Journal of Robotic Surgery最新文献

{"title":"Effectiveness of modified surgical position on patients undergoing robot-assisted laparoscopic radical prostatectomy: a systematic review and meta-analysis.","authors":"Chuanliang Zhang, Lei Zhao, Xuchuan Zhou, Yaqian Yu, Nan Wang, Yifang Hou, Ming Xiao, Guowei Zeng","doi":"10.1007/s11701-025-02896-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02896-z","url":null,"abstract":"<p><p>To systematically evaluate the comparative efficacy of modified versus conventional positioning in robot-assisted laparoscopic radical prostatectomy (RALP) for prostate cancer.  We systematically searched PubMed, Web of Science (WOS), China National Knowledge Internet (CNKI), VIP Database, and Wanfang Databases up to August 2025 for randomized controlled trials (RCTs). Two investigators independently screened studies, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool. Meta-analysis was performed using RevMan 5.3, calculating mean differences (MD) for continuous outcomes and odds ratios (OR) for dichotomous outcomes, with 95% confidence intervals (CIs). Seven RCTs involving 719 patients (380 modified vs. 339 conventional) were included. Modified positioning significantly reduced operative time (MD: - 11.92 min, 95% CI: - 21.04 to - 2.80, P = 0.01) and positioning time (MD: - 3.79 min, 95% CI: - 4.73 to - 2.85, P < 0.001). It lowered risks of adverse events ( OR:0.24, 95% CI:0.11 to 0.51, P = 0.0002), robotic arm collisions (OR: 0.10, 95% CI: 0.02 to 0.47, P = 0.003), and second docking requirements (OR: 0.08, 95% CI: 0.01 to 0.42, P = 0.003). No significant intergroup difference was observed in blood loss (MD: - 1.55 mL, 95% CI: - 5.25 to 2.15, P = 0.41). Modified positioning enhances both safety and efficiency in RALP by reducing operative duration, minimizing robotic technical challenges, and decreasing perioperative complications. These findings strongly advocate for its adoption in standard clinical practice to optimize surgical workflows and improve patient outcomes.Registration: Registration number (PROSPERO): CRD 42024616927, registered on 2/12/2024.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"698"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309647","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 pyeloplasty in ureteropelvic junction obstruction (UPJO): a systematic comparison of single- and multiple-port techniques.","authors":"Ying Liu, Jing He, Lei Wang, Zhi Wen, Yan-Wen Zhang, Qiong Yuan, Xue-Mei Xu","doi":"10.1007/s11701-025-02840-1","DOIUrl":"https://doi.org/10.1007/s11701-025-02840-1","url":null,"abstract":"<p><p>In recent years, the utilization of single-port robotic-assisted pyeloplasty (SP-RP) has been growing. However, it is still unclear whether it offers better outcomes relative to multi-port robotic-assisted pyeloplasty (MP-RP). To investigate this, a meta-analysis was executed comparing the perioperative and functional outcomes between SP-RP and MP-RP. We systematically searched SinoMed, Google Scholar, Embase, PubMed, and Scopus, up to June 1, 2025. All outcomes were pooled using a random-effects model, heterogeneity was assessed using both I² and τ². Additionally, sensitivity analyses were executed to stabilize results with high heterogeneity. This meta-analysis included 229 patients from seven studies, who underwent either SP-RP or MP-RP. Regarding surgical success rates, patients undergoing SP-RP or MP-RP demonstrated comparable effectiveness (RR = 1.00, 95% CI 0.96 to 1.06, P = 0.87, I² = 0%, τ² = 0). Compared to patients receiving MP-RP, patients undergoing SP-RP showed similar results in surgery time (WMD = -2.81 min, 95% CI -20.94 to 15.32 min, P = 0.76, I² = 72%, τ² = 409.36), blood loss(WMD =  -3.97 ml, 95% CI -9.25 to 1.30 ml, P = 0.14, I² = 32%, τ² = 12.61), complication rates(RR = 0.90, 95% CI 0.42 to 1.92, P = 0.78, I² = 0%, τ² = 0), length of hospital stay (WMD = -0.42 days, 95% CI -0.90 to 0.06 days, P = 0.09, I² = 74%, τ² = 0.25), pain scores at discharge (WMD = 0.23, 95% CI -0.52 to 0.97, P = 0.55, I² = 37%, τ² = 0.17), and renal function recovery(WMD = 0.79 mL/min/1.73 m², 95% CI -4.59 to 6.17 mL/min/1.73 m², P = 0.77, I² = 67%, τ² = 10.88). Statistically, the differences between the two were not significant. However, during the sensitivity analysis, compared to MP-RP, we found that excluding Beksac's study led to a significantly shorter hospital stay for SP-RP. This exclusion also reduced heterogeneity, resulting in more stable outcomes (WMD = -0.31 days, 95% CI -0.56 to -0.06 days, P = 0.01, I² = 0%, τ² = 0). SP-RP offers comparable effectiveness and safety to MP-RP, with consistently better cosmetic outcomes. A possible reduction in hospital stay was observed only in the sensitivity analysis and should be interpreted with caution.