Journal of Robotic Surgery最新文献

{"title":"Mastering the robot-assisted pyeloplasty learning curve: analysis of operative efficiency, safety, and functional outcomes.","authors":"Mahmoud Farzat, Florian M Wagenlehner","doi":"10.1007/s11701-025-02562-4","DOIUrl":"10.1007/s11701-025-02562-4","url":null,"abstract":"<p><p>Robot-assisted pyeloplasty (RAPY) for ureteropelvic junction obstruction (UPJO) is a technically challenging procedure. This study evaluates the learning curve by analyzing operative time, complications, and renal function recovery across sequential cases. A retrospective study of sixty consecutive patients who underwent RAPY between 2019 and 2024, performed by a single surgeon in a specialized robotic department, was performed. Cases were divided into three phases: early (first 20), middle (21-40), and late (41-60). Outcomes included operative time, complications (as classified by the Clavien-Dindo system), length of hospital stay, and improvement in glomerular filtration rate GFR. Mean age was 56 years, 57% of UPJO was on the left side. 55% of patients were males, 90% presented with symptoms, and the mean lateral distribution of the affected kidneys in renal scintigraphy statistical analysis was 32%. All preoperative parameters showed no significant differences among the study groups. The mean console time was 91 min. The mean hospital stay was 4.8 days, and the mean bladder catheter days were 4.2 days. Operative time decreased significantly from the early to the late phases (118 ± 28 vs. 65 ± 18 min, p < 0.001). The overall complication rate was 16%, minor complications 11%, and major complications 5%. Major complications (Clavien ≥ III) decreased from 25 to 5% (p =0.02) from the early to the late phase. Five patients were readmitted within 90 days after surgery. GFR improvement was consistent across all phases (+ 14.2 mL/min, p =0.25). The RAPY learning curve plateaus at 40 cases, with optimized efficiency and safety and significant improvements in both efficiency and safety until then.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"394"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643815","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":"Comment on: \"Safety and functional outcomes of Versius surgical platform in prostate cancer radical prostatectomy: a single-arm meta-analysis\" by Chen et al.","authors":"Yi Liu, Ninggang Yang, Hongjie Chen","doi":"10.1007/s11701-025-02572-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02572-2","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"388"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627410","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":"Advances in nanorobotics for gastrointestinal surgery: a new frontier in precision medicine and minimally invasive therapeutics.","authors":"Zixuan Rui, Sepehr Mehdizadeh, Mozhgan Abasi, Younes Pilehvar","doi":"10.1007/s11701-025-02550-8","DOIUrl":"https://doi.org/10.1007/s11701-025-02550-8","url":null,"abstract":"<p><p>Nanorobotics is catalyzing a paradigm shift in GI surgery by synergizing nanoscale engineering, synthetic biology, and intelligent computation to create a novel frontier in precision medicine. This review critically discusses the most recent experimental breakthroughs in surgical nanorobots-from bioinspired actuation to programmable materials to autonomous tumor ablation to closed-looped therapeutic feedback-and charts their development from static constructions to intelligent agents with the ability to navigate the dynamic gastrointestinal (GI) environment. Systematically, we review how nanorobots integrate with artificial intelligence (AI)-fortified platforms, overcome GI-specific obstacles, and can facilitate site-specific intervention with spatiotemporal precision. Based on state-of-the-art preclinical models, organoid studies in humans, and in vivo deployment, we analyze biodegradability, pharmacokinetics, and regulatory readiness in pursuit of first-in-human trials. Aside from technical innovation, this review also addresses grand challenges in autonomy, off-target control, and ethical-legal frameworks, calling for an integrated, cross-specialty format to facilitate clinical translation. In visualizing neural-controlled nanorobots, self-healing machines, and living biosensor networks, we outline the pathway towards intelligent, minimally invasive surgery at the molecular level. This work posits surgical nanorobotics not as an incremental innovation but as a transformative axis for convergent surgical therapeutics in the next generation. It is an academic wake-up call for the strategic coming of age in this field from experimental brilliance to translational inevitability.