Journal of Robotic Surgery最新文献

{"title":"Implementation of a robotic hepato-pancreato-biliary surgery program: a swedish referral center's experience.","authors":"Tommaso Dall'Olio, Giampaolo Perri, Tim Reese, Ernesto Sparrelid, Stefan Gilg","doi":"10.1007/s11701-025-02241-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02241-4","url":null,"abstract":"<p><p>Robotic-assisted surgery has been recognized for enhancing the feasibility of minimally invasive procedures, particularly in high-complexity fields like hepato-pancreato-biliary (HPB) surgery. This study aims to describe the implementation and development of a robotic HPB surgery program at a Swedish referral center, during a structured transition from mostly open surgery, as well as evaluating perioperative outcomes. A retrospective observational study at Karolinska University Hospital (September 2020-July 2024) included patients undergoing robotic HPB resections. Data on demographics, procedure types, intraoperative metrics, and outcomes were collected. Program implementation followed a stepwise approach. A total of 495 robotic resections were performed by three generations of surgeons, including 235 liver, 208 pancreatic, and 52 biliary resections. The overall conversion rate to open surgery was 7.7%. Major complications were observed in 10.9% of cases, with a mortality rate of 0.8%. Exposure and training improved outcomes over time, indicating the value of a structured implementation approach and a stepwise introduction of new surgeons into the robotic program. The transition to robotic HPB surgery requires a well-organized approach that includes thorough training and close collaboration within a multidisciplinary team. The program focused on helping junior surgeons develop their skills, starting with simpler procedures to reduce risks and ensure patient safety. After 8 semesters, minimally invasive HPB surgeries have increased from 15 to 41%. Results show that the program is safe and effective, highlighting the importance of institutional support, teamwork, and strategic planning in building a successful and lasting robotic surgery program.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"101"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568452","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 robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections?","authors":"Abigail R Ingham, Stephen T McSorley, Donald C McMillan, David Mansouri, David Chong, Graham J MacKay, Aleksandra Wrobel, Chia Yew Kong, Ahmed Alani, Gary Nicholson, Campbell S D Roxburgh","doi":"10.1007/s11701-025-02261-0","DOIUrl":"10.1007/s11701-025-02261-0","url":null,"abstract":"<p><p>Obesity (BMI > 30 kg/m²) is rapidly increasing worldwide with 26% of the UK population being obese and 38% being overweight. Obesity is intimately related to several life-limiting conditions including colorectal cancer (CRC). Obese patients have a higher degree of perioperative systemic inflammatory response (SIR) and an increased risk of perioperative complications. The aim of this current study was to investigate whether robotic-assisted surgery mitigates the effects of obesity in left sided CRC resections on the SIR and clinical outcomes. All patients undergoing left-sided colorectal cancer resections from May 2021 to May 2023 were, prospectively, entered into a database with patient characteristics and perioperative short-term outcomes recorded. CRP was considered a surrogate for SIR. The relationship between obesity and complications were examined using Chi Square for linear association, Kruskal-Wallis for continuous data and multivariate binary logistic regression model. 221 patients who underwent RAS for left-sided CRC were analysed. Obesity was associated with more comorbidity (ASA, p < 0.01) and SSI (p < 0.05) but not with age, sex, procedure or pathology. POD3 CRP < 150 mg/l was also associated with obesity (p < 0.01). In turn, greater comorbidity was associated with age (p < 0.001), site of resection (p < 0.05), SSI (p < 0.05), postoperative blood transfusion (p < 0.01) and LOS (p < 0.001). On multivariate analysis, only greater ASA (p < 0.05) and surgical procedure (p < 0.01) were associated with the development of an SSI independently. Greater comorbidity but not obesity was independently associated with postoperative SIR and clinical outcomes in patients undergoing RAS. These results support the use of RAS for left sided CRC resections, particularly in the obese.