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"697"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309547","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 transvesical simple prostatectomy with circumferential mucosal anastomosis: long-term urinary and sexual function outcomes in a 292 patient cohort.","authors":"Luke Shumaker, Zev Leopold, Max Perilstein, Samuel Ricci, Daniel Eun","doi":"10.1007/s11701-025-02879-0","DOIUrl":"10.1007/s11701-025-02879-0","url":null,"abstract":"<p><p>To assess the long-term urinary and sexual function outcomes for men undergoing robotic-assisted simple prostatectomy (RASP) with circumferential mucosal anastomosis performed at a single, high-volume robotics center. RASP cases performed by a single surgeon from June 2013 through June 2024 using the da Vinci^® Xi robotic system were analyzed. Indications for surgery were bothersome lower urinary tract symptoms (LUTS) refractory to medical management and prostate volume ≥ 80 g. Urinary function and sexual function parameters were assessed by the American Urologic Association Symptoms Score (AUASS) and Sexual Health Inventory for Men (SHIM), respectively at routine 6-month postoperative visits. A uniform phone survey was conducted in September 2024, which assessed long-term functional outcomes by combining AUASS with questions on incontinence, erectile function, and orgasm. A Wilcoxon signed rank test was utilized to compare pre- and postoperative IPSS and SHIM scores with p < 0.05 considered significant. 292 patients underwent RASP during the query interval and were included in the perioperative analysis with a mean follow-up time of 22.6 months (SD ± 15.2). Mean preoperative AUASS was 17.9 (SD ± 7.9). Mean postoperative AUASS was 5.7 (SD ± 5.2); W-statistic 352.0 (p < 0.001). Bother scores preoperative mean was 4.3 (SD ± 1.5), with postoperative values of 1.1 ± 1.4; W-statistic 395.0 (p < 0.001). Sexual Health Inventory for Men (SHIM) scores demonstrated a preoperative mean of 12.8 (SD ± 8.1). Postoperatively, the SHIM mean was 12.6 (SD ± 8.5); W-statistic: 4462.0 (p = 0.57). No patients required reoperation for LUTS, although one patient underwent completion prostatectomy for malignancy identified on RASP pathology. No patients developed bladder neck contracture. Calls were placed to 288 patients (98.6% of total cohort) at a mean follow up of 66 (SD ± 34.7) months postoperatively, of which 198 (68.8%) answered and consented to survey participation. At the time of the follow-up survey, mean IPSS was 2.1 (SD ± 1.9), mean quality of life score was 0.7 (SD ± 0.8). With respect to continence, 196/198 (98.9%) patients experienced no stress incontinence. Two patients (1%) experienced urge incontinence and one patient (0.5%) utilized an incontinence pad. Regarding sexual activity, 157 (79.3%) patients were sexually active at the time of survey compared to 159 (80.3%) prior to surgery. Of those who remained sexually active, 152 (96.8%) were satisfied with postoperative orgasm, and 149 (94.9%) were satisfied with postoperative erectile function. Notably, 11 (7.0%) of men endorsed a \"bothersome or distressing\" orgasm change. RASP has a low complication rate, low risk of urinary incontinence, no significant impact on erectile function, and provides durable improvements in lower urinary tract symptoms. A small portion of men do experience sustained, bothersome orgasm change following RASP.