Journal of Robotic Surgery最新文献

{"title":"Surgeons' Perception Questionnaire on Robotics (SPQR): development and preliminary validation of a surgeon-reported instrument for robotic surgery.","authors":"Maria Chiara Sighinolfi, Peter Wiklund, Simone Assumma, Marco Sandri, Giuseppe Pallotta, Erdem Canda, John Hubert, Abolfazl Hosseini, Nina Harke, Markus Graefen, Riccardo Schiavina, Justin Collins, Riccardo Autorino, Filippo Annino, Silvia Secco, Marcio Covas Moschovas, Nathan Senthil, Ruben De Groote, Geert De Nayer, Alex Mottrie, Virginia Varca, Nicolo Lentini, Simone Scuderi, Giuseppe Carrieri, Ugo Falagario, Riccardo Bertolo, Alberto Breda, Alessandro Antonelli, Andrea Minervini, Filippo Turri, Angelo Totaro, Riccardo Bientinesi, Carlo Gandi, Giuseppe Palermo, Filippo Gavi, Simona Presutti, Enrico Panio, Nazario Foschi, Francesco Pinto, Marco Montesi, Francesco Rossi, Pierluigi Russo, Ela Patel, Shady Saikali, Yu Ozawa, Giorgia Gaia, Stefano Brusoni, Diana Giannarelli, Anna Fagotti, Vipul Patel, Sergio Alfieri, Bernardo Rocco","doi":"10.1007/s11701-026-04090-1","DOIUrl":"https://doi.org/10.1007/s11701-026-04090-1","url":null,"abstract":"<p><p>Robotic surgical platforms are diversifying, and clinical outcomes are increasingly comparable across systems, yet the console surgeon's subjective experience remains poorly characterized. We developed a surgeon-reported questionnaire on robotic surgical systems and performed a preliminary psychometric evaluation in robotic radical prostatectomy. The Surgeons' Perception Questionnaire on Robotics (SPQR) includes 31 five-point items in six domains: technical and operational aspects, key surgical tasks, ergonomics and physical comfort, communication and workflow integration, learning curve, and overall evaluation. In a cross-sectional web-based survey, surgeons rated the platform they primarily used for robotic radical prostatectomy. Internal consistency was assessed with polychoric-based Cronbach's alpha and McDonald's omega; exploratory (EFA) and confirmatory factor analysis (CFA) were performed in the same sample. Fifty-nine surgeons participated (response rate 42%); 81% evaluated the da Vinci Xi. Overall internal consistency was high (alpha 0.96; omega 0.97). Alpha and omega were ≥ 0.84 in five domains but below 0.70 for ergonomics and physical comfort (0.64 and 0.67). EFA suggested three factors (system performance and satisfaction; learning curve and training; ergonomics). CFA showed high incremental fit (comparative fit index 0.985) but inadequate absolute fit (root mean square error of approximation 0.097; standardized root mean square residual 0.135), and the ergonomics factor was weakly defined. The SPQR showed high internal consistency in most domains and a provisional multidimensional structure. Because the sample was small, highly experienced, predominantly male, and dominated by one platform, these findings require confirmation in larger independent cohorts before the SPQR is used for platform comparisons.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228831","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":"Comparative perioperative and oncological outcomes of the da Vinci Xi versus Si robotic surgical systems in rectal cancer surgery: a systematic review and meta-analysis.","authors":"Ivens Murad Garcia Magalhães, Fillipe Augusto de Oliveira Paixão, Gustavo Tamura, Pedro Averbach","doi":"10.1007/s11701-026-04059-0","DOIUrl":"10.1007/s11701-026-04059-0","url":null,"abstract":"<p><p>The da Vinci Xi replaced the Si with a boom-mounted architecture intended to remove the re-docking and multiquadrant limits on pelvic access. Whether it changes outcomes in rectal cancer surgery is unresolved: existing syntheses pooled rectal with colonic resection. Five databases, Google Scholar and citation graphs were searched to August 2026, without language or design restriction, for comparative studies reporting outcomes separately by platform in rectal cancer resection. Screening, extraction and risk-of-bias assessment were done in duplicate. Random-effects models with a Hartung-Knapp adjustment were used; certainty was rated with GRADE. Eight non-randomised cohorts (843 patients; 380 Xi, 463 Si) were included. Pooling all five cohorts reporting operative time, the mean difference was - 27.7 min (95% confidence interval - 80.4 to + 25.0; I² 95%); restricted to the four reporting means with standard deviations, thus conditional on excluding the largest cohort, it was - 50.6 min (- 69.4 to - 31.7). Docking time was shorter with the Xi in all three reporting cohorts, which defined it differently or not at all. The evidence is very uncertain about the effect of platform on anastomotic leak (risk ratio 0.53, 0.24 to 1.14), complications, conversion, reoperation, margin involvement and specimen quality; certainty was very low throughout. The evidence is very uncertain about the effect of the da Vinci Xi compared with the Si on perioperative and oncological outcomes in rectal cancer, and functional outcomes have not been compared. Because the platforms were compared across periods, centres and levels of experience, no estimate isolates the platform.PROSPERO registration CRD420261480007, registered 18 August 2026, before data extraction.