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"98"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558292","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":"Comparing the operative, oncological, post-operative outcomes and complications of robotic and laparoscopic pancreaticoduodenectomy for the treatment of pancreatic and periampullary cancers: a systematic review and meta-analysis with subgroup analysis.","authors":"Konstantinos Kossenas, Riad Kouzeiha, Olga Moutzouri, Filippos Georgopoulos","doi":"10.1007/s11701-025-02239-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02239-y","url":null,"abstract":"<p><p>The majority of previously published meta-analyses compare robotic and laparoscopic pancreaticoduodenectomy (RPD vs. LPD) across both benign and malignant lesions. This meta-analysis aims on focusing exclusively on malignant lesions, providing a detailed and targeted evaluation of operative, oncologic, and post-operative outcomes. This systematic review and meta-analysis adhered to PRISMA 2020 guidelines and the Cochrane Handbook and followed a pre-registered protocol on PROSPERO. A comprehensive search of PubMed, Scopus, and Cochrane Library databases was conducted up to August 1, 2024. Risk of bias was performed with the ROBINS-I tool. We calculated the odds ratios and the mean differences for the dichotomous and continuous outcomes, respectively. Sensitivity analysis was conducted to evaluate the robustness of findings. Subgroup analyses were performed for pancreatic cancer cases exclusively. In total, eight studies involving 6648 patients (1964 RPD and 4684 LPD) were included. Significant outcomes included reduced length of hospitalization for RPD (MD = -0.94, P = 0.005) and lower conversion rates (OR = 0.20, P < 0.00001). In addition, the number of harvested lymph nodes was significantly higher for RPD (MD = 1.02, P = 0.01). Overall morbidity was significantly lower for RPD (OR = 0.50, P = 0.05). Non-significant differences were observed for estimated blood loss (P = 0.72), operative duration (P = 0.28), blood transfusion rates (P = 0.12), R0 resection rates (P = 0.60), major complications (P = 0.54), pancreatic fistula rates (P = 0.06), delayed gastric emptying (P = 0.58), reoperation rates (P = 0.20), and 90-day mortality (P = 0.97). Sensitivity analysis reduced heterogeneity without altering significant results, with the exception of overall morbidity which became non-significant in some cases, highlighting study-specific influences. Subgroup analysis for pancreatic cancer showed consistent findings with the main analysis, except overall morbidity, which became non-significant, suggesting that periampullary cancers may have influenced the observed benefits of RPD. Further analysis was limited by data availability. While RPD offers potential benefits, including shorter hospitalization, lower conversion rates, higher number of harvested lymph nodes and lower morbidity, the limited number of high-quality studies, study heterogeneity, and conflicting evidence with prior meta-analyses underscore the need for further well-designed trials focusing on specific patient populations to guide surgical decision-making. PROSPERO registration CRD42025634636.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"97"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558288","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":"Assessing operative variability in robot-assisted radical prostatectomy (RARP) through AI.","authors":"Laura Zuluaga, Jewel Bamby, Kennedy E Okhawere, Burak Ucpinar, Shirin Razdan, Ketan K Badani","doi":"10.1007/s11701-025-02225-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02225-4","url":null,"abstract":"<p><p>Robotic-assisted radical prostatectomy (RARP) is the most commonly performed robotic procedure in urology. Using artificial intelligence (AI), surgical steps and practices can be assessed and validated through surgical video, and connected to patient outcomes. This information can potentially change clinical outcomes and improve the quality of care. 48. We conducted an analysis of 883 RARP cases from 2017 to 2023, across six different institutions. A surgical intelligence platform (Theator Inc., Palo Alto, CA) was employed during all surgeries, and used to identify six surgical practices: bladder neck suture, leak test, Rocco stitch, standard dorsal venous complex (DVC) ligation (S-DVC), delayed DVC ligation (D-DVC), and Retzius-space reconstruction. We analyzed descriptive statistics, including frequencies and measures of central tendency. Categorical variables were presented using frequency and percentage. Continuous variables were presented with median and interquartile range. 87. Institution A had the highest number of cases (n = 675, 76.4%), followed by Institution B (n = 127, 14.4%), Institution C (n = 48, 5.4%), Institution D (n = 20, 2.3%), Institution E (n = 9, 1.0%), and Institution F (n = 4, 0.5%). The mean surgical duration across institutions was 163.4 min ± 56.6. The surgical intelligence platform identified the following median rates of surgical practice adoption across institutions: bladder neck suture (32.9%, range: 50-0%), leak test (92.9%, range: 95.8-77.7%), Rocco stitch (18.3%, range: 75-0%), S-DVC ligation (40.2%, range: 100-0%), D-DVC ligation (87.3%, range: 98.4-11.1%), and Retzius-space reconstruction (0%, range: 5-0%). 