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"693"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304163","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":"Reply to \"Ensuring clinical translation of the Hernia ASCEND Hugo™ RAS training pathway: the need for outcome validation and anatomical accuracy\".","authors":"Francesco Brucchi, Gianlorenzo Dionigi, Filip Muysoms","doi":"10.1007/s11701-025-02887-0","DOIUrl":"10.1007/s11701-025-02887-0","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"696"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309492","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":"Application of artificial intelligence in esophageal surgery: a systematic review.","authors":"Janosch Kröger, Nicolas Jorek, Alexander Seitel, Leon Mayer, Gabriel A Salg, Nerma Crnovrsanin, Frank Pianka, Thomas Pausch, Lena Maier-Hein, Christoph Michalski, Henrik Nienhüser","doi":"10.1007/s11701-025-02854-9","DOIUrl":"10.1007/s11701-025-02854-9","url":null,"abstract":"<p><p>The aim of this systematic review was to summarize and analyze the available literature on the application of artificial intelligence systems in esophageal surgery, focusing on anatomy recognition, instrument detection, and surgical phase recognition. Esophageal cancer poses a significant global health challenge, ranking as the seventh most common cancer worldwide. Esophagectomy is the only curative treatment for non-metastatic esophageal cancer. While the introduction of minimally invasive esophagectomy and later robot-assisted minimally invasive esophagectomy significantly improved surgical precision and patient outcome, this development promoted a transition to increasing digitalization and video processing. Subsequently facilitating the integration of artificial intelligence is a promising tool in the enhancement of esophageal surgery. A systematic search was conducted following the PRISMA guidelines in the Medline and Web of Science databases. Studies published between January 2019 and June 2025 published in English and without restrictions to study type were included. Inclusion criteria focused on artificial intelligence-based anatomy recognition, instrument recognition, and phase recognition in esophageal surgery. Studies addressing preoperative and postoperative risk prediction or artificial intelligence applications not directly related to the surgical procedure were excluded. The systematic literature search yielded 7063 results. After screening, we identified six studies examining artificial intelligence applications in esophagectomy focusing on anatomy, instrument, and phase recognition. Artificial intelligence can be a useful tool-especially for intraoperative anatomy recognition-reaching detection rates comparable to trained surgeons in real time as seen in one study, reaching a Dice coefficient of 0.58, which was close to that of an expert esophageal surgeon (0.62) and significantly higher than the general surgeon (0.47, p= 0.0019). Due to the heterogeneity of study aims, utilized algorithms and outcome measures direct comparison between studies was not feasible. Artificial intelligence has demonstrated significant potential in enhancing esophageal surgery by improving anatomical recognition and optimizing surgical workflow. Despite these advancements, challenges remain in standardizing datasets, refinement of annotation methodologies, and seamless integration into real-time surgical navigation systems. To ensure clinical applicability, future research should focus on large-scale validation and prospective clinical trials to establish artificial intelligence's clinical utility and safety in minimally invasive esophagectomy.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"694"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304062","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":"Prospective study of a structured robotic surgery training program in a public cancer hospital in Brazil.","authors":"Ricardo Zugaib Abdalla, William Carlos Nahas, Ivan Cecconello, Ulysses Ribeiro","doi":"10.1007/s11701-025-02881-6","DOIUrl":"https://doi.org/10.1007/s11701-025-02881-6","url":null,"abstract":"<p><p>The implementation of robotic surgery represents a major advance for oncological surgical care, particularly in public health systems, but requires robust training and proctorship for established surgeons. To assess surgeon performance and clinical outcomes following a structured, proctored training program for robotic surgery in a Brazilian public cancer hospital. This prospective, randomized trial (ClinicalTrials.gov: NCT02292914, https://clinicaltrials.gov/ct2/show/NCT02292914 ) recruited 564 cancer patients (2014-2020) for either robotic (n = 326) or control (laparoscopic/open, n = 238) procedures. Sixteen surgeons (> 10 years oncology experience) underwent a standardized four-stage laboratory and perioperative proctored curriculum. Outcomes included operative duration, blood loss, lymph node yield, and intraoperative complications. Data were analyzed in IBM-SPSS v20.0 (chi-square, Fisher's exact, Mann-Whitney, paired t-test, GEE; p < 0.05). All surgeons completed the laboratory curriculum; eight met full operative certification criteria. Robotic procedures took longer than controls (mean 304.9 vs 259.1 min; p < 0.001), with significantly less blood loss (mean 266.2 vs 598.2 mL; p < 0.001). Lymph node yields and complication rates did not differ. Operative durations decreased with experience. Structured, proctored training enabled safe transition to robotic surgery in this high-volume public cancer center. The model is scalable and adaptable to other institutions and innovations in public hospitals.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"695"},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304137","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":"Transition to robotic surgery in urologic oncology: a comparative analysis between pre-robotic and robotic eras in a high-volume tertiary center.","authors":"Angelo Porreca, Luca Di Gianfrancesco, Davide De Marchi, Francesca Simonetti, Marina Coppola, Antonella Stefano, Pietro Gallina, Antonio Amodeo, Gianpaolo Franzoso, Alessandro Giuriola, Susy Dal Bello, Filippo Marino","doi":"10.1007/s11701-025-02862-9","DOIUrl":"10.1007/s11701-025-02862-9","url":null,"abstract":"<p><p>The transition from open and laparoscopic techniques to robotic-assisted surgery has transformed the landscape of urologic oncology. However, few studies have directly compared institutional outcomes before and after the adoption of robotic platforms. The objective is to evaluate the clinical and organizational impact of implementing robotic surgery by comparing perioperative outcomes and hospital metrics between the pre-robotic era (2019-2020) and the robotic era (2021-2023) in a high-volume tertiary referral center. A retrospective cohort analysis was conducted on patients undergoing radical prostatectomy (RP), partial nephrectomy (PN), or radical cystectomy (RC) between January 2019 and December 2023. Surgical approach was laparoscopic (RP, PN) or open (RC) during 2019-2020, and robotic for all procedures from 2021 onward. Data on operative time, length of stay (LOS), extended hospitalizations (> 15 days), and 30-day readmissions were collected and compared between the two periods. A total of 1179 procedures were performed, with a marked increase in surgical volume after the implementation of robotic platforms (189 procedures in 2019-2020 vs. 990 in 2021-2023). The robotic era was associated with a significant reduction in median LOS across all procedures: RP (7.5-3.0 days), PN (6.5-4.1 days), and RC (15.5-7.3 days). The rate of extended hospitalizations dropped from 20.3 to 2.1% overall. Readmission rates remained stable, except for RC, which maintained a higher rate in both eras. Operative times remained comparable between the two periods. The transition to robotic-assisted surgery was associated with a substantial increase in surgical volume and significant improvements in perioperative outcomes, including shorter hospital stays and fewer prolonged admissions, while maintaining surgical safety. These results underscore that such improvements are primarily linked to the structured implementation of the program under the guidance of experienced robotic surgeons, rather than to the technology itself.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"692"},"PeriodicalIF":3.