbers ranging from 1 to 7. The overall SLN detection rate was 90.3%, with unilateral detection in 9.7% of patients and bilateral detection in 80.6%. During the surgery, two complications occurred, and an additional two developed afterward. In 3.2% of cases, it was required to switch to a conventional laparoscopic procedure. Lymphatic metastases were identified in 3 patients (9.7%). The median hospital stay was 2 days.</p><p><strong>Conclusion: </strong>vNOTES can be a viable alternative to retroperitoneal SLNB, providing distinct benefits, especially for obese and morbidly obese patients with EC.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"145-152"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of subcutaneous emphysema and port site damage between robotic platforms in gastrectomy.","authors":"Kengo Hayashi, Kenichi Ishibayashi, Kenta Doden, Saki Hayashi, Ryota Matsui, Toshikatsu Tsuji, Hideki Moriyama, Jun Kinoshita, Noriyuki Inaki","doi":"10.1080/13645706.2025.2612480","DOIUrl":"10.1080/13645706.2025.2612480","url":null,"abstract":"<p><strong>Background: </strong>Robotic gastrectomy (RG) is increasingly adopted for the treatment of gastric cancer due to its technical advantages. However, specific complications such as subcutaneous emphysema (SE) and port site dilation (PSD) may arise due to pneumoperitoneum and trocar manipulation. This study aimed to investigate the incidence and risk factors of SE and PSD, with a focus on differences between robotic platforms.</p><p><strong>Methods: </strong>This retrospective study included 126 patients who underwent RG between April 2021 and April 2025. SE was defined as subcutaneous gas extending to the anterior chest wall on postoperative day 1. PSD was evaluated using intraoperative videos and defined as a visible gap between the trocar and abdominal wall. Multivariable logistic regression was performed to identify independent predictors of SE and PSD, including robotic system type (da Vinci Xi vs. hinotori^™).</p><p><strong>Results: </strong>SE and PSD were observed in 20 (15.9%) and 21 (16.7%) patients, respectively. The use of the hinotori^™ was independently associated with a lower incidence of SE (OR: 0.085, 95% CI: 0.01-0.70, <i>p</i> = 0.02) and PSD (OR: 0.089, 95% CI: 0.016-0.39, <i>p</i> = 0.001). No significant association was found between SE or PSD and postoperative complications of Clavien-Dindo grade ≥ II or ≥ III.</p><p><strong>Conclusions: </strong>The docking-free hinotori^™ platform significantly reduced the incidence of SE and PSD compared to the da Vinci Xi. Recognizing the mechanical features of each robotic system and tailoring platform selection to patient and procedural factors may improve surgical outcomes.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"87-95"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"vNOTES <i>versus</i> laparoscopic chromopertubation for tubal factor and unexplained infertility: a comparative study.","authors":"Emre Mat, Murat Levent Dereli, Ismail Baglar, Pınar Birol İlter, Pınar Yıldız, Mehmet Mete Kırlangıç, Uğur Kemal Öztürk, Özer Birge, Gazi Yıldız","doi":"10.1080/13645706.2026.2613118","DOIUrl":"10.1080/13645706.2026.2613118","url":null,"abstract":"<p><strong>Background: </strong>As vaginal natural orifice transluminal endoscopic surgery (vNOTES) is gaining momentum and consolidating its position in minimally invasive surgery for various benign gynecologic conditions, we aimed to evaluate the feasibility, acceptability, and safety of vNOTES chromopertubation compared to laparoscopic chromopertubation in women with suspected tubal factor or unexplained infertility.</p><p><strong>Methods: </strong>Women who underwent vNOTES or laparoscopic chromopertubation between January 2022 and June 2024 were retrospectively studied. After applying exclusion criteria, 58 eligible patients were identified and analyzed. The primary outcomes were surgical complications, overall satisfaction with the procedure, and postoperative pain. Secondary outcomes included the duration of the procedure and participants' postoperative experience of sexual discomfort or pain during intercourse.</p><p><strong>Results: </strong>The basic preoperative demographic and clinical characteristics were comparable. No complications occurred in either surgical group (0/24 <i>vs.