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"390"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Robotic-assisted kyphoplasty demonstrates superior efficacy, safety, and procedural efficiency compared to fluoroscopy-guided techniques\".","authors":"Nihayat Ullah, Muhammad Tausif, Suliman Khan","doi":"10.1007/s11701-025-02571-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02571-3","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"389"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638433","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":"Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow.","authors":"J P Lingl, T K Hoffmann, E Goldberg-Bockhorn, J Greve, F Boehm","doi":"10.1007/s11701-025-02551-7","DOIUrl":"10.1007/s11701-025-02551-7","url":null,"abstract":"<p><p>Exoscopic surgery is an emerging visualization technique in head and neck surgery, offering a promising alternative to conventional surgical microscopes. AI-assisted functions and high-quality imaging support its integration into modern surgical workflows. Eleven head and neck procedures were evaluated, including otologic surgery, parotidectomy and microvascular anastomosis using exoscopic techniques. Subjective feedback was obtained from four primary surgeons and four surgical assistants (response rate 100%) via a custom, non-validated questionnaire comprising 18 items. Six questions compared exoscope versus standard magnification (microscope or surgical loupes) across domains including anatomical structure identification, depth perception, field illumination and magnification, preoperative setup handling, and overall preference. Twelve questions addressed ergonomic comfort, 3D glasses and head-mounted display (HMDmd) wearability, and intraoperative handling. Ergonomic strain was assessed using the validated Rapid Upper Limb Assessment (RULA). Exoscopic systems demonstrated advantages, such as superior 4K-3D imaging, enhanced depth perception, improved ergonomics and facilitated intraoperative collaboration and education. RULA scores indicated reduced musculoskeletal strain, especially during longer procedures. Mean setup time was 4:14 min (range: 4:05-4:45 min), including draping (mean 2:04 min; range: 1:50-2:30 min). Surgeons described a brief adaptation period, primarily related to foot pedal control and digital interface navigation. AI-assisted features, including Auto-Center and Voice Control, further optimized workflow. Exoscopic surgery offers benefits for head and neck procedures requiring sustained magnification and precision. Short training times and ongoing technological advancements, such as improved working distances, head-mounted displays, and cost efficiency, are expected to further enhance its clinical value.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"391"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638434","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":"Comment on: Short-term outcomes of robotic versus laparoscopic gastrectomy for proximal gastric cancer: a systematic review and meta-analysis of propensity score-matched or baseline-balanced retrospective studies.","authors":"FuDuo Zhang, QingYing Meng, YuanHong Wang, JiaWei Li","doi":"10.1007/s11701-025-02569-x","DOIUrl":"https://doi.org/10.1007/s11701-025-02569-x","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"387"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Perioperative outcomes of the SHURUI single-port robotic system in urologic surgery: a systematic review and single-arm meta-analysis\" by Li and Luo.","authors":"Yi Liu, Ninggang Yang, Hongjie Chen","doi":"10.1007/s11701-025-02570-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02570-4","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"385"},"PeriodicalIF":2.2,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620844","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":"The role of emerging innovations in the future of surgery and the need for medical education adaptation: a letter to the editor.","authors":"Murtaja Satea Shafeea","doi":"10.1007/s11701-025-02566-0","DOIUrl":"https://doi.org/10.1007/s11701-025-02566-0","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"383"},"PeriodicalIF":2.2,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620849","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":"Artificial intelligence-based action recognition and skill assessment in robotic cardiac surgery simulation: a feasibility study.","authors":"Gennady V Atroshchenko, Lærke Riis Korup, Nasseh Hashemi, Lasse Riis Østergaard, Martin G Tolsgaard, Sten Rasmussen","doi":"10.1007/s11701-025-02563-3","DOIUrl":"10.1007/s11701-025-02563-3","url":null,"abstract":"<p><p>To create a deep neural network capable of recognizing basic surgical actions and categorizing surgeons based on their skills using video data only. Nineteen surgeons with