Journal of Robotic Surgery最新文献

{"title":"Augmenting colonoscopy with artificial intelligence and robotic assistance: a human-factors scoping review toward a task-based shared autonomy paradigm.","authors":"Luigi Manfredi, Alfredo Annicchiarico, Gianpiero Gravante","doi":"10.1007/s11701-026-03923-3","DOIUrl":"10.1007/s11701-026-03923-3","url":null,"abstract":"<p><p>Colonoscopy is central to colorectal cancer prevention but remains a high-demand psychomotor and cognitive procedure, characterized by operator dependency, variable performance, and substantial physical and mental workload. Increasing evidence links procedural quality and safety to clinician-related factors, including musculoskeletal strain, fatigue, and non-technical skills. Concurrently, artificial intelligence (AI) and robotic technologies are emerging as potential tools to address these limitations. We conducted a scoping review with narrative synthesis of literature on human factors, ergonomics, AI, robotic technologies, and shared autonomy in colonoscopy and surgical robotics. Evidence synthesis: Colonoscopy performance remains limited by non-negligible miss rates and variability driven by both technical and human factors. Ergonomic constraints and cognitive workload contribute significantly to operator strain and may affect vigilance and decision-making. AI systems-including computer-aided detection (CADe), diagnosis (CADx), and quality monitoring-have demonstrated improvements in detection metrics and procedural standardisation, although concerns regarding cognitive offloading and potential deskilling persist. In parallel, emerging robotic and soft-robotic platforms aim to enhance navigation, improve procedural ergonomics, and reduce operator musculoskeletal strain, although clinical evidence remains limited. These technologies converge within a task-based shared-autonomy paradigm integrating physical, perceptual, and cognitive augmentation, with different procedural tasks operating at different levels of human-system control. A task-based shared-autonomy framework may provide a coherent model for integrating AI and robotics into colonoscopy while preserving human supervision and clinical judgement. Future developments should prioritise human-centred design, workflow integration, and multidimensional evaluation strategies to ensure safe and effective clinical implementation.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168866","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":"Post-market safety signals of energy-based surgical devices: a cross-specialty disproportionality analysis of the FDA MAUDE database with robotic-platform validation and regulatory triangulation, 2015-2025.","authors":"Ruifeng Shi","doi":"10.1007/s11701-026-04060-7","DOIUrl":"https://doi.org/10.1007/s11701-026-04060-7","url":null,"abstract":"<p><p>Post-market safety evidence for energy-based surgical devices is fragmented. We characterized adverse-event signals in the FDA MAUDE database, validated them on a third (robotic) platform, and triangulated across regulatory and international sources. Medical Device Reports (2015-2025) under electrosurgical and ultrasonic product codes were analyzed with reporting odds ratios (RORs), stratified by specialty and procedure, with robustness checks. All reports under the robotic-system code were retrieved as a third-platform validation cohort. Signals were triangulated with FDA recalls, 510(k) clearances, the Health Canada and Australian TGA databases, exposure descriptors, and a retrospectively applied Poisson CUSUM feasibility analysis. Among 110,183 deduplicated reports (65.8% electrosurgical, 34.2% ultrasonic), electrosurgical devices showed an electrical-thermal fingerprint (burns ROR 3.84; electric shock ROR 15.34) and ultrasonic devices a mechanical-integrity fingerprint (foreign-body removal ROR 92.74), replicated directionally in Canada and Australia. The fingerprint localized to generator/monopolar components and varied by specialty and procedure. Within the robotic validation cohort, component-stratified analysis partly reproduced these signatures-robot-mounted monopolar instruments retained a burn signal, and robot-mounted ultrasonic instruments carried the highest injury-report share-while cross-platform, same-modality contrasts are reported strictly as report-composition (share-level) comparisons. Reporting artifacts (19.5% placeholder narratives; a 2025 robotic mass-reporting episode comprising 55.8% of the robotic cohort) left fingerprint RORs materially unchanged. A retrospectively applied CUSUM flagged the burn theme more than five years before the 2023-2024 Class I recalls, illustrating-without establishing prospective lead time-the potential of automated monitoring. Energy-modality failure-injury fingerprints were consistent across specialties, delivery platforms, three national databases, and regulatory actions. Automated, artifact-aware surveillance of vigilance databases is a promising complement to pre-market review and warrants prospective evaluation.