Journal of Robotic Surgery最新文献

{"title":"Robotic partial nephrectomy for complex renal masses: technical approach and perioperative outcomes.","authors":"Poulomi Dey, Shresth Manglik, Forqan Babu Shaikh, Satydip Mukherjee, Kumar Anshuman, Naman Chhabra, Rajeev Ranjan, Pradeep Narayan, Sanjay Kumar Dubey","doi":"10.1007/s11701-025-02823-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02823-2","url":null,"abstract":"<p><p>Robotic-assisted partial nephrectomy (RAPN) offers technical advantages for complex renal masses, but outcome validation from emerging centres remain limited. To describe our RAPN technique for complex renal tumours and evaluate perioperative outcomes during initial institutional experience. We performed 35 consecutive RAPN procedures using a five-port transperitoneal approach following STROBE guidelines. Technical steps, operative parameters, and complications were prospectively analysed. Complex cases included endophytic tumours, central locations, and proximity to the collecting system. Mean tumor size was 4.01 ± 0.76 cm with a mean RENAL nephrometry score of 6.4 ± 1.6, and 54.3% demonstrating an endophytic growth pattern. Mean operative time was 198.5 ± 12.5 min with console time 143.0 ± 12.9 min. Warm ischemia time averaged 29.2 ± 4.8 min. Conversion rate was 5.7%. Zero positive margins were achieved with acceptable functional preservation (mean creatinine increase 0.13 mg/dL). Trifecta outcomes were achieved in 82.9% of cases. Our RAPN technique achieves excellent perioperative outcomes for complex renal masses with reproducible results during the learning curve at emerging centres.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"660"},"PeriodicalIF":3.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226193","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-assisted hysterectomy for endometrial cancer: is there a correlation between uterine diameters, pelvic volume, and surgical outcomes?","authors":"Daniela Surico, Carmen Imma Aquino, Alessandro Vigone, Daniela Ferrante, Sabrina Baldi, Beatrice Bracci, Alessandro Libretti, Valentino Remorgida","doi":"10.1007/s11701-025-02820-5","DOIUrl":"https://doi.org/10.1007/s11701-025-02820-5","url":null,"abstract":"<p><p>Hysterectomy could be performed through a vaginal approach, laparotomy, or laparoscopy. Robotic surgery is a technique that can be defined as a particular type of laparoscopy, often used in interventions where microsurgery can help improve radicality and effectiveness. In choosing patients for the robotic technique, many characteristics could be studied to tailor the surgical choice. Our aim is to describe the anthropomorphic and radiological parameters linked to worse surgical outcomes for the potential stratification of patients in the preoperative decision about the type of surgery. In our center, the AOU Maggiore della Carità Hospital in Novara (Italy), 104 patients diagnosed with endometrial cancer and candidated for total hysterectomy, with various degrees of radicality, underwent robotic surgery. Patients' anthropomorphic parameters, such as body mass index, and radiological imaging such as uterine size and pelvis diameter, were compared with the surgical outcomes such as operating times, complications as blood loss, subsequent emergency room visits, and the possible need for laparotomy conversion. Our ratios between pelvic depth and uterine anteroposterior diameter (PD/UAP) and between uterine volume and pelvic volume index (UV/PCI) showed statistically significant correlations with surgical time.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"661"},"PeriodicalIF":3.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226206","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":"Effectiveness of haptic feedback during local and remote robotic surgery: single-blind cadaveric study.","authors":"Hironobu Takano, Yuma Ebihara, Satoshi Hirano, Toshiaki Shichinohe, Soichi Murakami, Hajime Morohashi, Eiji Oki, Kenichi Hakamada, Akinobu Taketomi, Norihiko Ikeda, Masaki Mori","doi":"10.1007/s11701-025-02826-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02826-z","url":null,"abstract":"<p><strong>Background: </strong>Robotic surgery has rapidly evolved, with telesurgery emerging as a promising extension. However, the lack of haptic feedback remains a key limitation, potentially compromising surgical safety. This study aimed to evaluate the impact of haptic feedback on surgical performance in both local and remote robotic settings using a cadaver model.