</i> 0/34). The duration of surgery (including additional interventions) and length of hospital stay were significantly shorter in the vNOTES CP group (<i>p</i> = 0.015 and 0.044, respectively). These differences were not observed when diagnostic-only cases were considered. The 6- and 12-h postoperative visual analogue scale (VAS) pain scores, as well as the total dose of non-narcotic analgesic used, were significantly lower in the vNOTES CP group (<i>p</i> = 0.004, <0.001, and 0.009, respectively). Changes in pre- and postoperative Female Sexual Function Index (FSFI) pain domain scores showed no statistically significant difference between the groups (<i>p</i> = 0.242). There were no differences in satisfaction with the method.</p><p><strong>Conclusions: </strong>vNOTES chromopertubation appears to be an effective and feasible alternative to laparoscopy for chromopertubation, with greater operability in obese women, better esthetic outcomes, less postoperative pain, and a comparable impact on female sexual life. Larger, multicenter, prospective studies that also report subsequent fertility outcomes are needed to further quantify and determine the safety and broad applicability of vNOTES chromopertubation.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"135-144"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of factors related to successful puncture of the intrahepatic bile duct in endoscopic ultrasound-guided biliary drainage.","authors":"Kentaro Sato, Mitsuru Sugimoto, Rei Suzuki, Hiroyuki Asama, Hiroshi Shimizu, Kento Osawa, Rei Ohira, Hiromasa Ohira","doi":"10.1080/13645706.2026.2618973","DOIUrl":"10.1080/13645706.2026.2618973","url":null,"abstract":"<p><strong>Background: </strong>The factors associated with the success of each step of EUS-BD have not been fully explored. This study aimed to identify the factors associated with successful bile duct puncture for EUS-BD.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of patients with malignant biliary obstruction who underwent EUS-BD at a single institution between 2015 and 2025.</p><p><strong>Results: </strong>EUS-BD was used to perform 46 bile duct punctures on 33 patients. The success rate of bile duct puncture was 80.4%. According to multivariate analysis, the angle of the scope and the puncture needle on the EUS monitor was identified as factors associated with the success of bile duct puncture (<i>p</i> < 0.01). The cutoff value for the angle between the scope and the puncture needle was 59 degrees, the area under the curve (AUC) was 0.86, the sensitivity of 75.7%, and the specificity was 100%.</p><p><strong>Conclusions: </strong>The angle of the scope and the puncture needle was identified as factors associated with the success of bile duct puncture. Applying a strong up-angle to the scope and minimizing the use of the elevator to adjust the angle between the scope and the puncture needle may improve the success rate of bile duct puncture during EUS-BD.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"107-115"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of vNOTES, vaginal, and laparoscopic hysterectomy: insights from a single-center study.","authors":"Ahkam Göksel Kanmaz, Emrah Töz, Kübra Adsaz, Yaşam Kemal Akpak, Jan Baekelandt","doi":"10.1080/13645706.2025.2605629","DOIUrl":"10.1080/13645706.2025.2605629","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the clinical outcomes, feasibility, and safety of three minimally invasive hysterectomy techniques-vaginal hysterectomy (VH), laparoscopic hysterectomy (LH), and transvaginal natural orifice transluminal endoscopic surgery (vNOTES)-in patients with benign uterine pathologies.</p><p><strong>Methods: </strong>This single-center, pragmatic retrospective cross-sectional study was conducted at a tertiary care center in İzmir, Türkiye, between January 2024 and April 2025. A total of 1,146 patients who underwent hysterectomy for benign gynecological indications were included: 298 VH, 730 LH, and 118 vNOTES. Patients with advanced pelvic organ prolapse, severe intra-abdominal adhesions, or incomplete records were excluded. Evaluated outcomes included operative time, estimated blood loss, uterine weight, postoperative pain (visual analogue scale at 12 and 24 hours), complication rates (Clavien-Dindo classification), and length of hospital stay.