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294070","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":"\"Far beyond the shape\": an early head-to-head comparative urodynamic analysis of three contemporary totally intracorporeal robotic orthotopic neobladder techniques.","authors":"Umberto Anceschi, Salvatore Basile, Daniele Amparore, Fabrizio Di Maida, Riccardo Mastroianni, Sabrina De Cillis, Giulia D'Ippolito, Antonio Andrea Grosso, Gabriele Tuderti, Eleonora Rosato, Rocco Simone Flammia, Luca Lambertini, Aldo Brassetti, Francesco Lupo Conte, Enrico Finazzi Agrò, Cristian Fiori, Francesco Porpiglia, Andrea Minervini, Giuseppe Simone","doi":"10.1007/s11701-025-02821-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02821-4","url":null,"abstract":"<p><p>The expanding use of totally intracorporeal orthotopic neobladder (ICONB) reconstruction after robot-assisted radical cystectomy has fostered multiple configuration variants, yet robust comparative functional data remain limited. This early head-to-head study aimed to assess whether three contemporary ICONB configurations-Padua Ileal Neobladder, Florence Robotic Intracorporeal Neobladder (FloRIN), and a Y-shaped neobladder-deliver comparable urodynamic and continence outcomes despite anatomical nuances. Three prospectively maintained institutional cystectomy databases were merged. Patients who underwent robot-assisted radical cystectomy with ICONB and completed a standardized early multichannel urodynamic assessment were included. Cystometric capacity, compliance, residual peristaltic activity, leak point pressures, and functional continence (daytime and night-time) were compared across configurations. Functional recovery probabilities were estimated using Kaplan-Meier curves and compared with the log-rank test. Non-parametric tests were applied for other comparisons. A total of 142 patients were analyzed (Padua n = 45, FloRIN n = 49, Y-shaped n = 48). Median cystometric capacity was highest in the Padua configuration (346 mL [IQR 272-400]) versus FloRIN (269 mL [242-305]) and Y-shaped (245 mL [200-290]; p < 0.001). Compliance was most favorable in FloRIN (22 mL/cmH₂O [15-27]) compared to Padua (16 [11-41]) and Y-shaped (12 [10-19]; p = 0.029). Residual peristaltic activity and leak point pressures showed minor differences without functional impact. Daytime continence rates were similar (Padua 80%, FloRIN 83%, Y-shaped 79%; p = 0.40); night-time continence followed the same pattern (65%, 70%, 66%; p = 0.30). Kaplan-Meier curves demonstrated overlapping functional recovery trajectories (daytime p = 0.744; night-time p = 0.122). This early head-to-head comparison suggests that when core reconstructive principles are met, contemporary totally intracorporeal neobladder configurations yield distinct urodynamic profiles but comparable functional outcomes. Future efforts should define clear qualitative and temporal standards for urodynamic monitoring to support consistent functional evaluation as robotic cystectomy adoption expands.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"689"},"PeriodicalIF":3.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287313","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":"Preliminary clinical experience with a robot-assisted system in preoperative hookwire localization of pulmonary nodules: a prospective pilot study.","authors":"Pengfei Li, Wenheng Zheng, Zheng Wang, Xueling Zhang, Zhuang Tong, Liang Zhang, Hehuan Yao, Chenlei Zhang, Gebang Wang, Yu Liu, Zheyu Liu, Yegang Ma, Weiguo Xie, Bingding Huang, Hongxu Liu","doi":"10.1007/s11701-025-02824-1","DOIUrl":"10.1007/s11701-025-02824-1","url":null,"abstract":"<p><p>Accurate preoperative localization is critical for the surgical resection of small pulmonary nodules, yet conventional CT-guided hookwire placement remains operator-dependent and technically demanding. This prospective study evaluated the clinical performance of a robot-assisted navigation system for CT-guided preoperative hookwire localization of pulmonary nodules. The trial enrolled 60 patients scheduled for localization followed by VATS. Primary endpoints included first-attempt puncture success rate, needle placement accuracy, localization success rate, procedure duration, number of punctures, radiation dose, and complication rate, with subgroup analyses by lesion characteristic and patient positioning. The first-attempt puncture success rate was 100.0%, with an median needle placement accuracy of 5.7 mm (IQR 4.2-7.9). Localization success was achieved in 94.8% of nodules (55/58). The median procedure duration was 16.6 min (14.0-22.9), and the median radiation dose was 281.2 mGy·cm (227.1-365.8). The overall complication rate was 5.2% (3/58). Accuracy was consistent across subgroups, although lower lobe lesions and prone positioning were associated with longer procedure times, and prone positioning also increased radiation exposure, without compromising accuracy. These findings demonstrate the feasibility, precision, and safety of this system, supporting its potential to standardize and improve preoperative localization in thoracic surgery. Trial registration: Registry: https://www.chictr.org.cn/ , TRN: ChiCTR2500095919, Registration date: January 15, 2025.