Journal of Robotic Surgery最新文献

{"title":"Da Vinci-assisted vs laparoscopic nissen fundoplication for GERD: a systematic review and meta-analysis of randomized controlled trials on patient-reported outcomes, dysphagia, and long-term failure.","authors":"Wajahat Mirza, Mehak Ejaz Khan, Muhammad Uneeb, Hadi Mohammad Khan, Sundus Dadan, Abdul Rafeh Awan, Muhammad Ahmad Nadeem, Hamza Nasir Chatha","doi":"10.1007/s11701-025-02869-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02869-2","url":null,"abstract":"<p><p>The comparative effectiveness of da Vinci robot-assisted versus conventional laparoscopic Nissen fundoplication for gastroesophageal reflux disease remains controversial despite increasing adoption of robotic platforms. Previous meta-analyses have yielded conflicting results regarding patient-centered outcomes and long-term durability. We conducted a systematic review and meta-analysis of randomized controlled trials comparing da Vinci-assisted versus conventional laparoscopic Nissen fundoplication. This review was prospectively registered with PROSPERO (CRD420251139110). We searched MEDLINE, Embase, Cochrane CENTRAL, Web of Science, Scopus, ClinicalTrials.gov, WHO ICTRP, and grey literature sources through August 2025. Primary outcomes included postoperative dysphagia, proton pump inhibitor use, and intraoperative complications. Secondary outcomes encompassed reoperation rates, operative time, length of stay, and conversion to open surgery. Risk ratios and mean differences were calculated using random-effects models. Evidence certainty was assessed using the GRADE methodology. Four randomized controlled trials involving 160 patients (79 robotic, 81 conventional laparoscopic) met the inclusion criteria. No significant differences were observed in early dysphagia (RR 1.05, 95% CI 0.45-2.45), postoperative proton pump inhibitor use (RR 0.97, 95% CI 0.25-3.79), or intraoperative complications (RR 0.43, 95% CI 0.07-2.81). Secondary outcomes showed no differences in reoperation rates (RR 1.65, 95% CI 0.40-6.90), length of hospital stay (MD -0.03 days, 95% CI -0.41 to 0.36), or conversion rates (RR 1.23, 95% CI 0.19-7.99). Operative time demonstrated substantial heterogeneity; sensitivity analysis revealed significantly longer times with robotics when one outlier study was removed (MD 40.28 min, p < 0.00001). Da Vinci robot-assisted and conventional laparoscopic Nissen fundoplication achieve equivalent clinical outcomes with no significant differences in patient-reported outcomes, complications, or long-term effectiveness, while robotic procedures consistently require longer operative times and substantially higher costs without demonstrable clinical benefits. These findings question the routine application of robotic platforms in antireflux surgery until cost-effectiveness and operative efficiency are optimized.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"678"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276391","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":"Accuracy comparison between active robot and freehand techniques in modified mid-segment-first extraction of impacted mandibular third molars: an in vitro study.","authors":"Bin-Zhang Wu, Qian-Xiao Liu, Xi-Yuan Luo, Ming-Pei Gao, Peng-Fei Jia, Li-Feng Wang, Hong Su, Zi-Yu Yan, Nian-Hui Cui","doi":"10.1007/s11701-025-02819-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02819-y","url":null,"abstract":"<p><p>This study compared the precision of cortical-window osteotomy and tooth sectioning performed with an active robotic system versus conventional freehand techniques during the modified mid-segment-first (MMSF) extraction of impacted mandibular third molars (M3Ms). The feasibility of applying active robotic technology to alveolar surgery was also assessed. Standardized mandibular replicas containing fully impacted horizontal M3Ms (n = 18 per group) were allocated into two groups: an active robot-assisted group (ARG) and a freehand group (FHG). For all specimens, preoperative CBCT scans were merged with intraoral digital impressions to design the osteotomy and tooth sectioning pathways. Primary endpoints were cortical bony window accuracy and tooth segmentation accuracy. Dice similarity scores were significantly higher in the ARG compared with FHG (0.90 ± 0.03 vs. 0.29 ± 0.09, p < 0.001). Root mean square (RMS) deviation (0.14 [0.10-0.22] mm vs. 1.39 [1.07-2.09] mm, p < 0.001) and angular deviation (2.02 [1.31-3.16]° vs. 19.48 [13.30-29.07]°, p < 0.001) were lower in the ARG group, as was bone injury depth (0.00 [0.00-1.15] mm vs. 2.21 [0.89-3.56] mm, p < 0.001). Both excessive and insufficient removal were significantly less frequent in robotic procedures (p < 0.001). Robotic-assisted MMSF extraction demonstrated greater precision, reduced invasiveness, and improved safety compared to freehand techniques in vitro. These findings support the preliminary feasibility of active robotic systems in alveolar surgery; however, as this was an in vitro study, further evaluation is needed to balance the gains in accuracy against the inherent limitations. This study provides the first quantitative in vitro evidence validating the technical feasibility of an active robotic platform for dentoalveolar surgery, laying the groundwork for future clinical applications.