</p><p><strong>Results: </strong>VH had the shortest operative time, while vNOTES was faster than LH. Uterine weight was significantly higher in the LH and vNOTES groups. Postoperative pain at 12 hours was lowest in the vNOTES group, with no significant difference at 24 hours. The vNOTES group demonstrated the lowest overall complication rate (2.5%), and vaginal cuff complications were observed only in the VH and LH groups.</p><p><strong>Conclusions: </strong>vNOTES hysterectomy was associated with lower early postoperative pain and fewer complications, supporting its safety and effectiveness in appropriately selected patients. Prospective multicenter studies are warranted to confirm these findings.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"153-161"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel sine-shaped electrode for reducing the thermal damage of intestinal anastomosis induced by radiofrequency energy.","authors":"Lin Mao, Langlang She, Zhongxin Hu, Xupo Xing, Zhengyi Han, Xin Zheng, Chengli Song","doi":"10.1080/13645706.2025.2612482","DOIUrl":"10.1080/13645706.2025.2612482","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop and evaluate a novel sine-shaped electrode for reducing the thermal damage of intestinal anastomosis induced by radiofrequency energy.</p><p><strong>Methods: </strong>An electrode with a sine-shaped structure was designed, and electrothermal simulations were conducted to evaluate the thermal damage to the welded intestine compared with the reference concave-convex electrode. <i>Ex vivo</i> tissue welding experiments were performed to investigate the temperature variation in the anastomotic stoma using an infrared thermal imager. The strength and microstructure of the anastomotic stoma were assessed using burst pressure measurements and histopathological observations, respectively.</p><p><strong>Results: </strong>Simulation results revealed that the sine-shaped electrode reduced the maximum temperature, compared to the concave-convex electrode (81.5 vs. 93.2 °C). <i>Ex vivo</i> experiments indicated that the maximum temperatures of anastomotic stoma welded by the sine-shaped electrode and the concave-convex electrode were 80.3 °C and 96.8 °C, respectively, and the corresponding burst pressures of anastomotic stoma for the two groups were 55 ± 2 mmHg and 46 ± 2 mmHg, respectively. Histopathological results suggested that the tissues were anastomosed more tightly using the sine-shaped electrode.</p><p><strong>Conclusion: </strong>The application of the sine-shaped electrode in RF tissue welding can protect the tissue from excessive thermal damage.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"96-106"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence and related factors associated with uterine leiomyoma following laparoscopic myomectomy: a meta-analysis.","authors":"Jun Zhao, Lei Zhang, Huan Zhao, Xiaolin Ma","doi":"10.1080/13645706.2026.2643432","DOIUrl":"https://doi.org/10.1080/13645706.2026.2643432","url":null,"abstract":"<p><strong>Background: </strong>There is still no clear consensus on long-term follow-up data for uterine leiomyoma (UL) recurrence and the major risk factors for recurrence after UL resection. This study aimed to investigate UL recurrence and related factors after laparoscopic myomectomy (LM).</p><p><strong>Methods: </strong>The local and international literature on UL recurrence rates and related factors after LM was systematically collected, with the search period up to December 31st, 2024. Stata 16.0 software was used for meta-analysis. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model with the Hartung-Knapp-Sidik-Jonkman adjustment, regardless of the I²value.</p><p><strong>Results: </strong>A total of eight studies were included, and 2,160 patients receiving LM were followed up for more than 12 months. The total number of recurrence cases was 497, and the crude recurrence rate was 23.0%. The meta-analysis results indicated that preoperative UL size ≥ 10 cm (OR = 2.15, <i>p</i> < 0.001), uterine size >10 or 14 weeks (OR = 2.40, <i>p</i> = 0.001), and preoperative UL number ≥2 (OR = 2.46, <i>p</i> < 0.001) were risk factors for UL recurrence after LM. There was no statistically significant association between age ≥35 years, BMI ≥ 24 or 25 kg/m², postoperative delivery or pregnancy, and post-LM UL recurrence.</p><p><strong>Conclusions: </strong>In this study, the risk factors for UL recurrence after LM were obtained through meta-analysis, which is more stable and reliable than the results of a single study and can provide a reference and basis for clinically identifying the risk factors related to LM recurrence after surgery, fully evaluating the risk of recurrence before surgery and predicting high-risk groups.