Laparoscopic Endoscopic and Robotic Surgery最新文献

{"title":"Semi-active robot-assisted total hip arthroplasty versus conventional surgery: A meta-analysis of randomized controlled studies","authors":"Ayman K. Saleh,&nbsp;Mohammed Abdelgwad Ismail Emara,&nbsp;Mohamed Harby Abd elghani El sherif,&nbsp;Abdelkhalek Abdelghafar Ibrahim Alzalabany,&nbsp;Mohamed Nagah Ahmed Ibrahim,&nbsp;Naif N. Alshahrani,&nbsp;Tohamy G.T. Hassan","doi":"10.1016/j.lers.2026.02.002","DOIUrl":"10.1016/j.lers.2026.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>Conventional total hip arthroplasty (cTHA) may be technically challenging in some scenarios. Robotic-assisted THA (rTHA) was introduced in the 1980s with an active ROBODOC system. Considering the miscellaneous drawbacks of this early system, more recent semi-active systems were subsequently introduced. The present meta-analysis aimed to compare the operative and clinical outcomes of rTHA assisted by semi-active systems with those of cTHA in randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>The present study was conducted in line with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 expanded statement. Three databases were searched for relevant studies (July 2025) in English, including PubMed, Web of Science Core Collection and Scopus. The outcome data included the operative time, amount of intraoperative and total blood loss, duration of hospital stay, number of patients in the Lewinnek or Callanan safe zones, postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, postoperative Harris hip score and leg length discrepancy (LLD). The risk of bias in the included studies was assessed via the risk of bias assessment tool.</div></div><div><h3>Results</h3><div>Eleven RCTs with 834 patients were included in this study. No significant differences were found between rTHA and cTHA regarding blood loss, hospital stay, WOMAC score or Harris hip score. While cTHA had a significantly shorter operative duration (MD: 22.12; 95% CI: 9.75, 34.48), rTHA was associated with a significantly greater frequency of patients in the Lewinnek (OR: 4.11; 95% CI: 2.04, 8.31) and Callanan (OR: 3.93; 95% CI: 1.15, 13.57) safe zones and a significantly lower LLD (SMD: -0.45; 95% CI: -0.60, -0.30).</div></div><div><h3>Conclusion</h3><div>Compared with cTHA, rTHA is a more accurate surgical technique with comparable blood loss, hospital stay and clinical scores.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 102-109"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502767","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":"A multimodal analysis of correlations between the NASA task load index, facial expressions, and eye tracking with procedure time among novice endoscopists","authors":"Wenjing He,&nbsp;Jingxiang Ong,&nbsp;Princess Maglanque,&nbsp;Lawrence Gillman,&nbsp;Bin Zheng,&nbsp;Bertram Unger,&nbsp;Krista Hardy,&nbsp;Ashley Vergis","doi":"10.1016/j.lers.2026.04.003","DOIUrl":"10.1016/j.lers.2026.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>Flexible endoscopy is widely used to diagnose and treat gastrointestinal diseases. However, acquiring endoscopic skills can be challenging, and traditional teaching methods often lack formal structures for skill evaluation. This study aims to examine the correlations between cognitive workload, facial expressions, pupil dilations, and task performance in simulated endoscopic procedures.</div></div><div><h3>Methods</h3><div>A cross-sectional study, involving 17 novice medical students, was conducted from October to December 2022 at the Surgical Modeling, Simulation and Robotics Laboratory at the Health Sciences Centre, University of Manitoba. The participants completed a flexible sigmoidoscopy simulation procedure. Eye gaze and facial expressions were tracked during the procedure, and NASA task load index (NASA-TLX) scores were collected post-procedure. The participants were divided into three groups (Top, Medium, and Bottom) on the basis of procedure time.