</p><p><strong>Methods: </strong>Six gastrointestinal surgeons were assigned to local or remote groups and performed standardized bowel traction tasks using the Saroa™ surgical robot. Haptic feedback was tested at three levels: none (0), moderate (0.5), and full (1.0). Each participant completed the task three times under each condition. Task completion time, grip force, and forceps path length were measured.</p><p><strong>Results: </strong>Grip force significantly decreased with increasing haptic feedback levels, particularly in the non-dominant (left) hand. No significant differences in task completion time or forceps path length were found across feedback levels or between local and remote settings, except for a longer right-hand path length in the remote group at feedback level 0.5.</p><p><strong>Conclusions: </strong>Haptic feedback reduced grip force in both local and remote robotic surgery, suggesting enhanced surgical safety. However, its effect on efficiency metrics was limited. These findings support the integration of haptic feedback in telesurgical systems, although further validation with complex procedures and more participants is warranted.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"662"},"PeriodicalIF":3.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226224","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":"Team-based learning curve and cost efficiency in robot-assisted hysterectomy: a four-phase CUSUM study of 915 cases.","authors":"Ikuko Sakamoto, Takahiro Nozaki, Yoshihiko Ito, Kosuke Matsuda, Keiko Kagami","doi":"10.1007/s11701-025-02847-8","DOIUrl":"https://doi.org/10.1007/s11701-025-02847-8","url":null,"abstract":"<p><p>Team learning may influence both efficiency and hospital margins in robot-assisted hysterectomy (RAH), yet phase-specific economic data remain limited. We analyzed 915 consecutive RAHs (single-center, April 2019-August 2024). A CUSUM of operative time with segmented regression identified four phases (breakpoints at cases 155, 551, 800). Outcomes included operative metrics (operative, console, docking, patient-in-room times), blood loss, Clavien-Dindo complications, and itemized direct hospital costs under Japan's DPC system; the profit margin was calculated as the profit divided by the total surgical fees. As an institutional benchmark, outcomes from 164 laparoscopic hysterectomies (LH) performed during the same period were also analyzed. Operative time rose in Phase 2 and declined thereafter; major complications (CD ≥ III) remained 0-1.3%. Median total costs decreased from ¥401,116 (Phase 1) to ¥390,035 (Phase 4), a 2.76% reduction; profit margins improved in both benign (to ~ 37%) and malignant cases (to ~ 57%). In the Mastery Phase, RAH demonstrated a higher profit margin for both benign (37.4% vs 35.5%) and malignant (56.8% vs 53.0%) cases compared to the LH benchmark. Team proficiency-beyond individual surgeon skill-was associated with shorter operative time and improved hospital margins at maturity. Findings support institutional standardization and team training to accelerate the RAH learning curve.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"658"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213837","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 adrenalectomy: a comprehensive review of perioperative outcomes, comparative efficacy, and technological advancements.","authors":"Danilo Coco, Silvana Leanza","doi":"10.1007/s11701-025-02843-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02843-y","url":null,"abstract":"<p><p>The adrenal glands are small but vital endocrine organs responsible for hormone production, which is essential for stress response, fluid balance, and blood pressure regulation. Adrenalectomy, the surgical removal of one or both adrenal glands, is indicated in various benign and malignant conditions such as pheochromocytomas, aldosterone-producing adenomas, and adrenocortical carcinoma. Historically performed via open surgery, adrenalectomy has evolved significantly with the introduction of laparoscopic adrenalectomy in the 1990s and more recently, robotic adrenalectomy. Robotic adrenalectomy enhances surgical precision through 3D visualization, articulated instruments, and improved ergonomics, thereby addressing the limitations inherent to laparoscopic adrenalectomy. This narrative review synthesises the findings from pivotal studies that compare the perioperative outcomes of robotic adrenalectomy and laparoscopic adrenalectomy. Robotic adrenalectomy demonstrates favourable outcomes in terms of operative precision, reduced estimated blood loss, and comparable or shorter hospital