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168445","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":"Lymph node yield and station count in early robot-assisted versus established video-assisted resection for non-small cell lung cancer: higher total node counts reflect yield per sampled station.","authors":"Jong-Duk Kim, Yong Seong Lee, Jung Wook Yang","doi":"10.1007/s11701-026-04047-4","DOIUrl":"https://doi.org/10.1007/s11701-026-04047-4","url":null,"abstract":"<p><p>Whether robot-assisted thoracic surgery (RATS) improves nodal staging over video-assisted thoracoscopic surgery (VATS) early in adoption is unknown. We compared occult nodal upstaging and lymph node (LN) retrieval between early RATS and an established VATS practice by one surgeon, and asked whether total LN count reflects the number of stations sampled. Retrospective single-surgeon cohort of consecutive lung cancer resections with systematic LN dissection (2023-2026). Primary outcome: occult nodal upstaging (pathologic N + in clinically N0 patients). Secondary outcomes: LN yield, distinct stations sampled, and yield per sampled station, and perioperative outcomes. Eighty-seven patients qualified (RATS, n = 49; VATS, n = 38; 92.1% of VATS operations after RATS introduction). Occult upstaging was 10.6% vs. 10.5% (95% CI for the difference, - 14.8 to + 13.7% points; not significant). Total LN yield was higher with VATS (13.8 vs. 17.7; p = 0.018), whereas stations sampled were similar (4.7 vs. 4.7; equivalent within post-hoc margins of ± 1 and ± 0.75 but not ± 0.5 stations); yield per sampled station was lower with RATS (2.5 vs. 3.3; p = 0.001), mostly in mediastinal stations. This did not attenuate across the 49 RATS cases and persisted after multivariable adjustment (rate ratio 1.29; 95% CI 1.04-1.60). Operative time was longer with RATS; complications and R0 resection did not differ. No significant difference in occult upstaging was observed, but the study was underpowered and this result is inconclusive. Higher VATS node counts reflected yield per sampled station rather than more stations, for reasons that could not be determined. Station-level yield should be reported alongside total node count.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166702","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":"Anesthesiological considerations and complications in robotic surgery: a retrospective analysis.","authors":"P Kuhn, M Oremek, A L Kuenster, A Labonte, M Kroeplin, T O Vilz, J Kalff, M Soehle, M Thudium","doi":"10.1007/s11701-026-04045-6","DOIUrl":"10.1007/s11701-026-04045-6","url":null,"abstract":"<p><p>Robotic-assisted surgery has become increasingly prevalent across various surgical disciplines. Understanding anesthesiological factors influencing perioperative outcome is essential for optimizing patient care. This retrospective analysis evaluated 200 patients who underwent robotic surgery across three surgical categories: gastrointestinal (GI, n=60), hepatopancreticobiliary (HPB, n=28), and colorectal (n=112) procedures. We conducted an exploratory analysis of associations between anesthesiological parameters-including fluid management, surgical duration, and blood loss-and clinical outcomes such as intensive care unit (ICU) length of stay, total hospital length of stay, complication severity (Clavien-Dindo classification) using univariable and multivariable regression models. The exploratory analyses suggested potential associations between surgical duration and outcomes across surgical specialties in multivariable analysis. For GI procedures, longer surgical duration was associated with higher odds of severe complications (Clavien-Dindo grade ≥III; OR = 1.80 (1.21, 2.66)). In colorectal surgery, surgical duration was independently associated with both development of severe complications (OR = 1.28 (1.01, 1.62)) and total hospital length of stay (log-scale, β = 0.08 (0.03, 0.12)). Fluid intake was associated with an increased hospital length of stay in colorectal surgery (log-scale, β = 0.10 (0.03, 0.17)). Anesthesiological management, particularly surgical duration and fluid management, showed associations with perioperative outcomes in robotic surgery. The estimated effects provide preliminary insights into the magnitude of these associations and may serve as a basis for hypothesis generation and the design of future prospective studies. Further studies are needed to confirm these findings and to investigate the potential clinical relevance of anesthesiological and perioperative management strategies.