</div></div><div><h3>Results</h3><div>The total procedure time increased from the top (12.94 ± 2.11 min) to the medium (21.36 ± 2.62 min) and bottom performers (30.39 ± 3.42 min; <em>p</em>&lt; 0.05), with similar trends for time to full scope advancement (<em>p</em>= 0.02). Eye tracking revealed most gaze focused on the screen (94.95% ± 8.52%) and central view (87.78% ± 7.86%), with no significant group differences. There was minimal variation across groups in the NASA-TLX scores (58.00 ± 15.81 vs. 67.62 ± 7.84 vs. 67.33 ± 10.32, <em>p</em>= 0.32). The correlations between the procedural, cognitive, and physiological measures were generally weak.</div></div><div><h3>Conclusions</h3><div>Performance level during simulated flexible sigmoidoscopy was associated with procedural efficiency. Objective behavioral markers, including cognitive workload, facial expressions, and eye-tracking metrics, may serve as valid indicators of skill level, may provide opportunities for targeted feedback and personalized training in simulation-based education.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 75-82"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502751","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":"Laparoscopic diaphragmatic plication with mesh reinforcement for diaphragmatic eventration: A single-center case series","authors":"Jie Fang,&nbsp;Zhaoqi Shi,&nbsp;Qilong Chen,&nbsp;Diyu Huang","doi":"10.1016/j.lers.2026.05.001","DOIUrl":"10.1016/j.lers.2026.05.001","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 120-123"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502752","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 laparoscopic treatment of complex renal calculi: Perioperative and functional outcomes from a single-center experience","authors":"Jie Yuan,&nbsp;Shicheng Yu,&nbsp;Mingchao Wang,&nbsp;Zhenghui Wang,&nbsp;Gonghui Li","doi":"10.1016/j.lers.2026.05.002","DOIUrl":"10.1016/j.lers.2026.05.002","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 114-117"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502754","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: Precision without transparency—are the complications being underreported?","authors":"Kaushik Bhattacharya,&nbsp;Dhananjaya Sharma","doi":"10.1016/j.lers.2025.12.003","DOIUrl":"10.1016/j.lers.2025.12.003","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 118-119"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502755","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":"Hostile male pelvis and its impact on robot-assisted radical prostatectomy outcomes","authors":"Michał C. Czarnogórski,&nbsp;Riccardo Rendon,&nbsp;Maciej Socha,&nbsp;Wojciech Flis,&nbsp;Layla Settaf-Cherif,&nbsp;Adam Ostrowski,&nbsp;Krzysztof Koper,&nbsp;Tomasz Drewa,&nbsp;Jan Adamowicz","doi":"10.1016/j.lers.2026.01.003","DOIUrl":"10.1016/j.lers.2026.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>A “hostile male pelvis” describes unfavorable pelvic anatomy that impairs surgical access during robot-assisted radical prostatectomy (RARP), with key factors including narrow pelvic diameters and increased dorsal venous complex (DVC) volume. This research aims to define the “hostile male pelvis” with the aforementioned variables to identify individuals who would have an increased risk of positive surgical margins (PSMs) after RARP.</div></div><div><h3>Methods</h3><div>The population tested consisted of males who were diagnosed with organ-confined prostate cancer, irrespective of their Gleason score, who were eligible for radical surgical treatment, who underwent RARP at a single tertiary high-volume center (Ludwik Rydygier Collegium Medicum, Poland), and who were operated on by an experienced surgeon between March 2023 and March 2025. MRI-derived pelvic diameters—anatomic, robotic (RC), and diagonal conjugates—and DVC volume were assessed. The associations of these factors with PSM at the prostatic apex were analyzed.</div></div><div><h3>Results</h3><div>The study included 117 adult males. PSM at the prostatic apex occurred in 19.7% of the patients. RC provided high sensitivity (0.87), whereas DVC volume offered high specificity (0.76) for predicting PSM at the prostatic apex. At the estimated optimal cutoff point (RC: 9.95 cm, DVC: 15.65 cm³), the baseline PSM probability was 25.9%. A DVC volume &gt;15.65 cm³ significantly increased the PSM risk (OR = 1.24, 95% CI: 1.05–1.52; <em>p</em> = 0.028), with each 1 cm³ increment increasing the OR by 24%.