stay, especially in complex scenarios involving obesity, large tumours, or altered anatomy. Complication rates remain low, and R0 resection rates exceed 95% in well-selected malignancies, supporting the oncological adequacy of robotic adrenalectomies. While robotic adrenalectomy offers superior surgeon ergonomics and a relatively short learning curve, its high initial costs and lack of tactile feedback present notable limitations. Technological advancements, including high-definition 3D optics, fluorescence imaging, and artificial intelligence integration, have further refined the potential of robotic adrenalectomies. However, the evidence remains largely retrospective, with limited prospective randomised trials evaluating long-term outcomes and cost-effectiveness. Robotic adrenalectomy appears to be particularly advantageous in complex adrenal cases, offering a safe, minimally invasive option with the potential for improved recovery and surgical outcomes. Future research should focus on the long-term oncologic efficacy, patient-reported outcomes, and economic sustainability of robotic adrenalectomy in diverse clinical settings. Robotic adrenalectomy represents a significant milestone in adrenal surgery, with growing evidence supporting its selective use as a preferred approach in experienced centres and in appropriately chosen patients.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"659"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213859","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 emergency general surgery, future or fallacy?: case-matched comparison of operative and clinical outcomes during the adoption phase in a tertiary centre.","authors":"Kirsty Cole, Azita Shahdoost-Rad, Youssef Ibrahim, Grace Chaplin, Philip H Pucher","doi":"10.1007/s11701-025-02851-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02851-y","url":null,"abstract":"<p><strong>Aims: </strong>Robotic surgery continues to expand rapidly in elective settings; however, its role in emergency care is limited to date. This study aims to evaluate the safety and feasibility of the adoption of robotic emergency general surgery (EGS) within a high-volume centre.</p><p><strong>Methods: </strong>Robotic EGS cases performed between 2020 and 2024 at a large UK university hospital were identified and matched 1:3 to non-robotic cases based on operation type, age, gender, and pathology. Data on demographics, operative details, and operative and clinical outcomes were collected. Groups were compared using appropriate statistical tests.</p><p><strong>Results: </strong>A total of 369 patients were included, with 95 (25.7%) in the robotic and 274 (74.3%) in the non-robotic (open/laparoscopic) EGS group. There were no differences between groups for demographics, procedures, or pathology. No statistically significant differences were observed in major complications (10.5% vs 9.1%, p = 0.688), conversion to open surgery (1.1% vs 3.9%, p = 0.174), post-operative length of stay (4 vs 3 days, p = 0.814), and 6-month mortality (0.0% vs 2.9%, p = 0.092) between robotic and non-robotic groups. Adjusted analyses showed no association between surgical approach and differences in operative time, major complications, or post-operative stay.</p><p><strong>Conclusion: </strong>The introduction of robotic emergency general surgery is safe and feasible with comparable short-term clinical outcomes to non-robotic approaches. Further research is needed to explore the impact of an established robotic EGS programme on long-term clinical, patient, and surgeon-reported outcomes.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"657"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207931","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":"Laparoscopic versus robot-assisted nephroureterectomy for management of upper-tract urothelial carcinoma.","authors":"Saad Alshahrani, Amany Ahmed Soliman, Ashraf H Abdellatif, Abd El-Fattah Al Sheikh, Ayman Mohammed Abdulmohaymen, Mosab A A Alzubier","doi":"10.1007/s11701-025-02849-6","DOIUrl":"https://doi.org/10.1007/s11701-025-02849-6","url":null,"abstract":"<p><p>Upper tract urothelial carcinoma (UTUC) is a rare urothelial malignancy. Radical nephroureterectomy (RNU) remains the standard of care for UTUC. Use of robot-assisted nephroureterectomy (RANU) has grown to be the favored approach for management of UTUC. The present study aimed to compare operative and postoperative outcomes of laparoscopic nephroureterectomy (LNU) and RANU in studies with matched and unmatched cohorts. The present study was conducted according