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228866","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":"Nephrometry scores differ in their association with warm ischemia time during robot-assisted partial nephrectomy: comparison of RENAL, RPN, PADUA, and SPARE.","authors":"Mitsuru Komeya, Kota Kobayashi, Ryosuke Jikuya, Tomoyuki Tatenuma, Go Noguchi, Hiroki Ito, Yusuke Ito, Kentaro Muraoka, Hisashi Hasumi, Kazuhide Makiyama","doi":"10.1007/s11701-026-04094-x","DOIUrl":"https://doi.org/10.1007/s11701-026-04094-x","url":null,"abstract":"<p><p>Nephrometry systems are widely used before robot-assisted partial nephrectomy (RAPN), but their relation to intraoperative complexity may differ. We compared RENAL, RPN, PADUA, and SPARE using continuous warm ischemia time (WIT) and assessed whether the scores added information beyond tumor diameter and routine clinical variables. We retrospectively analyzed 579 single-tumor RAPN cases with complete data for all four scores (2016-2023). Associations with WIT were assessed using Spearman correlations and patient-level paired bootstrap comparisons. Tumor diameter was evaluated as an additional comparator. Incremental value was assessed by adding each nephrometry score to a baseline model containing tumor diameter, age, sex, body mass index, laterality, surgeon experience, surgical approach, and fiscal year. Model performance was evaluated using adjusted R² and 10-fold cross-validation. RPN showed the strongest correlation with WIT (ρ = 0.553), followed by tumor diameter (ρ = 0.519). The difference between them was small (Δρ = 0.034, 95% CI - 0.020 to 0.089). RPN had the highest adjusted R² (0.341) among single-predictor models. All four scores improved the baseline model; the numerically largest improvement was observed with PADUA (Δ adjusted R²=0.096; Δ cross-validated RMSE = - 0.397 min). RPN had the strongest stand-alone association with WIT, but its correlation was not clearly stronger than that of tumor diameter. Each nephrometry score added information beyond tumor diameter and routine clinical variables, with the magnitude of incremental improvement differing among systems.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228824","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":"Robotic-assisted living-donor hysterectomy for uterus transplantation: a systematic review of surgical techniques, donor safety, and recipient outcomes.","authors":"Saeed Baradwan, Hassan M Latifah, Bandr Hafedh, Mohammad Alyafi, Ehab Badghish, Lina Aazam, Neveen Awadh, Majed Saeed Alshahrani","doi":"10.1007/s11701-026-04093-y","DOIUrl":"10.1007/s11701-026-04093-y","url":null,"abstract":"<p><p>Uterus transplantation (UTx) has emerged as a promising treatment for women with absolute uterine factor infertility (AUFI), enabling pregnancy and live birth with their own genetic offspring. Living-donor uterus procurement remains the most technically demanding component of the procedure. Robotic-assisted donor hysterectomy has been introduced to improve surgical precision, reduce donor morbidity, and preserve graft quality, while recipient implantation is performed via laparotomy. This systematic review evaluated current evidence on robotic-assisted living-donor hysterectomy for UTx, focusing on surgical techniques, donor safety, recipient outcomes, and reproductive success. Databases and trial registries were searched from inception through June 2026. Six studies reporting 29 unique robotic-assisted living-donor hysterectomies across five countries met the inclusion criteria. All procedures used the da Vinci Xi robotic platform. Operative time and estimated blood loss decreased with increasing surgical experience, while major donor complications (Clavien-Dindo grade III or higher) were less frequent in later series. Among cases with reported follow-up, no graft loss was observed; restoration of menstruation, embryo transfer, clinical pregnancy, and live birth were achieved, including ten live births in the largest programme. Robotic-assisted living-donor hysterectomy for uterus transplantation appears technically feasible and has been associated with viable grafts and successful pregnancies in highly selected cases. However, major donor complications, including ureteric injury requiring reimplantation and bilateral oophorectomy, were observed, and the true incidence of donor morbidity remains uncertain. Current evidence remains limited to small observational studies, and these findings support careful evaluation within structured, multidisciplinary programmes and international registries rather than widespread expansion.