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"677"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276370","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":"Risk factors of inaccurate screw placement in robotic spine surgeries: why do robots make error and how to avoid them?","authors":"S Vidyadhara, R Dinesh Iyer, Abhishek Soni, T Balamurugan, Dhiyanesh Krishnamurthy","doi":"10.1007/s11701-025-02884-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02884-3","url":null,"abstract":"<p><p>The study design is retrospective study. Robotic spine surgery has evolved rapidly over the past two decades, with growing adoption. However, research on error sources in robotic-assisted pedicle screw placement remains scarce. This study investigates the incidence, risk factors, and intraoperative error types linked to screw malposition. We retrospectively analyzed patients who underwent robotic-assisted thoracic and lumbar spine surgeries at our center since Oct 2023. The incidence of screw breaches, intraoperative errors, and risk factors, such as BMI, pathology, and surgical approach, were assessed. Screw malpositions were identified on postoperative O-arm scans and classified by error cause. Intraoperative revision protocols were documented. A total of 1060 patients (5644 pedicle screws) were included. Screw malposition occurred in 13 patients (1.2%) involving 22 screws (0.39%). The mean BMI of patients with malposition was 27.3 versus 26.5 overall. Among the 13 cases, 8 had lumbar degenerative pathology, 3 scoliosis, 1 high-grade listhesis, and 1 revision for proximal junctional failure. Skiving was the most frequent error (6 cases), followed by arm shift (4), patient movement (2), and registration error (1). Learning curve had a significant role with 12/22 screw malpositioning happening in the initial 50 robotic cases. No significant correlation was found between malposition and pathology type or surgical approach. Robotic systems improve pedicle screw accuracy but are not immune to errors. Skiving is the most common issue and can be minimized by selecting flat bony entry points and avoiding sloping surfaces. Other causes include arm shift, patient movement, and registration errors.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"681"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276324","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":"KangDuo system versus da Vinci system for robot-assisted radical prostatectomy: a systematic review and meta-analysis based on prospective studies.","authors":"ZongYing Lv, Jing He, LiangSuo Zhang, GuiYuan Chen","doi":"10.1007/s11701-025-02834-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02834-z","url":null,"abstract":"<p><p>The da Vinci robotic platform, as the earliest operative platform implemented in routine clinical use, has been employed for various complex surgical conditions owing to its precision in manipulation. However, its prohibitive costs have restricted widespread adoption in certain regions. Consequently, China's domestically developed KangDuo robotic surgical platform was developed to address this need. Currently, comparative studies on perioperative outcomes between these two platforms for performing robot-assisted radical prostatectomy (RARP) remain scarce. This meta-analysis aims to systematically compare perioperative outcomes among these robotic platforms. A structured search of the literature was undertaken across several principal online databases-such as PubMed, Web of Science, the Cochrane Library, and SpringerLink-to locate prospective investigations comparing K-RARP with D-RARP published before August 1, 2025. The comparative outcomes across the two robotic systems consisted of total operating time, estimated intraoperative blood loss, length of hospitalization, urinary continence recovery, post-operative complications, and positive surgical margin rates. This quantitative synthesis included four comparative studies encompassing an aggregate of 188 participants. The results revealed no significant differences in PSM rates (OR 1.06, 95% CI 0.55-2.04; p = 0.86), estimated intraoperative blood loss (WMD - 1.04 ml, 95% CI - 21.72 to 19.63; p = 0.92), length of hospitalization (WMD - 0.32 days, 95% CI - 1.33 to 0.70; p = 0.54), urinary continence (OR 0.96, 95% CI 0.50-1.83; p = 0.90), when contrasting K-RARP with D-RARP. Moreover, no meaningful differences were detected in the incidence of Clavien-Dindo grade I complications (OR 1.14, 95% CI 0.33-3.89; p = 0.84), grade II complications (OR 1.11, 95% CI 0.39-3.18; p = 0.84), or overall complication incidence (OR 1.28, 95% CI 0.59-2.76; p = 0.53). However, for K-RARP, operative duration was significantly longer (WMD 41.34 min, 95% CI 22.42-60.26; p < 0.05). As the inaugural comparative assessment of perioperative outcomes between KangDuo and da Vinci robotic systems, this study demonstrated that while K-RARP required significantly longer operative times, it achieved comparable outcomes to D-RARP in EBL, positive surgical margin rate, hospital stay, continence, and complication rates. This evidence positions the KangDuo platform as a viable future option for localized prostate cancer management. However, this conclusion remains preliminary and exploratory, and will need to be confirmed through large-scale, multicenter, multi-regional randomized controlled trials combined with long-term follow-up.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"679"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276349","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 versus open esophagectomy: a propensity score-matched analysis from a tertiary cancer center in India.","authors":"Anupam Lahiri, Shaifali Goel, Abhishek Aggarwal, Syed Assif Iqbal, Anuj Mehta, Ullas Batra, Jaskaran Sethi, Shivendra Singh","doi":"10.1007/s11701-025-02870-9","DOIUrl":"https://doi.org/10.1007/s11701-025-02870-9","url":null,"abstract":"<p><p>Robotic esophagectomy has gained prominence over open esophagectomy for resectable esophageal cancer. However, high-quality comparative data remain limited, particularly from the Indian subcontinent. This study compares perioperative and long-term outcomes between robotic and open esophagectomy using propensity score matching. We analyzed 209 patients who underwent McKeown's total esophagectomy between January 2014 and December 2024 at a tertiary cancer center in India. Patients were divided into robotic (n = 156) and open esophagectomy (n = 53) groups. In robotic, the thoracic component was performed robotically, while cervical and abdominal phases used conventional open techniques. All anastomoses were handsewn in a tensionless, two-layer manner. Propensity score matching created 48 matched pairs. Primary outcomes were overall survival (OS) and disease-free survival (DFS). After propensity matching, the robotic cohort demonstrated superior 5-year overall survival (64.7% vs 53.4%, p = 0.045). Robotic showed significant advantages in reduced blood loss (174 vs 237.7 ml, p < 0.003), hospital stay (11.7 vs 14.4 days, p = 0.013), extubation day (0.4 vs 0.8 days, p = 0.008), and ICU duration (2.2 vs 3.4 days, p = 0.001). Respiratory complications requiring ICU were lower in the robotic cohort (8.3% vs 22.9%, p = 0.049). Robotic esophagectomy offers survival advantages over open esophagectomy with superior perioperative outcomes. This appears driven by reduced perioperative morbidity rather than enhanced cancer control, supporting robot adoption in experienced centers.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"672"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276384","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":"Improved operative efficiency with the da Vinci Xi: a comparative study of robotics and laparoscopic ventral mesh rectopexy.","authors":"Tuur Debbaut, Ahmed M Chaoui, Ismaël Chaoui, Joachim Geers, Frederick Olivier, Stijn Schepers, Roel Venken, Kurt Verbeke, Mohamed Abasbassi","doi":"10.1007/s11701-025-02848-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02848-7","url":null,"abstract":"<p><p>Laparoscopic ventral rectopexy (LVR) is a widely used technique in the treatment of rectal prolapse but faces limitations due to restricted working space within the narrow confines of the pelvic cavity and suboptimal ergonomics. The advent of robotic platforms, particularly the da Vinci Xi system, has offered solutions by enhancing visualization and precision. This study retrospectively compares outcomes between LVR and robotic ventral rectopexy (RVR), and between the da Vinci Si and Xi robotic systems. This retrospective cohort study analyzed 315 a consecutive series of patients who underwent minimally invasive ventral mesh rectopexy between March 2019 and October 2024 by a single operator at a single institution. Patients were divided into laparoscopic (n = 72) and robotic (n = 