</div></div><div><h3>Conclusion</h3><div>RC and DVC volume may predict apical PSM, supporting their role in defining the “hostile male pelvis”.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 96-101"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502750","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":"Clinical superiority and economic viability of robotic surgery for prostate cancer: A quantitative meta-analysis","authors":"Bhavana Singh,&nbsp;Ruhi Dixit,&nbsp;Atindra K Pandey,&nbsp;Ankita Chakrawal,&nbsp;Manjusha Pal,&nbsp;Nishu Kesh,&nbsp;Manoj Pandey,&nbsp;Rakesh Ranjan,&nbsp;Lalit Kumar","doi":"10.1016/j.lers.2026.05.003","DOIUrl":"10.1016/j.lers.2026.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Prostate cancer is a leading malignancy among men worldwide. Surgical management, including open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robot-assisted radical prostatectomy (RARP), remains a cornerstone for treating localized disease. This meta-analysis aimed to evaluate the clinical efficacy and cost-effectiveness of RARP compared with those of ORP and LRP.</div></div><div><h3>Methods</h3><div>A systematic search of the PubMed/MEDLINE, Embase, Cochrane, and Scopus databases was conducted up to March 2025. Random effects meta-analysis was used to calculate odds ratios (ORs) and mean differences with 95% confidence intervals (CIs). Meta-regression was used to explore the sources of heterogeneity. An expanded 20-year Markov model with probabilistic sensitivity analysis was used to assess cost-effectiveness using averaged multi-study inputs and meta-derived transition probabilities. Future costs and health outcomes (quality-adjusted life years, QALYs) were discounted at an annual rate of 3%.</div></div><div><h3>Results</h3><div>Forty studies were included (33 on clinical outcomes and 7 on cost-effectiveness). RARP was associated with significantly lower odds of urinary incontinence (vs. LRP: OR = 0.58, 95% CI: 0.53 to 0.63, <em>p</em> &lt; 0.01; vs. ORP: OR = 0.68, 95% CI: 0.55 to 0.84, <em>p</em> &lt; 0.01) and erectile dysfunction (vs. LRP: OR = 0.43, 95% CI: 0.33 to 0.55, <em>p</em> &lt; 0.01; vs. ORP: OR = 0.74, 95% CI: 0.60 to 0.90, <em>p</em> &lt; 0.01). In addition, RARP was associated with lower overall complications (OR = 0.70, 95% CI: 0.52 to 0.93, <em>p</em> = 0.01) than LRP, and lower biochemical recurrence (OR = 0.72, 95% CI: 0.57 to 0.92, <em>p</em> = 0.008) and lower all-cause mortality (OR = 0.52, 95% CI: 0.34 to 0.78, <em>p</em> = 0.002) than ORP. The 20-year Markov model yielded incremental cost-effectiveness ratios (ICERs) of US $16,547/QALY for RARP versus LRP and US $27,610/QALY versus ORP.</div></div><div><h3>Conclusion</h3><div>Compared with LRP and ORP, RARP clearly demonstrates clinical superiority in terms of functional recovery and oncologic control. With ICERs below commonly accepted high-income thresholds over a 20-year horizon, RARP may offer good value in resource-rich settings. However, ICERs exceed the willingness-to-pay thresholds of typical low- and middle-income countries, highlighting the need for cost-reduction strategies, targeted adoption in high-benefit subgroups, or the integration of emerging lower-cost robotic platforms to improve accessibility in low- and middle-income countries.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 83-95"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502756","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":"Stump cholecystitis: A focused review of current evidence","authors":"Anupam Kumar Gupta","doi":"10.1016/j.lers.2026.04.001","DOIUrl":"10.1016/j.lers.2026.04.001","url":null,"abstract":"<div><div>Stump cholecystitis is an uncommon but clinically significant cause of post-cholecystectomy syndrome resulting from inflammation of a residual gallbladder remnant or cystic duct stump. Patients may present months to years after the initial operation with symptoms mimicking acute cholecystitis or biliary colic. Diagnosis is often delayed because of low clinical suspicion and variable imaging findings. This narrative review indicates