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228854","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":"Comparison of robotic and laparoscopic gastrectomy using textbook oncologic outcome: a matched cohort study.","authors":"Eun Young Kim, Ji Won Seo, Ki Bum Park, Seung Taek Lim, Kyong Hwa Jun, Hyung Min Chin","doi":"10.1007/s11701-026-04019-8","DOIUrl":"https://doi.org/10.1007/s11701-026-04019-8","url":null,"abstract":"<p><p>By evaluating whether a patient simultaneously satisfies multiple desirable goals, textbook oncologic outcome (TOO) offers a composite assessment of cancer-surgery quality. This study investigated whether TOO attainment after curative gastric cancer surgery differed according to the operative approach. We retrospectively reviewed 945 patients with gastric adenocarcinoma who received curative-intent robotic gastrectomy (RG; n = 161) or laparoscopic gastrectomy (LG; n = 784) between 2017 and 2025. Propensity score matching yielded 147 patients in each group. When each of the following was recorded, a TOO was attained: margin-negative resection, assessment of at least 15 lymph nodes, survival beyond 30 postoperative days, hospital discharge no later than postoperative day 7, and guideline-appropriate adjuvant chemotherapy. We compared operative characteristics, postoperative recovery, complications, and survival between the approaches. Among matched patients, the complete TOO was attained after 66.0% of RG procedures and 43.5% of LG procedures (P < 0.001). Although RG had a longer operating time, it was linked to quicker gastrointestinal healing and discharge as well as decreased blood loss. The between-group difference in the composite measure was driven chiefly by discharge within 7 days. Overall and major complication rates did not differ significantly. Multivariable analysis identified RG (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.52-4.07; P < 0.001) and distal gastrectomy (OR, 3.32; 95% CI, 1.46-7.56; P = 0.004) as positive correlates of TOO attainment, whereas estimated blood loss of at least 50 mL was a negative correlate (OR, 0.37; 95% CI, 0.21-0.67; P = 0.001). The approaches showed no significant difference in estimated 5-year overall or disease-free survival. Patients undergoing RG met all five TOO criteria more frequently, largely because they were more likely to leave the hospital by postoperative day 7 rather than because of differences in oncologic radicality. RG was also associated with lower blood loss and faster early recovery, while morbidity and survival were comparable between approaches. These findings should be interpreted as reflecting an advantage of RG in postoperative recovery and length of stay rather than demonstrable superiority in overall oncologic or surgical quality.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225212","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":"Comparison of the safety and 24-36-month efficacy of medial unicompartmental knee arthroplasty versus total knee arthroplasty in elderly patients (≥ 75 years) with isolated medial-compartment knee osteoarthritis.","authors":"Shaolong Wang, Yucheng Fu, Zonglei Guo, Jincheng Zhang, Cheng Lin, Hongyi Wang","doi":"10.1007/s11701-026-04086-x","DOIUrl":"https://doi.org/10.1007/s11701-026-04086-x","url":null,"abstract":"<p><p>The number of very elderly patients presenting with end-stage knee osteoarthritis (OA) is rising rapidly, yet the comparative merits of medial unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) in this group remain insufficiently characterised. We compared the perioperative safety and short-term clinical and patient-reported efficacy of the two procedures in patients aged 75 years and older with isolated medial-compartment OA. This single-centre retrospective cohort study compared patients aged ≥ 75 years undergoing primary medial UKA or TKA for isolated medial-compartment OA between January 2018 and December 2022. Among 268 eligible patients (68 UKA and 200 TKA), 1:2 nearest-neighbour propensity-score matching, incorporating operating surgeon together with demographic, comorbidity, radiographic and baseline functional covariates, yielded 60 UKA and 120 TKA patients. Perioperative outcomes, KSS, OKS, pain VAS, ROM, postoperative FJS-12, complications, readmission, reoperation and satisfaction were compared over 24-36 months. Standardised mean differences assessed baseline balance; treatment-effect estimates, risk differences and 95% confidence intervals (CIs) were reported. Matching yielded 180 patients, with all post-match absolute SMDs < 0.10 (maximum 0.087). UKA was associated with shorter operative time (64.3 vs. 84.2 min), lower estimated blood loss (99.9 vs. 183.6 mL), smaller