Journal of Robotic Surgery最新文献

{"title":"Postoperative pain after robotic versus VATS thymectomy: a comparative cohort study.","authors":"Junichi Murakami, Toshiki Tanaka, Mototsugu Shimokawa, Sota Yoshimine, Naohiro Yamamoto, Hiroshi Kurazumi, Kimikazu Hamano","doi":"10.1007/s11701-025-02857-6","DOIUrl":"https://doi.org/10.1007/s11701-025-02857-6","url":null,"abstract":"<p><strong>Objective: </strong>Robotic-assisted thoracoscopic surgery (RATS) is an alternative to video-assisted thoracoscopic surgery (VATS) for thymectomy, but detailed comparisons of postoperative pain, a critical patient-centered outcome, are limited. This study aimed to compare longitudinal pain trajectories and recovery outcomes between RATS and VATS thymectomy.</p><p><strong>Methods: </strong>This retrospective cohort study included 125 consecutive patients who underwent minimally invasive thymectomy (58 RATS, 67 VATS) from 2011 to 2025. The primary endpoints were postoperative pain intensity, measured using serial Numerical Rating Scale (NRS) scores, and the time to pain recovery (NRS ≤ 2). Group comparisons were made using appropriate statistical tests, and a multivariate model was used to adjust for confounders and identify independent predictors for pain recovery.</p><p><strong>Results: </strong>The RATS group had lower overall NRS scores compared to the VATS group (p < 0.001) and achieved the time to pain recovery (NRS ≤ 2) in a shorter time (log-rank p < 0.001). RATS was also associated with less blood loss and a shorter postoperative hospital stay. Analgesic requirements were lower for the RATS group only during the first three postoperative days (p = 0.004). On multivariate analysis, the RATS approach (Hazard Ratio [HR], 3.28; p < 0.001) and omission of chest tube drainage (HR, 2.42; p = 0.001) were independent predictors of faster pain recovery.</p><p><strong>Conclusions: </strong>RATS for thymectomy is associated with lower intensity of postoperative pain, leading to a faster recovery compared to VATS. These findings suggest the robotic approach offers superior patient-centered benefits, particularly in the early postoperative period.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"668"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253325","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":"Application and postoperative rehabilitation effects of HURWA, Cori, and Brainlab robots in TKA under the ERAS concept.","authors":"Mingyou Wang, Zhuodong Tang, Yuping Lan, Ruiqi Lan, Mingli Wang, Xunzhou Song, Hongping Wang","doi":"10.1007/s11701-025-02859-4","DOIUrl":"10.1007/s11701-025-02859-4","url":null,"abstract":"<p><p>As science and technology continue to progress, the variety and number of robots used in assisted total knee arthroplasty (TKA) have steadily increased, allowing more surgeons and patients to benefit from enhanced medical precision and improved knee joint function, ultimately leading to a better quality of life. This retrospective study compared the outcomes of 164 patients undergoing total knee arthroplasty (TKA), either conventionally or assisted by one of three robotic systems (Brainlab, HURWA, or Stryker Cori), all within an Enhanced Recovery After Surgery (ERAS) protocol. Whilst robotic groups had longer incisions and the Brainlab system required more time, the domestic HURWA robot demonstrated superior performance in achieving optimal FFC and LFC angles. By postoperative day 3, the Brainlab group reported higher pain scores, but this difference resolved by 90 days. Crucially, there were no significant differences in final knee function (KSS, ROM), inflammatory markers, blood loss, complication rates, or patient satisfaction (all > 95%) between any groups. The findings indicate that despite early variations, all three robotic systems facilitate effective recovery and satisfactory clinical outcomes comparable to conventional TKA under ERAS, without increasing perioperative risks.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"669"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253300","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":"Global research trends of robotic-assisted surgery in Urogynecology and Reconstructive Pelvic Surgery: a bibliometric and visualization analysis based on web of science.","authors":"Jian Wang, Mingyuan Fan, Ziyang Qiang, Hailin Ren, Huiling Chen, Yupei Dai","doi":"10.1007/s11701-025-02872-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02872-7","url":null,"abstract":"<p><p>Robotic-assisted surgery in Urogynecology and Reconstructive Pelvic Surgery (URPS) has gained significant attention, yet there is a lack of comprehensive bibliometric and visual analysis in this area. This study aims to systematically map and visualize the global research landscape of robotic-assisted surgery in URPS. A literature search was conducted using the Web of Science Core Collection database, and selected publications were analyzed bibliometrically. The results were visualized using VOSviewer, CiteSpace, and the Bibliometrix package in R software. A total of 355 articles and reviews met the inclusion criteria. Research activity in this field is concentrated mainly in Europe, North America, and Asia, with the United States being the leading contributor, accounting for approximately 60% of publications. The Mayo Clinic is the top institution, and Professor Brian J. Linder is the most productive scholar. International Urogynecology Journal and Urogynecology are the most influential journals in this field. High-frequency keywords include \"robotic surgery,\" \"sacrocolpopexy,\" and \"pelvic organ prolapse.