243) groups, with the robotic cohort further categorized into Si (n = 159) and Xi (n = 84) subgroups. The outcomes measures included operative time, console time, hospital stay and perioperative complications. The robotic group demonstrated a shorter median length of stay (1vs.2 days, p < 0.01) with similar operative times. Prior hysterectomy was associated with increased operative time, while age and redo surgery were not. The Xi platform significantly reduced operative and console times compared to the Si (80vs.100 min, p < 0.01; 55vs.68 min, p < 0.01). This is the first study to demonstrate that the robotic-assisted technique has shorter operative times as compared to laparoscopic technique. Among robotic platforms, the da Vinci Xi system further enhances these benefits, surpassing the Si platform in efficiency. These findings establish robotic rectopexy, particularly with the Xi system, as the preferred method for optimizing surgical outcomes in the surgical treatment of rectal prolapse syndromes.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"676"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276325","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 \"Critical appraisal of \"Proposal for the Hernia ASCEND Hugo™ RAS training pathway: acquisition of skills by comprehensive exercise‑based nimbleness and dexterity training\"\".","authors":"Francesco Brucchi, Gianlorenzo Dionigi, Filip Muysoms","doi":"10.1007/s11701-025-02886-1","DOIUrl":"10.1007/s11701-025-02886-1","url":null,"abstract":"<p><p>We appreciate the constructive comments by Haider et al. regarding our proposal for the Hernia ASCEND Hugo™ RAS training pathway. Their observations underscore key priorities for the ongoing refinement and validation of structured robotic hernia training. In our reply, we emphasize that the ASCEND framework is grounded in the Proficiency-Based Progression (PBP) model, which has demonstrated measurable improvements in surgical performance and safety across multiple specialties. We clarify that while our initial report did not include outcome data, multicenter validation studies linking ASCEND milestones to clinical endpoints are in progress. Moreover, we address concerns about generalizability and cost, reaffirming that ASCEND was independently designed by surgical educators and conceived as a modular and scalable program adaptable to diverse healthcare settings. We share the view that long-term validation should be guided by independent scientific societies to ensure neutrality and global comparability. Through these initiatives, ASCEND aims to contribute to the standardized, outcome-driven, and accessible adoption of robotic hernia surgery worldwide.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"673"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276369","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":"Robotic 3-arm Roux-en-Y gastric bypass: a feasible, safe and cost-effective approach based on patient selection.","authors":"Christian Omar Ramírez Serrano Torres, Daniel Antonio Domínguez Díaz, Aman Goyal, Jorge Quinto Ruiz, Paul Irving Castillo Cosío, Mathew Mendoza, Luigi Marano, Adel Abou-Mrad, Rodolfo J Oviedo","doi":"10.1007/s11701-025-02877-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02877-2","url":null,"abstract":"<p><p>Robotic-assisted Roux-en-Y gastric bypass (RYGB) is a well-established procedure in bariatric surgery, offering enhanced precision, ergonomics, and visualization. While the conventional four-arm robotic approach is widely used, it may increase operative costs and complexity. This report presents a case of a 33-year-old female with a BMI of 50.7 who underwent a robotic three-arm RYGB, aiming to evaluate the feasibility, safety, and efficiency of this streamlined technique. A modified three-port configuration was used, along with suture-based liver retraction. Key steps included gastric pouch creation, gastrojejunal and jejunojejunal anastomoses using stapled and hand-sewn techniques, and Roux limb configuration confirmed by methylene blue leak testing. The procedure was completed without intraoperative complications, with a console time of 120 min. The patient resumed oral fluids within 1 h, ambulated at 2 h, and was discharged within 24 h. No postoperative complications were observed. Compared to the standard four-arm approach, the three-arm technique maintained surgical efficacy while potentially reducing costs, postoperative pain, and improving reproducibility. This case highlights the potential utility of a three-arm robotic RYGB approach in select patients. Larger studies are needed to validate these findings and assess long-term outcomes, training adaptability, and scalability across surgical centers.