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"690"},"PeriodicalIF":3.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287314","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":"Quality assessment of patient-facing urologic telesurgery content using validated tools.","authors":"Tarak Davuluri, Paul Gabriel, Matthew Wainstein, Obi Ekwenna","doi":"10.1007/s11701-025-02871-8","DOIUrl":"10.1007/s11701-025-02871-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;With increasing accessibility to Artificial Intelligence (AI) chatbots, the precision and clarity of medical information provided require rigorous assessment. Urologic telesurgery represents a complex concept that patients will investigate using AI. We compared ChatGPT and Google Gemini in providing patient-facing information on urologic telesurgical procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;19 questions related to urologic telesurgery were generated using general information from the American Urologic Association (AUA) and European Robotic Urology Section (ERUS). Questions were organized into 4 categories (Prospective, Technical, Recovery, Other) and directly typed into ChatGPT 4o and Google Gemini 2.5 (non-paid versions). For each question, a new chat was started to prevent any continuation of answers. Three reviewers independently reviewed the responses using two validated healthcare tools: DISCERN (quality) and Patient Education Material Assessment Tool (understandability and actionability).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mean DISCERN scores (out of 80) were higher for Gemini than ChatGPT in all domains except \"Other\". Prospective 49.2 versus 39.1; technical 52.3 versus 44.3; recovery 53.7 versus 45.4; other 54.3 versus 56.5; overall 52.4 versus 45.8 (Fig. 1). PEMAT-P understandability uniformly exceeded 70% for both platforms: prospective 80.0% versus 71.7%; technical 80.1% versus 79.8%; recovery 79.2% versus 80.1%; other 79.2% versus 81.3%; overall 79.7% versus 78.1% (Fig. 2). Actionability was uniformly low; only Gemini met the 70% threshold in the prospective domain (Fig. 3). Fig. 1 A Mean DISCERN scores (out of 5) with standard deviations for each response B Mean total DISCERN scores (out of 80) among each question category and overall. Numerical representation in the graph was rounded to the closest whole number for easier interpretation. Graphed value is still the true value. [56.5 represented numerically as 57, etc.…] Fig. 2 A Mean PEMAT-P Understandability scores with standard deviations for each response B Mean PEMAT-P Understandability scores among each question category and overall (70% minimum threshold for responses to be deemed \"understandable\"). Numerical representation in the graph was rounded to the closest whole number for easier interpretation. Graphed value is still the true value. [71.70% represented numerically as 72%, etc.…] Fig. 3 A Mean PEMAT-P Actionability scores with standard errors for each response B Mean PEMAT-P Actionability scores among each question category and overall (70% is the minimum threshold for responses to be deemed \"actionable\"). Numerical representation in the graph was rounded to the closest whole number for easier interpretation. The graphed value is still the true value. [65.40% represented numerically as 65%, etc.…] CONCLUSION: ChatGPT and Gemini deliver relevant and understandable information related to urologic telesurgery, with Gemini more consistently ","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"687"},"PeriodicalIF":3.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287230","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}