varying levels of robotic experience performed three wet lab tasks on a porcine model: robotic-assisted atrial closure, mitral stitches, and dissection of the thoracic artery. We used temporal labeling to mark two surgical actions: suturing and dissection. Each complete recording was annotated as either \"novice\" or \"expert\" based on the operator's experience. The network architecture combined a Convolutional Neural Network for extracting spatial features with a Long Short-Term Memory layer to incorporate temporal information. A total of 435 recordings were analyzed. The fivefold cross-validation yielded a mean accuracy of 98% for the action recognition (AR) and 79% for the skill assessment (SA) network. The AR model achieved an accuracy of 93%, with average recall, precision, and F1-score all at 93%. The SA network had an accuracy of 56% and a predictive certainty of 95%. Gradient-weighted Class Activation Mapping revealed that the algorithm focused on the needle, suture, and instrument tips during suturing, and on the tissue during dissection. AR network demonstrated high accuracy and predictive certainty, even with a limited dataset. The SA network requires more data to become a valuable tool for performance evaluation. When combined, these deep learning models can serve as a foundation for AI-based automated post-procedural assessments in robotic cardiac surgery simulation. ClinicalTrials.gov (NCT05043064).</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"384"},"PeriodicalIF":2.2,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620843","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":"The robotic revolution in cardiac surgery.","authors":"Jack Ng Kok Wah","doi":"10.1007/s11701-025-02535-7","DOIUrl":"10.1007/s11701-025-02535-7","url":null,"abstract":"<p><p>Robotic-assisted cardiac surgery (RACS) is revolutionizing the landscape of cardiovascular interventions through technological precision, minimally invasive techniques, and improved clinical outcomes. Despite its rapid expansion, significant gaps remain regarding standardization, cost-efficiency, surgeon learning curves, and patient-centered outcomes. The study critically examines current innovations, evaluates comparative clinical and economic impacts, and synthesizes key trends and contradictions from 26 recent studies. The objective is to assess the clinical efficacy, scalability, and systemic implications of RACS across diverse procedures, such as mitral valve repair, coronary artery bypass grafting, and emerging robotic heart and congenital surgeries. Employing a mixed-methods approach, including qualitative analysis of patient experiences and quantitative evaluation of national databases and long-term outcomes, the review integrates systematic reviews, case studies, and meta-analyses for a comprehensive comparative synthesis. Findings highlight superior perioperative outcomes, faster recovery, and reduced complication rates in RACS compared to the conventional surgery. Robotic proficiency correlates strongly with surgical volume, institutional infrastructure, and interdisciplinary training, while economic evaluations remain mixed, indicating higher upfront costs but potential long-term savings. Notably, patient satisfaction is consistently high due to reduced invasiveness and faster rehabilitation yet concerns about accessibility and healthcare equity persist. Contradictory evidence surrounds the cost-benefit balance in low-volume centers and the influence of patient complexity on the learning curve, although emerging evidence suggests that these factors are becoming less prohibitive with experience and technological refinement. The review identifies gaps in multicenter longitudinal studies, standard training frameworks, and integration of Internet of Robotic Things (IoRT) in clinical workflows. It recommends expanding global data-sharing platforms, refining robotic surgical curricula, and enhancing AI-driven support systems for precision guidance. The implications span patient care quality, surgical education, healthcare economics, and future robotic innovations. Limitations include potential publication bias and underrepresentation of low-resource settings. Future research should focus on longitudinal, multicentric trials evaluating robotic outcomes across different demographics, procedures, and healthcare infrastructures. In conclusion, the robotic revolution in cardiac surgery promises transformative advances, yet requires coordinated global efforts to bridge disparities, optimize training, and validate its long-term value in complex cardiovascular care.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"386"},"PeriodicalIF":2.2,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627412","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}