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169377","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":"Force feedback and vocal cord dysfunction after robotic esophagectomy: a comparison of the da Vinci 5 and Xi systems.","authors":"Cho Eun Lee, Jiyeon Kim, Danbee Kang, Seong Yong Park","doi":"10.1007/s11701-026-04046-5","DOIUrl":"https://doi.org/10.1007/s11701-026-04046-5","url":null,"abstract":"<p><p>The da Vinci 5 (DV5) is the first robotic platform to integrate force feedback (FFB), which may limit excessive traction and tissue injury. Its clinical impact in robotic transthoracic esophagectomy remains unclear. We compared perioperative outcomes between the da Vinci Xi and DV5 systems. This retrospective study included consecutive patients who underwent robotic transthoracic esophagectomy for esophageal squamous cell carcinoma by a single high-volume surgeon between December 2024 and July 2026. Patients treated with the Xi system without FFB (n = 126) and the DV5 system with FFB (n = 37) were compared. Vocal cord dysfunction (palsy or hypomobility) was assessed by routine postoperative laryngoscopy. Outcomes were analyzed using multivariable logistic regression, with stabilized inverse probability of treatment weighting (IPTW) as a sensitivity analysis. Vocal cord dysfunction was less frequent in the DV5 group (Xi, 33.3% vs. DV5, 13.5%), and the association persisted after multivariable and IPTW adjustment (adjusted odds ratio [OR], 0.33; IPTW OR, 0.27). Vocal cord palsy was also less frequent (27.8% vs. 10.8%), although the difference was not significant after adjustment. In an exploratory analysis, overall 30-day complications were less frequent in the DV5 group (74.6% vs. 54.1%; adjusted OR, 0.43), but the difference was attenuated after IPTW adjustment. Total and recurrent laryngeal nerve lymph node yields did not differ. DV5 with integrated FFB was associated with less frequent vocal cord dysfunction and comparable operative outcomes. These findings may provide the first clinical data suggesting FFB could reduce traction-related nerve injury in robotic esophagectomy.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171216","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":"Single-port robotic and conventional multiport laparoscopic colectomy for colon cancer: an overlap-weighted comparison of perioperative and oncologic outcomes.","authors":"Min Hyeong Jo, Hye Ah Lee, Ho Seung Kim, Soon Sup Chung, Gyoung Tae Noh","doi":"10.1007/s11701-026-04065-2","DOIUrl":"https://doi.org/10.1007/s11701-026-04065-2","url":null,"abstract":"<p><p>Comparative evidence for single-port colectomy with robotic system remains limited, particularly for long-term cancer control. We compared perioperative recovery and oncologic outcomes following single-port robotic surgery (SPRS) and conventional multiport laparoscopic surgery (CMLS) in colon cancer. This retrospective study screened 710 patients treated surgically between March 2019 and February 2025. The analytic cohort was balanced with propensity score overlap weighting (PSOW), after which operative, postoperative, pathologic, and survival data were compared. The analysis included 472 patients (142 SPRS and 330 CMLS). PSOW balanced the four covariates specified in the propensity model. SPRS had a longer mean operative time (255.0 vs. 197.5 min, p < 0.001), but no patient required open conversion (0.0% vs. 3.1%, p = 0.011). Compared with CMLS, SPRS was followed by earlier passage of flatus (2.4 vs. 3.4 days), earlier tolerance of a soft diet (3.3 vs. 4.8 days), and a shorter postoperative stay (7.5 vs. 8.5 days) (all p ≤ 0.001). Pain scores through postoperative day 5 were lower after SPRS (all p < 0.001), whereas complication rates and pathologic measures were similar. Three-year relapse-free survival (RFS) was 95.2% after SPRS and 95.1% after CMLS (p = 0.835); the corresponding overall survival (OS) were 97.2% and 94.8% (p = 0.104). Surgical modality was not an independent predictor of RFS or OS. Within the available follow-up, SPRS provided oncologic results comparable to CMLS while being associated with less postoperative pain and enhanced recovery. These data support SPRS as a feasible approach for selected patients with colon cancer.