haemoglobin decline (1.5 vs. 2.6 g/dL), shorter stay (3.0 vs. 5.2 days) and earlier independent walking (18.3 vs. 29.6 h). Final KSS components were similar; UKA showed higher OKS and FJS-12, greater knee flexion and lower pain VAS. Complications occurred in 3/60 UKA (5.0%) and 19/120 TKA (15.8%; risk difference - 10.8% points, 95% CI - 19.4 to - 2.3; sensitivity-analysis adjusted OR 0.31, 95% CI 0.09-0.92). Transfusion was infrequent (1.7% vs. 3.3%); readmission and reoperation showed no clear difference. Final satisfaction was 98.3% versus 86.7% (risk difference + 11.7% points, 95% CI 4.8-18.6). In carefully selected patients aged ≥ 75 years with isolated medial-compartment OA, medial UKA was associated with lower measured perioperative burden and more favourable patient-reported outcomes than TKA over 24-36 months. The observed difference in complications should be interpreted cautiously because event counts were small and findings were sensitive to the choice of statistical test. Retrospective allocation, surgeon and implant heterogeneity, potential residual confounding and limited follow-up preclude causal or long-term durability conclusions.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228833","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":"Robot-associated inpatient hospital activity in Germany, 2019-2025: nationwide trends in coded robot categories and diagnostic case mix.","authors":"Roland Mojica Crespo","doi":"10.1007/s11701-026-04084-z","DOIUrl":"10.1007/s11701-026-04084-z","url":null,"abstract":"<p><p>Robot-assisted surgery has spread from urology into several other surgical fields, and different categories of robotic system are now coded separately in Germany. This nationwide descriptive time-series analysis used aggregated hospital data of the Institute for the Hospital Remuneration System for 2019 to 2025. All inpatient hospital cases carrying at least one code of the group for use of a surgical robot (group 5-987 of the German Operation and Procedure Classification) were included, and annual case volume, the coded robot categories, principal diagnoses grouped at the three-character level, sex, age, clinical complexity and length of stay were described, together with selected index procedures counted with and without a robot code. The annual number of cases increased 3.78-fold, from 32,691 in 2019 to 123,706 in 2025, and rose in every year. Prostate cancer remained the most frequent principal diagnosis group: its case number almost doubled from 14,796 to 29,407 while its share fell from 45.3% to 23.8%. Osteoarthritis of knee became the second most frequent, rising from 1,936 to 21,447 cases. The proportion of female cases increased from 26.1% to 40.9%. Among hospital cases with the code for radical prostatovesiculectomy, the proportion also carrying a robot code rose from 52.9% to 85.1%, and for knee endoprosthesis implantation from 1.1% to 8.9%. Recorded robot-associated inpatient hospital activity almost quadrupled over seven years, and both the coded robot categories and the diagnostic composition broadened. These data describe recorded activity and its composition but do not provide information on outcomes, costs or appropriateness.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228810","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":"Assist team self-efficacy, training needs, and operative outcomes in single-port robotic hepatopancreatobiliary surgery: a mixed-methods study to inform protocol development.","authors":"Yeon Su Kim, Haelim Kim, Yeon Hee Bong, Jin Hong Lim, Hyung Sun Kim","doi":"10.1007/s11701-026-04079-w","DOIUrl":"10.1007/s11701-026-04079-w","url":null,"abstract":"<p><p>Single-port (SP) robotic surgery imposes unique spatial and technical constraints on bedside assistance personnel; however, structured training protocols for hepatopancreatobiliary (HPB) procedures are lacking. A cross-sectional survey using a 7-item Likert self-efficacy instrument was administered to 11 operating room nurses and 19 physician assistants (PAs). Free-text responses were subjected to inductive thematic analysis. Retrospective data from 92 SP robotic HPB cases performed between august 2024 and July 2025 were analyzed. PAs were grouped according to seniority into Group 1 (≥ 5 years) and Group 2 (< 5 years). A cross-sectional survey using a 7-item Likert self-efficacy instrument was administered to 11 operating room nurses and 19 physician assistants (PAs). Free-text responses were subjected to inductive thematic analysis. Retrospective data from 92 SP robotic HPB cases performed between august 2024 and July 2025 were analyzed. PAs were grouped according to seniority into Group 1 (≥ 5 years) and Group 2 (< 5 years). Emergency response and instrument exchange were identified as key areas requiring training. A structured, six-module SP robotic HPB-assist training curriculum was proposed.