to the Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines. Selected keywords and MeSH (Medical Subject Headings) terms were used to search Web of Science, Scopus and Pubmed databases for relevant literature. Quality of studies included in this work were assessed using the Newcastle-Ottawa scale (NOS) for cohort studies. Extracted data were statistically analyzed and presented using Revman software. The 21 studies included in this meta-analysis were conducted on 32,882 patients. They comprised 22,624 patients (68.8%) who underwent LNU and 10,258 patients (31.2%) who underwent RANU. There were 7 studies that compared matched cohorts (19,984 patients, 60.8%) and 14 studies that compared unmatched groups (12,898 patients, 39.2%). RANU was associated with shorter duration of hospital stay in studies with matched cohorts, [mean difference (95% CI): 1.65 (0.49-2.81)], studies with unmatched cohorts [mean difference (95% CI): 0.93 (0.35-1.50)], and in all studies [mean difference (95% CI): 1.13 (0.66-1.60)]. Also, it was found that RANU was associated with significantly higher odds of lymph node dissection in the matched cohorts' studies [OR (95%): 0.58 (0.43-0.79)], unmatched cohorts' studies [OR (95%): 0.39 (0.30-0.51)] and all studies [OR (95% CI): 0.44 (0.35-0.55)]. Pooled analysis of all studies, studies with matched cohorts and studies with unmatched cohorts found that LNU and RANU had comparable operative duration, frequency of positive surgical margin, frequency of intraoperative complications, frequency of overall postoperative complications and frequency of hospital readmission. Discrepancies existed between different subsets regarding harvested lymph nodes count, estimated blood loss, major postoperative complications, postoperative blood transfusions and postoperative mortality. RANU had shorter hospital stay and higher odds of lymph node dissection. Also, RANU had comparable operative duration, frequency of positive surgical margin, frequency of intraoperative complications frequency of overall postoperative complications and frequency of hospital readmission when compared with LNU regardless cohorts matching.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"655"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207935","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":"Integration of robotics as standard surgical procedure during residency training for visceral surgery using a balanced scorecard (BSC).","authors":"Jessica Stockheim, Susanne Boehm, Mihailo Andric, Aristotelis Perrakis, Roland S Croner","doi":"10.1007/s11701-025-02833-0","DOIUrl":"https://doi.org/10.1007/s11701-025-02833-0","url":null,"abstract":"<p><p>Advancements in robotic assistance systems increased the number of robotic procedures. Successfully integrating robotics requires structured, effective management strategies and comprehensive training programs. The study aimed to develop a Balanced Scorecard (BSC) for the \"Robotic Curriculum for young Surgeons\" (RoCS) to establish robotic surgery as a standard surgical procedure during residency training for visceral surgery'. Strategic goals, derived from the department's vision, mission, and strategy, were assigned to four perspectives: (1) financial, (2) patient, (3) internal processes, (4) learning and development. Key performance indicators (KPIs) and their allocation to strategic goals were assessed through expert interviews and visualized in a strategy map. Data analysis was performed retrospectively comparing 2023 to 2022. Twenty KPIs were validated as suitable for tracking progress toward the 17 established strategic goals. Four performance indicators were considered susceptible to subjective influences. Expert interviews identified two additional KPI recommendations. The BSC and strategy map show the KPI relationship and their impact on strategic goals. Yearly comparison showed an overall improvement of eight KPIs. The RoCS-BSC represents an adaptable management tool tailored to fulfill the healthcare system's requirements for implementing robotic-assisted surgery, covering patient care, surgical quality, education, and economic considerations. This study places clinical training in visceral surgery within an economic context by integrating healthcare system components. The RoCS-BSC offers a supporting framework to facilitate the systematic integration of robotic operations as a standard procedure in the surgical training of future generations.