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic intermuscular dissection and endoscopic submucosal dissection for treatment of rectal neuroendocrine tumors: a retrospective cohort study.","authors":"Liu Han, Huiting Hou, Yuyong Tan, Rong Li, Chengbai Liang, Liang Lv, Yongjun Wang, Deliang Liu, Liang Min","doi":"10.1080/13645706.2026.2642667","DOIUrl":"https://doi.org/10.1080/13645706.2026.2642667","url":null,"abstract":"<p><strong>Background: </strong>The incidence of rectal neuroendocrine tumors (rNETs) is increasing due to widespread colonoscopy screening. Conventional endoscopic techniques have difficulties in achieving complete resection of rNETs with deep submucosal invasion. Endoscopic intermuscular dissection (EID) enables removal of the mucosa, submucosa, and inner circular muscle layer while preserving rectal wall integrity.</p><p><strong>Methods: </strong>We retrospectively analyzed the patients diagnosed with rNETs between May 2022 and May 2025 at our hospital. Clinical data, endoscopic findings, histopathological results, and follow-up outcomes were reviewed.</p><p><strong>Results: </strong>A total of 13 patients underwent EID for rNETs were enrolled, with 13 ESD cases included for paired comparison. Both groups demonstrated sufficient histologically complete resection rates (92.3% vs 100%, p>0.99). EID required longer procedure time (38.31 ± 12.84 vs. 29.54 ± 4.75 min, p=0.036). Hospitalization costs showed no significant difference (14795.92 ± 2946.61 vs. 12363.00 ± 2585.15, p=0.105).1 case of delayed bleeding occurred in each group, respectively, with no other serious adverse events. No recurrence was reported in 25 cases that achieved histologically complete resection.</p><p><strong>Conclusions: </strong>EID is safe and effective for rNET resection without increasing costs compared to ESD. It may be a feasible option for selected rNETs with suspected deep submucosal invasion requiring adequate vertical margins.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot investigation of robot-assisted total hysterectomy using the toumai^® Laparoscopic surgical Robot system.","authors":"Pietro Pasquini, Enrico Pazzaglia, Emily Jamaer, Koen Traen, Evelyn Despierre, Diego Raimondo, Anna Myriam Perrone, Renato Seracchioli, Pierandrea De Iaco, Alexandre Mottrie","doi":"10.1080/13645706.2026.2643794","DOIUrl":"https://doi.org/10.1080/13645706.2026.2643794","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to evaluate the technical feasibility, perioperative safety, and surgical workflow of the Toumai^® Laparoscopic Surgical Robot System in gynecology by reporting the first Robot-Assisted Total Hysterectomy (RATH) using this platform in Europe.</p><p><strong>Methods: </strong>A total hysterectomy with bilateral salpingo-oophorectomy was performed on a patient with recurrent HPV-related CIN 3 at AZORG Hospital (Aalst, Belgium) in May 2025. The procedure was conducted by a surgeon with > 200 prior robotic hysterectomies. All surgical team members underwent formal system training. Preoperative, intraoperative, and postoperative data were collected, including operative times, complications, estimated blood loss, and hospital stay. The setup, port placement, and docking process were detailed to serve as a reference for future users.</p><p><strong>Results: </strong>The procedure was completed without intraoperative complications, conversions, or need for additional ports. Total operative time was 70 min: 6 min for port placement, 9 min for docking, 46 min of console time, and 9 min for closure. Estimated blood loss was 30 mL The patient was discharged on postoperative day one, and follow-up at 14 days was unremarkable. The surgical setup provided adequate ergonomics and workflow efficiency, with all robotic arms functioning without issue. Instrumentation was comparable to existing platforms.</p><p><strong>Conclusion: </strong>In this first European experience, Toumai^® enabled a safe and efficient multi-port RATH with 70 min' total time and 30 mL blood loss, without complications or conversion. These feasibility data warrant a prospective series to assess reproducibility, learning curve, and cost-effectiveness.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}