Christopher Connors, Olamide Omidele, Micah Levy, Daniel Wang, Juan Sebastian Arroyave, Esther Kim, Herik Acosta Gonzalez, Osama Zaytoun, Ketan Badani, Michael Palese
{"title":"Trends, outcomes, and predictors of open conversion during minimally invasive radical nephroureterectomy for upper tract urothelial carcinoma: a national analysis from 2010 to 2020.","authors":"Christopher Connors, Olamide Omidele, Micah Levy, Daniel Wang, Juan Sebastian Arroyave, Esther Kim, Herik Acosta Gonzalez, Osama Zaytoun, Ketan Badani, Michael Palese","doi":"10.1007/s11701-025-02311-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02311-7","url":null,"abstract":"<p><p>We evaluated trends, predictors, and outcomes of unplanned open conversion for patients with upper tract urothelial carcinoma (UTUC) undergoing robotic radical nephroureterectomy (R-RNU) or laparoscopic RNU (L-RNU). The National Cancer Database was queried from 2010 to 2020 for patients with non-metastatic UTUC treated with RNU. Trends in surgical approach and conversion were evaluated. Demographics and outcomes including lymph node dissection, lymph node yield, positive surgical margins (PSM), prolonged length of stay (PLOS) (≥ 90th percentile), unplanned readmission (UR), and 30- and 90-day mortality were compared between converted and unconverted cases. Multivariate logistic regression evaluated predictors of conversion and whether conversion predicted adverse clinical outcomes. 25,523 cases were included (robotic = 40.4%, laparoscopic = 36.9%, open = 22.7%), where 3.2% and 9.2% of R-RNU and L-RNU cases were converted, respectively. From 2010 to 2020, robotic cases increased while open and laparoscopic approaches decreased, p < 0.001. A higher T-stage and a ureteral tumor site predicted conversion while a higher R-RNU and L-RNU facility volume, respectively, were protective against conversion, all p < 0.05. Compared to unconverted cases, conversion generally resulted in a higher rate of all adverse outcomes, and was predictive of 30-day mortality, PLOS, UR, and PSM, all p < 0.05. Conversion to open RNU is becoming less frequent but is more common with a laparoscopic approach. Oncologic complexity and facility surgical volume influence conversion rates which in turn are associated with higher rates of morbidity, mortality, and greater resource utilization when compared to unconverted cases.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"140"},"PeriodicalIF":2.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on: \"Robotic versus open surgery for ureteroenteric stricture after radical cystectomy: a systematic review and meta‑analysis\".","authors":"Rachana Mehta, Ranjana Sah, Venkata Dileep Kumar Veldi","doi":"10.1007/s11701-025-02318-0","DOIUrl":"https://doi.org/10.1007/s11701-025-02318-0","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"139"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comments on \"transperitoneal vs retroperitoneal robotic partial nephrectomy: a meta-analysis and systematic review of propensity-matched studies\".","authors":"Kangyu Wang, Li Yang","doi":"10.1007/s11701-025-02316-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02316-2","url":null,"abstract":"<p><p>This letter provides a review of the meta-analysis by Rong et al. comparing transperitoneal (TPPN) and retroperitoneal (RPPN) robotic partial nephrectomy. While the study offers valuable insights into perioperative outcomes, such as operating time, hospital stay, blood loss, and complications, there are several methodological concerns. These include the use of non-randomized controlled trials, which may introduce bias, the lack of long-term follow-up, and high heterogeneity across studies. The letter also addresses the evaluation of serious complications and data extraction methods. It suggests that future research should focus on randomized controlled trials, longer follow-up, and more detailed analysis of complications. Overall, while acknowledging the authors' work, this letter highlights areas for improvement to strengthen the study's conclusions for clinical practice.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"138"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on: \"The environmental impact of multi‑specialty robotic‑assisted surgery: a waste audit analysis\".","authors":"Qi Xu","doi":"10.1007/s11701-025-02306-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02306-4","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"137"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outlook for robotics-related clinical trials: current status and future directions.","authors":"Haoran Dai, Junchen Zhu, Xianzuo Zhang","doi":"10.1007/s11701-025-02288-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02288-3","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"136"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
XiLan Wang, SanYe Liu, WenJuan Lei, Dan Zhao, Longhe Xu, Zeguo Feng, Feng Long