103. This study demonstrates how surgical intelligence is utilized to assess different key surgical steps in RARP videos, enabling objective, accurate measurement of variability in practices among institutions. Surgical intelligence increases the availability of surgical metrics across institutions and surgeons and facilitates mitigation of adverse effects by informing the usage of best practices, potentially leading to better clinical outcomes and a higher quality of care. 72.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"99"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558287","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 comprehensive review and meta-analysis comparing robot-assisted and 3D laparoscopic gastrectomy for gastric cancer.","authors":"Qian-Wen Wang, Jun Leng, Wei Li, Jin Chen","doi":"10.1007/s11701-024-02212-1","DOIUrl":"10.1007/s11701-024-02212-1","url":null,"abstract":"<p><p>This review and meta-analysis evaluates the short-term surgical results of robot-assisted gastrectomy compared to 3D laparoscopic gastrectomy in individuals with gastric cancer. This study used scholarly articles from peer-reviewed articles of PubMed. Further, this study uses other sources, such as, Embase, CNKI, and the Cochrane Library, to gather relevant studies on gastrectomy for gastric cancer which are made public from the inception of these databases up to July 15, 2024. This study seeks to primarily draw similarities between the therapeutic efficacy of robot-assisted gastrectomy (RG) and the 3D laparoscopic gastrectomy (3D-LG). Similarly, this study will strictly adhere to the inclusion and exclusion guidelines, focusing on randomized controlled trials (RCTs) and cohort research. A total of 1231 gastric cancer patients were involved in incorporating seven retrospective cohort studies as the final analysis in the study with 533 undergoing robot-assisted gastrectomy and 698 undergoing 3D-LG. The results showed that patients who received robotic-assisted gastrectomy experienced superior outcomes regarding EBL and time-to-first postoperative exhaust compared to those who underwent 3D-LG. However, the robotic-assisted approach was related to a reduced number of LNY. Besides, there were similarities between the two surgical techniques in relation to OT, LOHS, and post-surgery complications. In summary, robot-assisted gastrectomy is acknowledged as a secure and efficient treatment option for individuals with stomach cancer. This approach demonstrated notable benefits compared to 3D-LG, particularly with regard to estimated intraoperative blood loss and the timing of the first postoperative exhaust.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"96"},"PeriodicalIF":2.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544179","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-assisted surgery in the Arab world: are we there yet?","authors":"Raed Azhar, Shady Saikali, Abdel Rahman Jaber, Ahmed Gamal, Omar AbouMarzouk, Mahmoud Abdelhakim, Albert El Hajj, Vipul Patel","doi":"10.1007/s11701-025-02260-1","DOIUrl":"https://doi.org/10.1007/s11701-025-02260-1","url":null,"abstract":"<p><p>Robotic-assisted surgery (RAS) has revolutionized surgical practice worldwide, with urology leading its adoption. Despite its global expansion, significant disparities exist in regional implementation, particularly in the Arab world. This study evaluates the current landscape of robotic surgery in the Arab world, highlighting advancements, challenges, and future directions. A literature review was conducted using PubMed, focusing on robotic procedures across multiple specialties in Arab countries. Data on installed robotic systems were obtained from industry reports and local distributors. A total of 56 relevant publications were identified. The highest volume of RAS publications originated from Saudi Arabia, Qatar, and the United Arab Emirates. Emerging trends include a rise in multidisciplinary robotic procedures, innovative telesurgical applications, and increased research output. However, high-quality, large-scale studies remain limited. The Arab world has made notable strides in RAS adoption, with key centers advancing research and clinical practice. Although full integration remains a work in progress, the foundation for widespread robotic surgical adoption in the Arab world is firmly in place.