that magnetic resonance cholangiopancreatography is considered the most useful modality for diagnosis, whereas endoscopic ultrasound and endoscopic retrograde cholangiopancreatography may assist in both diagnosis and treatment. Completion cholecystectomy remains the definitive treatment, although it can be technically challenging because of adhesions and distorted anatomy. Recent advances in laparoscopic/robotic techniques have facilitated minimally invasive completion cholecystectomy with favorable outcomes. Endoscopic approaches, such as cholangioscopy-guided lithotripsy or endoscopic ultrasound-guided drainage, have emerged as alternatives in selected high-risk patients. Early recognition and appropriate management are essential for preventing recurrent biliary complications.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 65-69"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502766","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":"Inflammatory stress and recovery after colorectal cancer surgery: The predictive role of early C-reactive protein across open, laparoscopic, and robotic approaches","authors":"Mariarita Tarallo,&nbsp;Giulia Sadiki,&nbsp;Daniele Crocetti,&nbsp;Immacolata Iannone,&nbsp;Michelangelo Miccini,&nbsp;Paolo Sapienza,&nbsp;Enrico Fiori","doi":"10.1016/j.lers.2026.02.001","DOIUrl":"10.1016/j.lers.2026.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>C-reactive protein (CRP) is a well-established biomarker of surgical stress and postoperative inflammation. This study aimed to compare the postoperative inflammatory response and recovery after colorectal cancer surgery via open, laparoscopic, or robotic approaches and to assess the predictive value of early CRP levels for complications and prolonged hospital stays.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 291 patients who underwent elective colorectal cancer resection between January 2021 and July 2025 at Policlinico Umberto I, Italy. CRP values were measured on postoperative days (PODs) 1, 3, and 5. Receiver operating characteristic curve analysis was performed, and the area under the curve (AUC) was calculated to assess the accuracy of the CRP level in predicting postoperative complications and prolonged length of stay (LOS ≥7 days).</div></div><div><h3>Results</h3><div>Overall, 46 patients (15.8%) experienced complications. The complication rates were 21.1% after open surgery, 13.5% after laparoscopic surgery, and 15.2% after robotic surgery (<em>p</em> = 0.42). CRP levels decreased from POD 1 to POD 5 in open surgery and laparoscopic surgery groups, whereas in the robotic surgery group they increased from POD 1 to POD 3 and then decreased by POD 5; CRP levels differed among the approaches at POD 1, POD 3, and POD 5 (<em>p</em> &lt; 0.05). The POD 1 CRP showed the best (yet modest) discrimination for complications (AUC 0.687), with high sensitivity (0.92) and low specificity (0.47), supporting its use primarily to rule out complications. The CRP values and dynamic indices (ΔCRP5-3 and ΔCRP5-1) showed limited accuracy, particularly for prolonged LOS (AUC ≤ 0.60).</div></div><div><h3>Conclusions</h3><div>Early postoperative CRP (POD1) may help identify patients at increased risk of postoperative complications after colorectal resection, although its discriminatory ability is modest. The high sensitivity and low specificity suggest a role in ruling out, rather than confirming, complications. Although the CRP level differed significantly among surgical approaches at PODs 1, 3, and 5, postoperative outcomes were comparable among the groups.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 70-74"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502749","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 of robotic splenic flexure colectomy using the Hugo™ RAS system: A case report","authors":"Ana Cristina Silva,&nbsp;Mónica Sampaio,&nbsp;Eurico Castro Alves","doi":"10.1016/j.lers.2025.11.001","DOIUrl":"10.1016/j.lers.2025.11.001","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"9 2","pages":"Pages 110-113"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148502753","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}