{"title":"Perioperative anesthesia management of remote 5G robot surgery and precautions for operation team.","authors":"XiLan Wang, SanYe Liu, WenJuan Lei, Dan Zhao, Longhe Xu, Zeguo Feng, Feng Long","doi":"10.1007/s11701-025-02238-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02238-z","url":null,"abstract":"<p><p>Remote 5G robot surgery not only improves the accuracy, accessibility and efficiency of surgery, but also promotes the remote sharing and integration of medical resources, effectively avoids the risk of transshipment, reduces the cost of remote medical treatment, and promotes the development of smart medical care. To successfully carry out remote 5G surgery, it is necessary to establish a medical team, and anesthesiologists should not only escort the operation but also find problems in time when accidents occur and coordinate the team for joint treatment. General anesthesia is selected for this kind of operation, and local nerve block is recommended for analgesia. The main feature of anesthesia is that the patient is completely braked during the whole operation, and it is necessary to provide good muscle relaxation and suitable anesthesia sedation depth. In addition, due to the limited operating space of the head, special posture, long-term artificial pneumoperitoneum, the harm of hypothermia, delayed awakening or postoperative delirium, individualized multi-mode analgesia and other problems. The above problems have caused some challenges and difficulties for anesthesiologists.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"133"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vipul Patel, Justin W Collins, Jacques Marescaux, Mischa Dohler, Shady Saikali, Prokar Dasgupta, Sumeet Reddy, Ahmed Gamal, Ela Patel, Travis Rogers, Adnan Siddiqui, Alberto Breda, Alex Mottrie, Ameer Hassan, Andrew Hung, Angeles Secord, Bernardo Rocco, Carla Pugh, Chandru Sundaram, Maria Chiara Sighinolfi, E Christopher Ellison, Eduardo Parra Davila, Erik Wilson, Husam Balkhy, Jihad Kaouk, Cui Liang, Louis R Kavoussi, Martin Roche, Martin Martino, Mehran Anvari, Patrice Sylla, Rafael Ferreira Coelho, Raju Thomas, Ralph Clayman, Raymond Leveillee, Ricardo Estape, Ross Goldberg, Ryan Madder, Santiago Horgan, J Scott Magnuson, Senthil Nathan, Sharona Ross, Anthony Costello, Zhang Xu, Sanket Chauhan, Jay Redan, Richard Satava, Brian Miles, Ajit K Sachdeva, Marcio Covas Moschovas
{"title":"International multispecialty consensus statement and expert opinion of best practices in telesurgery.","authors":"Vipul Patel, Justin W Collins, Jacques Marescaux, Mischa Dohler, Shady Saikali, Prokar Dasgupta, Sumeet Reddy, Ahmed Gamal, Ela Patel, Travis Rogers, Adnan Siddiqui, Alberto Breda, Alex Mottrie, Ameer Hassan, Andrew Hung, Angeles Secord, Bernardo Rocco, Carla Pugh, Chandru Sundaram, Maria Chiara Sighinolfi, E Christopher Ellison, Eduardo Parra Davila, Erik Wilson, Husam Balkhy, Jihad Kaouk, Cui Liang, Louis R Kavoussi, Martin Roche, Martin Martino, Mehran Anvari, Patrice Sylla, Rafael Ferreira Coelho, Raju Thomas, Ralph Clayman, Raymond Leveillee, Ricardo Estape, Ross Goldberg, Ryan Madder, Santiago Horgan, J Scott Magnuson, Senthil Nathan, Sharona Ross, Anthony Costello, Zhang Xu, Sanket Chauhan, Jay Redan, Richard Satava, Brian Miles, Ajit K Sachdeva, Marcio Covas Moschovas","doi":"10.1007/s11701-025-02298-1","DOIUrl":"https://doi.org/10.1007/s11701-025-02298-1","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"135"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sébastien Frey, Federica Facente, Wen Wei, Ezem Sura Ekmekci, Eric Séjor, Patrick Baqué, Matthieu Durand, Hervé Delingette, François Bremond, Pierre Berthet-Rayne, Nicholas Ayache
{"title":"Optimizing intraoperative AI: evaluation of YOLOv8 for real-time recognition of robotic and laparoscopic instruments.","authors":"Sébastien Frey, Federica Facente, Wen Wei, Ezem Sura Ekmekci, Eric Séjor, Patrick Baqué, Matthieu Durand, Hervé Delingette, François Bremond, Pierre Berthet-Rayne, Nicholas Ayache","doi":"10.1007/s11701-025-02284-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02284-7","url":null,"abstract":"<p><p>The accurate recognition of surgical instruments is essential for the advancement of intraoperative artificial intelligence (AI) systems. In this study, we assessed the YOLOv8 model's efficacy in identifying robotic and laparoscopic instruments in robot-assisted abdominal surgeries. Specifically, we evaluated its ability to detect, classify, and segment seven different types of surgical instruments. A diverse dataset was compiled from four public and private sources, encompassing over 7,400 frames and 17,175 annotations that represent a variety of surgical contexts and instruments. YOLOv8 was trained and tested on these datasets, achieving a mean average precision of 0.77 for binary detection and 0.72 for multi-instrument classification. Optimal performance was observed when the training set of a specific instrument reached 1300 instances. The model also demonstrated excellent segmentation accuracy, achieving a mean Dice score of 0.91 and a mean intersection over union of 0.86, with Monopolar Curved Scissors yielding the highest accuracy. Notably, YOLOv8 exhibited superior recognition performance for robotic instruments compared to laparoscopic tools, a difference likely attributed to the greater representation of robotic instruments in the training set. Furthermore, the model's rapid inference speed of 1.12 milliseconds per frame highlights its suitability for real-time clinical applications. These findings confirm YOLOv8's potential for precise and efficient recognition of surgical instruments using a comprehensive multi-source dataset.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"131"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply to comment on: \"Evaluating the safety of robotic total gastrectomy (RTG) versus laparoscopic total gastrectomy (LTG) with D2 lymphadenectomy for gastric cancer\".","authors":"Konstantinos Kossenas","doi":"10.1007/s11701-025-02303-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02303-7","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"132"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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