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"675"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276390","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":"Orthopedic robotic surgery: multiple analytical approaches and a bibliometric study of the top 100 most cited papers.","authors":"Siddig Ibrahim Abdelwahab, Manal Mohamed Elhassan Taha, Abdullah Farasani, Jobran M Moshi, Abrar Fahad Alshahrani, Ahmad Assiri, Saeed Alshahrani, Muhammad H Sultan, Khaled A Sahli, Hussam M Shubaily, Waseem Hassan","doi":"10.1007/s11701-025-02876-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02876-3","url":null,"abstract":"<p><p>In the literature, three studies-each employing the Web of Science-bibliometrically analyzed orthopedic robotic surgery publications, identifying 224, 587, and 793 documents, respectively. We hypothesized that, based on a comprehensive search string, a larger set of publications exists in orthopedic robotic surgery than previously reported. Furthermore, scientometric analyses specifically focusing on the top 100 most influential articles in this field remain scarce. To test this hypothesis, Scopus was used for the first time in this domain. Three analytical approaches were applied: Title-Abstract-Keyword (TAK) analysis, abstract-based analysis, and title-based analysis. Compared with earlier Web of Science studies (224, 587, and 793 publications), the Scopus-based search retrieved substantially larger datasets: 1480 publications from title-only searches, 4851 from abstracts, and 8561 from TAK searches (articles and reviews only). For the first time, the top 100 most cited papers in orthopedic robotic surgery were bibliometrically analyzed with average age of 9.16 years and 134 citations per paper. Collectively, they involved 399 authors from 156 departments across 18 countries and were published in 47 journals. Leading contributors (authors, institutions, countries, sponsors, and sources) were identified. Citation-based indicators, annual publication output, and collaboration networks across authors, institutions, and countries were examined. Finally, uni-, bi-, and tri-gram analyses were employed to map the research focus of the top 100 most cited papers. This study demonstrated that Scopus retrieves substantially larger datasets in orthopedic robotic surgery than prior Web of Science analyses. The top 100 most cited papers in orthopedic robotic surgery focused on arthroplasty, spine interventions, and rehabilitation. Key themes included implant positioning and accuracy in hip and knee arthroplasty, precision in pedicle screw placement for spine surgery, and the role of robotic exoskeletons in gait rehabilitation.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"674"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276336","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 head-mounted mixed reality platform for robotic flexible endoscope control in minimally invasive cholecystectomy: an animal feasibility study.","authors":"Xinan Sun, Jiaxuan Xin, Zhikang Ma, Jianchang Zhao, Bo Yi","doi":"10.1007/s11701-025-02866-5","DOIUrl":"https://doi.org/10.1007/s11701-025-02866-5","url":null,"abstract":"<p><p>Robotic surgical systems have advanced minimally invasive surgery by enhancing dexterity and precision, yet endoscopic camera control remains a persistent bottleneck due to reliance on assistants or manual manipulation that disrupts workflow continuity. We developed MicroVision, a robotic endoscopic platform that translates natural head movements into real-time viewpoint adjustments through a head-mounted mixed reality interface. The system integrates a flexible binocular endoscope with six degrees of freedom and a position-orientation decoupled design, enabling intuitive orientation control and stable, high-definition visualization even in confined anatomical spaces. In a porcine cholecystectomy model (n = 10), MicroVision was compared with conventional laparoscopy. Verbal instructions to camera assistants were almost eliminated, dropping from 15.3 to 0.2 per procedure (P < 0.001), and mean operative time was reduced from 74.8 to 66.0 min (P = 0.038). Camera movements decreased by more than 70%, and intraoperative blood loss was reduced by nearly one quarter. All procedures were completed successfully without complications or system failures. These findings demonstrate that MicroVision enhances surgical efficiency, visualization, and workflow reliability while maintaining established safety standards, underscoring its potential contribution to robotic surgery.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"670"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253332","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}