\" The current research focus is on robotic-assisted sacrocolpopexy, with functional outcomes such as quality of life and sexual function likely to be core areas of future research. As an emerging subdiscipline, the academic recognition and research impact of URPS still need further enhancement. This study is the first systematic bibliometric analysis of robotic-assisted surgery in the URPS field, and the findings will help scholars comprehensively understand the development landscape and research hotspots, providing valuable insights for future clinical practice optimization and research direction choices.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"671"},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259611","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":"Correction: Machine learning-based prediction of post-operative outcomes in robotic-assisted radical prostatectomy: a multi-variable analysis of 758 cases.","authors":"Emad Rajih, Walaa M Borhan, Yasir Hassan Elhassan, Assaad El-Hakim","doi":"10.1007/s11701-025-02855-8","DOIUrl":"https://doi.org/10.1007/s11701-025-02855-8","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"666"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253334","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 comparative study of tunnel placement accuracy in robotic-assisted versus traditional combined anterior and posterior cruciate ligament reconstruction.","authors":"Gang Yang, Zhi-Hua Zhang, Ling-Hui Dai, Lang-Ran Wang, Hong-Jie Huang, Jia-Yi Shao, Kai-Ping Liu, Ding-Ge Liu, Xi Gong, Hai-Jun Wang, Yin Pei, Fan Hu, Shuang-Shuang Deng, Rui-Jie Liu, Jian-Quan Wang, Xin Zhang","doi":"10.1007/s11701-025-02865-6","DOIUrl":"https://doi.org/10.1007/s11701-025-02865-6","url":null,"abstract":"<p><p>This study developed a new surgical robot for cruciate ligament reconstruction and compared its accuracy of bone tunnel placement with traditional surgical methods in combined posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) reconstruction. 8 human cadaver knees were used for robot-assisted combined PCL and ACL reconstruction, and three-dimensional (3D) computed tomography (CT) was performed after operation to confirm the bone tunnel information. Postoperative 3D CT images of eight patients completed by the same operator with conventional techniques were also acquired. The operation time, bone tunnel position and length were measured and compared between robotic and conventional surgery. Regarding the tunnel position, there was no significant difference between the planned and actual tunnels in robotic surgery and the anatomical site of the cruciate ligament (P > 0.05). However, there are significant differences between robotic and conventional surgery (P < 0.001). Compared with traditional surgery, the robotic surgery demonstrated higher accuracy in the drilling of the cruciate ligament tunnel. Regarding the length of the cruciate ligament tunnel, no statistically significant discrepancy was observed between the actual and planned tunnels (P > 0.05), with a maximum error of less than 2 mm. The robot was able to accurately control the length of the cruciate ligament tunnel. The robots can be used to assist in combined ACL and PCL reconstruction with higher accuracy than traditional surgery. It is a potentially powerful tool to enhance cruciate ligament reconstruction surgery.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"667"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253322","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 high-intensity theater as a means to improve efficiency by increasing operative throughput: a retrospective analysis of a high-volume robotic center in the UK.","authors":"Olivia Raglan, Richard Flint, Nada Assi, Sarah Bennet, Anna McDougall, Manou Manpreet Kaur, Jeffrey Ahmed","doi":"10.1007/s11701-025-02858-5","DOIUrl":"https://doi.org/10.1007/s11701-025-02858-5","url":null,"abstract":"<p><p>Reducing surgical waiting lists remains a key national priority for healthcare systems such as the NHS in the UK. High-intensity theater (HIT) lists, designed to increase surgical throughput by optimizing theater time and perioperative care, have been proposed as a solution. However, comparative data evaluating their safety and efficiency remain limited. To evaluate the productivity and safety of robotic HIT operating lists for benign gynecological surgery, as compared to standard weekday NHS operating lists. This was a retrospective cohort study using a prospectively maintained hospital registry. Robotic gynecological procedures performed on five HIT lists between Nov 2023 and July 2024 were compared with standard elective NHS lists during the same period. Patient demographics, operative times, complication rates, and length of stay were analyzed. A total of 194 cases were included (164 standard, 30 HIT). Case complexity was lower in the HIT cohort (p = 0.049). Mean operative time was significantly reduced in the HIT group (72.5 vs. 129.3 min, p < 0.001), with no increase in postoperative complications (13% vs. 29%, p > 0.05). HIT patients had significantly shorter hospital stays (0.4 vs. 1.2 days, p < 0.001), and comparable rates of readmission and training case involvement. HIT robotic gynecological operating lists enable efficient, safe surgical care with shorter operative times and earlier discharge, without compromising training or patient safety. Wider adoption of this model may help to reduce NHS surgical backlogs and optimize theater utilization.