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229258","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":"Short-term surgical outcomes of robotic versus laparoscopic radical gastrectomy for gastric cancer: a propensity score-matched retrospective cohort study.","authors":"Dongdong Zhang, Ning Ning, Lin Chen","doi":"10.1007/s11701-026-04074-1","DOIUrl":"10.1007/s11701-026-04074-1","url":null,"abstract":"<p><p>Robotic gastrectomy (RG) is increasingly used for gastric cancer, but real-world comparative data from Chinese institutions during the early phase of robotic program implementation remain limited. We retrospectively identified patients who underwent radical gastrectomy between January 2015 and October 2025. The primary comparison included 54 patients who underwent RG and 162 who underwent Laparoscopic gastrectomy (LG). After exclusion of patients with missing propensity-score covariates, 53 RG and 143 LG patients were eligible for matching. One-to-two nearest-neighbor matching was performed using a caliper of 0.2 standard deviations of the logit of the propensity score, yielding 45 RG and 88 LG patients. The principal outcomes was the number of lymph nodes retrieved. After matching, all included covariates were balanced. The median number of lymph nodes retrieved did not differ significantly between RG and LG (30 [interquartile range, 25-42] vs 34 [27-47]; 95% Confidence Interval [CI]: -10.0-2.0, p = 0.181). RG was associated with a shorter postoperative length of stay (16 vs 18 days; 95% CI: -4.1-0.1, p = 0.016) and fewer positive lymph nodes (0 vs 2; 95% CI: -3.3-0.7, p = 0.007). Median operative time was 310 minutes for RG and 300 minutes for LG (95% CI: -20.5-40.5, p = 0.072). CUSUM analysis revealed a V-shaped recovery for LN retrieval, and confirmed operative efficiency convergence to the LG benchmark by the late phase (300 min, p = 0.053), together indicating a trend toward improved performance during the learning process. RG and LG achieved comparable lymph-node yields, while RG was associated with a shorter postoperative hospital stay. Exploratory sequential analyses suggested improvement in operative efficiency but did not establish a proficiency threshold. Complete outcome ascertainment and contemporaneous comparisons are needed.Clinical Trial: The study was registered retrospectively in the Chinese Clinical Trial Registry on August 27, 2026 (ChiCTR2600131011; http://www.chictr.org.cn).</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adoption of robot-assisted minimally invasive surgery across surgical specialties in France: a nationwide population-based study.","authors":"Anaïs Havet, François Bettega, Violaine Fernandez, Clara Bouvard, Cécile Payet, Jean-Christophe Lifante, Christophe Tresallet, Laurent Brunaud, Xavier Armoiry, Marie Viprey","doi":"10.1007/s11701-026-04081-2","DOIUrl":"10.1007/s11701-026-04081-2","url":null,"abstract":"<p><p>Robotic minimally invasive surgery has been used in France for nearly two decades, with monitoring enabled by the National Health Data System (SNDS) since March 2020. No French study has comprehensively described robotic procedures, including ENT, at a fine geographical scale. We aimed to assess the use of robotic and non-robotic minimally invasive surgery over time and across French departments (administrative subdivisions), describe patient and healthcare facility characteristics and investigate determinants of robotic surgery use. We identified adults undergoing robotic or non-robotic minimally invasive procedures in urology, gynaecology, digestive, thoracic, and ENT specialties between January 2017 and June 2023. From July 2020, robotic surgery use was described by specialty, quarter and department, and temporal trends were assessed using SARIMA models. Determinants of robotic surgery use were identified by specialty using multivariable logistic regression models. Between January 2017 and June 2023, 914,350 minimally invasive surgeries were performed, including 432,505 from July 2020 onwards, of which 19.2% were robotic. This proportion varied by specialty (urology: 63.6%, thoracic surgery: 18.5%, ENT: 16.8%, gynaecology: 9.7%, digestive surgery: 6.5%). Across all specialties, the proportion of robotic surgeries increased by 0.66% points per quarter. Minimally invasive surgery volume and robotic surgery use varied substantially across departments. Robotic surgery use was associated with patient sociodemographic characteristics and facility characteristics (facility type, number of beds and surgical volume). Robotic surgery use is increasing in France, with substantial variation across specialties, departments, patient and healthcare facility characteristics. Further studies on safety and effectiveness are needed to complement real-world monitoring.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}