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"95"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544182","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 impact of DaVinci simulator competitions on medical student interest in robotic surgery.","authors":"Anthony K Nwankwo, Shaina W Twardus, Abigail R Dupre, Anirudha S Chandrabhatla, Zuhayr Shaikh, Moritz J Lange, Noah S Schenkman","doi":"10.1007/s11701-025-02240-5","DOIUrl":"https://doi.org/10.1007/s11701-025-02240-5","url":null,"abstract":"<p><p>Robotic surgery has expanded significantly over the last decade. To help train learners, many institutions have implemented various training methods. Studies have shown that simulation training is an effective tool to develop skills for both residents and attending physicians. However, its influence on medical student training is unclear. Medical students were asked to compete in a 4-month da Vinci robotic console simulation tournament. Participants were given unlimited attempts to achieve the highest score possible on four different modules. Questionnaires were completed before and after the tournament to assess baseline demographics, surgical confidence, and perceptions toward robotic surgery. Performance data from the simulator was collected for each participant. A total of 12 medical students completed the tournament. Paired T-test analysis of pre-survey and post-survey questionnaires demonstrated significant increases in reported interest in robotic surgery (p < 0.001) and surgery overall (p = 0.0028). Self-reported surgical confidence using the simulator also increased significantly (p = 0.0043). There was an increase in overall performance across all modules when comparing first and last attempts (p < 0.001), (p < 0.001), (p = 0.0031), and (p = 0.011). Spearman's rank correlation analyses showed an association between overall performance and number of attempts for two of four modules (p = 0.0063) and (p = 0.046). Tournament-style simulation training increased medical students' surgical skill dexterity, confidence and interest in robotic surgery. Additional research with larger sample sizes are necessary to fully characterize the effectiveness of robotic surgical training for medical students.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"94"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544209","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":"Letter to the Editor on \"The impact of sarcopenia on postoperative complications and survival outcomes after robotic colorectal cancer surgery: a study based on single-center propensity score matching\".","authors":"Erkan Topkan, Sukran Senyurek, Nilufer Kilic Durankuş, Ugur Selek","doi":"10.1007/s11701-025-02265-w","DOIUrl":"https://doi.org/10.1007/s11701-025-02265-w","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"93"},"PeriodicalIF":2.2,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537934","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: \"Transperitoneal vs retroperitoneal robotic partial nephrectomy: a meta-analysis and systematic review of propensity-matched studies\".","authors":"Jing-Ya Deng, Li Wang","doi":"10.1007/s11701-025-02267-8","DOIUrl":"https://doi.org/10.1007/s11701-025-02267-8","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"92"},"PeriodicalIF":2.2,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537932","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":"Comparison of perioperative outcomes and prognosis between Da Vinci surgical system and Hinotori system in urologic tumor surgery: evidence from controlled trials.","authors":"Kangyu Wang, Li Wang, Jiangwei Man, Jianwei Yang, Hao Wang, Yalong Zhang, Li Yang","doi":"10.1007/s11701-025-02248-x","DOIUrl":"https://doi.org/10.1007/s11701-025-02248-x","url":null,"abstract":"<p><p>The objective is to evaluate the clinical efficacy and compare perioperative outcomes comparing the Da Vinci and Hinotori robotic systems in the treatment of urological tumors. We systematically reviewed an observational controlled study comparing the two systems in urologic tumor surgery. Six studies, published between 2023 and 2024, involving 904 patients, were included. Surgical parameters and postoperative outcomes were analyzed using Review Manager 5.4, p < 0.05 considered statistically significant. The Da Vinci system demonstrated significantly shorter operation time (OT) (WMD = 22.48, p < 0.001) and robotic intervention time (RIT) (WMD = 23.35, p < 0.001) compared to the Hinotori system. No significant differences were observed in estimated blood loss (EBL), major complications (MC), positive surgical margin rate (PSM), or biochemical recurrence (BCR) between the two groups. Sensitivity analysis confirmed the robustness of these findings, although moderate to high heterogeneity was noted in some outcomes. The Da Vinci robotic system is more efficient in terms of operation and robotic intervention time. However, both the Hinotori and Da Vinci systems provide comparable functional and oncologic outcomes. Given the novelty of the Hinotori system, further prospective studies with larger sample sizes are needed to validate these findings and assess long-term outcomes.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"88"},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524986","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}