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"656"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208001","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":"A systematic review of global experiences with Medtronic's Hugo™ robotic system for robot-assisted partial nephrectomy.","authors":"Saif Toubasey, Mehrshad Sultani Tehrani, Andrew Shepherd, Noah Beetge, Arun Thakur, Mughilan Muralitharan, Mohammed Hegazy, Samuel Davies, Ben Challacombe","doi":"10.1007/s11701-025-02818-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02818-z","url":null,"abstract":"<p><p>Robotic-assisted partial nephrectomy (RAPN) has become a widely used modality for the excision of renal tumours. Medtronic's Hugo™ Robotic-Assisted Surgery (RAS) system has emerged as a promising alternative to the established Intuitive da Vinci® platform. Due to increasing use, this systematic review has been conducted to assess the safety and efficacy of the Hugo™ RAS system for RAPN. A comprehensive search was conducted to identify eligible studies that reported outcomes and experience of using the Hugo™ system for RAPN. Following appropriate screening and risk of bias assessment using ROBINS-I, results were collated into a narrative synthesis. Eight studies were included in the review. Within these, 145 patients had undergone RAPN using the Hugo™ system. These studies comprised one comparative and seven single-arm case series. Patient demographics, peri-operative outcomes, pathological outcomes and safety and feasibility parameters were extracted from the included studies. Across all these metrics, the Hugo™ system performed well. One notable finding was longer docking times compared to the da Vinci® system; however, with increasing experience and familiarity with this novel platform, this is expected to decrease. Despite the lack of high-quality evidence and few studies, the Hugo™ RAS system is a feasible option for conducting RAPN. It offered comparable and promising initial outcomes in several aspects compared to da Vinci®, alongside flexibility in docking setup. Further large-scale comparative studies are needed to corroborate the findings of this review and evaluate the longer term safety and efficacy of the Hugo™ RAS system for RAPN.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"654"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207987","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":"Enhanced recovery and reduced opioid requirements following robot-assisted minimally invasive gastrectomy: a retrospective cohort study.","authors":"Katrin Winter, Nader El-Sourani, Carsten Szardenings, Ann-Kathrin Eichelmann, Jennifer Merten, Andreas Pascher, Mazen A Juratli, Jens Peter Hoelzen","doi":"10.1007/s11701-025-02839-8","DOIUrl":"https://doi.org/10.1007/s11701-025-02839-8","url":null,"abstract":"<p><p>Gastric cancer requires surgical resection for cure, with robot-assisted minimally invasive gastrectomy (RAMIG) emerging as an alternative to open gastrectomy (OG). Comparative data on postoperative pain and recovery remain limited. This study aimed to compare RAMIG versus OG in patients with resectable gastric cancer, focusing on postoperative opioid consumption, pain intensity, and recovery parameters. In this retrospective cohort study, 138 patients with resectable gastric cancer underwent either RAMIG (n = 39) or OG (n = 99) between May 2021 and August 2023. Primary endpoints were pain intensity (Numerical Rating Scale (NRS)) and opioid consumption. Secondary endpoints comprised intensive/intermediate care (ICU/IMC) and hospital stays, blood loss, severe complications, and operative duration. Statistical analysis used SPSS version 29.0 with Mann-Whitney U and Fisher's exact tests (p < 0.05). RAMIG showed reduced opioid consumption (p = 0.002) and lower NRS scores during mobilization on days 5 and 7 (p = 0.011; p = 0.002) and at rest on day 7 (p = 0.005). The RAMIG group experienced significantly shortened ICU/IMC stays (p < 0.001), reduced hospitalization duration (p < 0.001), and decreased intraoperative blood loss, although operative duration was prolonged. RAMIG demonstrates favorable outcomes regarding opioid requirements, pain management, ICU/IMC and hospital stays, and blood loss compared to OG, despite longer operative duration. These findings support RAMIG as an effective approach enabling accelerated recovery in patient-centered care, though prospective randomized validation studies are warranted. Trial registration: DRKS00036368, retrospectively registered 11th of March 2025.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"653"},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207955","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}