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165115","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":"Beyond feasibility: an oncology-first framework for defining the role of robot-assisted surgery in ovarian cancer-patient selection, surgical adequacy, and conversion pathways.","authors":"Gang Hu, Yan Lu, Yan Xin, Chaofan Shi, Yanfang He","doi":"10.1007/s11701-026-04020-1","DOIUrl":"https://doi.org/10.1007/s11701-026-04020-1","url":null,"abstract":"<p><p>Robot-assisted surgery has expanded in gynecologic oncology, but its role in ovarian cancer remains uncertain because oncologic success depends on completion of the required cancer operation rather than on the access route. This critical narrative review evaluates selective use of a robotic approach in apparent early-stage disease, interval cytoreduction after neoadjuvant chemotherapy, exceptional primary cytoreduction, and selected platinum-sensitive recurrence in candidates for secondary cytoreduction. Robotics-specific evidence is distinguished from conventional laparoscopic and mixed minimally invasive surgery (MIS) evidence, which is treated as indirect when a robotics-specific estimate cannot be isolated. Available robotics-specific evidence is predominantly retrospective or feasibility-based, and no randomized robotics-specific trial has established oncologic equivalence to laparotomy. Selected cohorts support technical feasibility and favorable short-term perioperative outcomes more consistently than long-term route equivalence, while patient-reported recovery remains insufficiently characterized. In apparent early-stage disease, intact specimen retrieval, systematic abdominopelvic assessment, and staging completeness are central. In interval and recurrent cytoreduction, complete gross resection is the principal surgical adequacy endpoint, whereas recovery, time to subsequent systemic therapy, patient-reported outcomes, and resource use are complementary endpoints. We propose a three-stage conceptual framework comprising preoperative route assessment, systematic intraoperative reassessment, and predefined conversion criteria. On current evidence, robot-assisted surgery is best regarded as a conditional route for carefully selected patients in experienced centers rather than as a default alternative to laparotomy.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166776","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":"Textbook outcome-based performance assessment during transition to the da Vinci SP system in reduced-port robotic gastrectomy.","authors":"Yerin Lee, Ji Yoon Jeong, Seungho Lee, Jawon Hwang, Sung Hyun Park, Minah Cho, Yoo Min Kim, Woo Jin Hyung, Hyoung-Il Kim","doi":"10.1007/s11701-026-04058-1","DOIUrl":"https://doi.org/10.1007/s11701-026-04058-1","url":null,"abstract":"<p><p>Although reduced-port gastrectomy with the da Vinci SP system offers a dedicated single-port platform, little is known about how an experienced robotic surgeon performs while changing platforms. We examined this transition by applying cumulative sum (CUSUM) analysis to textbook outcome (TO). We retrospectively analyzed 175 consecutive reduced-port robotic gastrectomies performed at a tertiary referral center from July 2021 through August 2025. The primary measure was TO, a composite of six perioperative requirements. Case-sequence performance was examined with CUSUM curves for TO and operative time. Among 175 patients, 164 achieved TO (93.7%; 95% CI, 89.1-96.5%) and 168 achieved adjusted TO (aTO; 96.0%); major complications occurred in 1.7%. The TO-CUSUM curve showed an apparent stabilization after approximately 60 cases, whereas operative-time CUSUM reached its observed nadir at case 107. The later period included more D2 dissections and complex procedures; the TO rate was 96.7% in the early period and 92.2% in the late period. During transition to the da Vinci SP platform, TO-based CUSUM provided a longitudinal description of perioperative quality as case selection and procedural complexity evolved. The distinct TO-CUSUM and operative-time CUSUM trajectories suggest that quality-related performance and procedural efficiency may evolve at different rates during platform transition.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168987","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":"Unveiling the Chasm in Japanese robot-assisted surgery diffusion: the interplay of surgical volume and intra-specialty spillover.","authors":"Yusuke Natsume, Shingo Kano","doi":"10.1007/s11701-026-04049-2","DOIUrl":"10.1007/s11701-026-04049-2","url":null,"abstract":"<p><p>To examine structural factors associated with the diffusion of robot-assisted surgery (RAS) in Japan, this study examined the associations of annual surgical volume, defined as the sum of open, conventional laparoscopic, and RAS cases, and prior intra-specialty experience with adoption speed. Using the 1st to 10th editions of