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"664"},"PeriodicalIF":3.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240024","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":"Does age influence surgical technique in bowel endometriosis? A multicenter analysis of 1547 cases.","authors":"Renato Barretto, Rogers Camargo Mariano da Silva, Rubens Paulo Gonçalves Filho, Marina Martinelli Sonnenfeld, Gilberto Jorge Saba, Claudia Regina Ribeiro Talaga, Milton Wajman, Thomas Moscovitz, Carlos Alberto Ortiz, Fabio Bottini Manchini, André Guilherme Manchini, Nathan Rostey, Bruno Mirandola Bulisani, Luiz Guilherme Lisboa Gomes, Murilo Rocha Rodrigues, Marina Ströher, Marcos Tcherniakovsky, Luiz Carlos Benjamim do Carmo","doi":"10.1007/s11701-025-02861-w","DOIUrl":"https://doi.org/10.1007/s11701-025-02861-w","url":null,"abstract":"<p><strong>Objective: </strong> To evaluate whether patient age influences the complexity of the surgical approach for bowel endometriosis, including the technique performed and the route of specimen extraction. Methods: Retrospective, multicenter observational study, set in tertiary referral hospitals in the state of São Paulo, Brazil. A total of 1,547 patients who underwent surgery for bowel endometriosis between 2016 and 2025. Interventions: Surgical management of bowel endometriosis using one of three techniques: shaving, discoid nodulectomy, or segmental resection. Specimen extraction was performed via Pfannenstiel incision or natural orifice specimen extraction (NOSE). Results: Clinical variables, surgical technique, specimen extraction route, complications (classified by Clavien-Dindo), and associated procedures were analyzed. The mean age was 37.8 years. Conservative techniques were more frequent, with shaving performed in 62.4% of cases. No statistically significant association was found between age and surgical technique (p > 0.05). Severe complications (grade ≥ III) occurred in 1.9% of cases, with no significant difference between age groups. The abdominal extraction route (Pfannenstiel incision) was more commonly used in patients under 35 years (OR 1.42; p = 0.01). Conclusion: Age did not influence the choice of surgical technique or the severity of complications but was associated with the route of specimen extraction, likely due to a higher rate of uterine preservation in younger patients.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"665"},"PeriodicalIF":3.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245460","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":"Impact of femoral component flexion on gap balancing in varus knees using robotic technology: a comparative study of single-radius and multi-radius designs.","authors":"Ratnakar Vecham, Paramanantham Madhavan, Tarun Jayakumar, Kishore Karumuri, Praharsha Mulpur, Adarsh Annapareddy, A V Gurava Reddy","doi":"10.1007/s11701-025-02752-0","DOIUrl":"https://doi.org/10.1007/s11701-025-02752-0","url":null,"abstract":"<p><p>Accurate flexion-extension gap balancing is critical in total knee arthroplasty (TKA), influencing postoperative stability and longevity. Femoral component flexion in the sagittal plane has been suggested as a means to adjust gap balance; however, its impact across different implant designs remains unclear. This study compares the influence of femoral component flexion on gap balancing between single-radius and multi-radius femoral components using robotic-assisted TKA. A prospective observational cohort study was conducted on 200 patients (100 in each cohort) undergoing primary robotic-assisted TKA for varus deformity with end-stage osteoarthritis. Patients were randomized to receive either single-radius (Stryker MAKO with Stryker Triathlon implants) or multi-radius (Meril CUVIS with Maxx-Freedom implants) femoral components. Intraoperative medial and lateral flexion-extension gaps were assessed at femoral flexion increments from 0° to 6° using robotic measurement software, and statistical analyses were done. Femoral component flexion had distinct impacts on gap balancing depending on implant design. Multi-radius implants showed significant variability with extension medial gaps progressively loosened (mean Change 0.19 mm/degree of flexion, p < 0.001), and flexion medial and lateral gaps progressively tightened (mean Changes 0.21 mm/degree, p < 0.001 and 0.24 mm/degree, p < 0.05, respectively). Conversely, single-radius implants demonstrated minimal variability in all gap measurements across degrees of femoral flexion (p > 0.05). Femoral component flexion significantly affects gap balancing during robotic-assisted TKA, particularly in multi-radius femoral components. Multi-radius designs require careful sagittal alignment to prevent undesirable gap variations, whereas single-radius implants exhibit more predictable gap balancing profiles, potentially simplifying intraoperative adjustments. Future research should evaluate long-term clinical outcomes related to these findings.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"663"},"PeriodicalIF":3.0,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233870","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 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}