the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data across fiscal years 2014-2023, diffusion trajectories were visualized for 21 procedures approved for insurance coverage by 2020 through bivariate plots of annual surgical volume versus RAS replacement rates. RAS diffusion exhibited non-linear dynamics associated with annual procedure volume. In niche markets with < 6,000 annual cases (n = 9), six procedures demonstrated high growth in RAS replacement rate. Conversely, among 12 procedures with ≥ 6,000 annual cases, four did not cross the 16.0% chasm threshold through FY2023, and three required 6 years to surpass it. These patterns were thought to reflect challenges in the transition from specialized centers to general hospitals. Furthermore, a trend consistent with \"intra-specialty spillover\" was observed, wherein procedures approved in FY2020 achieved higher initial adoption than those in FY2018; although inseparable from the overall expansion of RAS since 2018, this suggests that accumulated infrastructure and expertise may facilitate the uptake of subsequent techniques. These findings suggest that RAS diffusion is associated with annual procedure volume, organizational readiness, and specialty‑specific infrastructure alongside technical factors. Future implementation strategies may benefit from infrastructure sharing within and across specialties and resource optimization to bridge the observed diffusion chasm.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168616","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":"Comparative perioperative outcomes of Hugo™ RAS versus laparoscopic and Da Vinci platforms for partial nephrectomy: a systematic review and meta-analysis.","authors":"ZongYing Lv, Ren Zhang, Wei Wei, QinFeng Cai, Man Liu, JiaLi Wu, Qi Liu, ChaoMin Li, JianGuo Xiong","doi":"10.1007/s11701-026-04062-5","DOIUrl":"10.1007/s11701-026-04062-5","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) is a common urologic malignancy, and for localized T1 tumors, nephron-sparing surgery is now the standard of care. Laparoscopic and image-guided techniques have advanced as robotic platform procedures offer greater operator dexterity and procedural control. The da Vinci platform has dominated robot-assisted partial nephrectomy, but high costs and closed architecture limit broader use. The Hugo™ RAS system, featuring a modular design, has emerged as a promising alternative, with early studies showing feasibility and safety. However, current evidence remains preliminary, mostly single-center and small-sample. This meta-analysis aggregates data and conducts subgroup analyses to compare Hugo™ RAS with other techniques, aiming to provide more precise effect estimates and guide surgical platform selection. The four main databases (PubMed, EMBASE, Web of Science, and Cochrane Library) were thoroughly searched to identify eligible clinical studies. The selected research involved comparative evaluations of surgical metrics of partial nephrectomy performed with Hugo™ RAS vs. the da Vinci system and traditional laparoscopy. This systematic synthesis included four observational cohort studies with a total of 383 subjects. Combined metric evaluations indicated that Hugo™ RAS demonstrated no statistically significant variation relative to alternative minimally invasive approaches regarding surgery duration (MD = 2.81 min, 95% CI [- 37.42, 43.03], p = 0.89), duration of hospitalization (MD = - 0.23 days, 95% CI [- 1.59, 1.13], p = 0.74), intraoperative blood loss (MD = 18.5 ml, 95% CI [- 53.61, 90.6], p = 0.62), serum creatinine following surgery (MD = - 0.05 mg/dl, 95% CI [- 0.18, 0.08], p = 0.44), positive surgical margin incidence (OR = 0.59, 95% CI [0.19, 1.80], p = 0.35), minor-to-moderate postoperative adverse event frequency (OR = 0.98, 95% CI [0.45, 2.17], p = 0.97), major postoperative adverse event frequency (OR = 0.74, 95% CI [0.09, 6.17], p = 0.78), overall postoperative adverse event rate (OR = 1.05, 95% CI [0.39, 2.87], p = 0.92), or successful trifecta attainment (OR = 1.11, 95% CI [0.60, 2.07], p = 0.74). This meta-analysis provided some preliminary evidence: Hugo™ RAS did not demonstrate significant differences compared to other minimally invasive surgical procedures in terms of procedure time, hospital stay, intraoperative blood loss, postoperative renal function, rate of positive margins, postoperative morbidity, and composite success results. Overall, Hugo™ RAS seems to be a reasonable surgical alternative. However, large multi-site randomized clinical trials are still needed to substantiate this finding.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167860","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}