Journal of Robotic Surgery最新文献

{"title":"Robotic-assisted lymphovenous anastomosis to treat periorbital lymphedema and systematic review of lymphatic reconstruction of face and neck lymphedema.","authors":"Carlotta Imholz, Claudine Schaller, Jennifer A Watson, Carmen E Zurfluh, Alexandru Grigorean, Nicole Lindenblatt","doi":"10.1007/s11701-025-02552-6","DOIUrl":"10.1007/s11701-025-02552-6","url":null,"abstract":"<p><p>Head and neck lymphedema has gained increasing interest due to improved head and neck cancer survival. However, there exist no guidelines on its management so far. The study reports on the first robotic-assisted lymphovenous anastomosis (LVA) in the head and neck region and further systematically reviews the current literature on lymphatic microsurgery in patients with face and neck lymphedema, aiming to analyze the feasibility and efficacy of different reconstructive techniques. The feasibility of robotic-assisted LVA in the face was assessed and clinical outcomes reported. In addition, a systematic review of the current literature on lymphatic reconstruction of head and neck lymphedema was conducted in accordance with the PRISMA guidelines. The review was registered on PROSPERO (CRD420250651455). Robotic-assisted LVA of the periorbital region led to a significant reduction in edema and improved function. The literature search yielded 468 articles, of which 18 articles were deemed eligible for full-text reading, finally resulting in the inclusion of 10 articles. All included studies showed feasibility of lymphatic reconstruction in the head and neck region and achieved alleviation of lymphedema and its symptoms. However, the small number of patients and heterogenous assessment methods of lymphedema made it difficult to draw definite conclusions on the surgical management of head and neck lymphedema. Robotic-assisted lymphatic reconstruction for face and neck lymphedema is a promising microsurgical technique, however further studies are necessary to create guidelines on the management of head and neck lymphedema.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"380"},"PeriodicalIF":2.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620847","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":"Reply to commentary on: \"Comparing the operative, oncological, post-operative outcomes and complications of robotic and laparoscopic pancreaticoduodenectomy for the treatment of pancreatic and periampullary cancers\" by George Tantallakis.","authors":"Konstantinos Kossenas","doi":"10.1007/s11701-025-02568-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02568-y","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"378"},"PeriodicalIF":2.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620846","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":"Advancement of the Da Vinci robotic system in choledochal cyst surgery: a multidimensional comparative study with traditional laparoscopic techniques.","authors":"Noor-Ul-Eman Haider, Syed Muhammad Rayyan, Mueed Iqbal","doi":"10.1007/s11701-025-02548-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02548-2","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"379"},"PeriodicalIF":2.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620881","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":"Standard operating procedures and learning curve analysis for surgical assistants in robot-assisted distal pancreatectomy.","authors":"Jianlu Zhang, Pengyu Li, Pan Zhang, Yajun Wang, Junchao Guo","doi":"10.1007/s11701-025-02574-0","DOIUrl":"https://doi.org/10.1007/s11701-025-02574-0","url":null,"abstract":"<p><p>Robot-assisted pancreatic surgery (RPS) is increasingly adopted across institutions. While structured training and longitudinal skill acquisition are essential for optimal outcomes, the learning progression of surgical assistants in RPS remains inadequately characterized. This study presents our institution's standard operating procedures (SOP) for robot-assisted distal pancreatectomy (RDP) developed through a single-team cohort experience and defines the assistant learning curve based on operative time, thereby establishing evidence-based benchmarks for RPS training programs. In this retrospective study, data of consecutive patients who underwent RDP in our team from November 2022 to March 2025 were analyzed. The assistant learning curve was constructed using cumulative sum (CUSUM) analysis of operative time. The preoperative parameters, intraoperative outcomes, and postoperative metrics were compared between phases. Ninety-one patients were included in this study. Based on operative time analysis, the learning curve was stratified into two distinct phases: the initial learning phase (cases 1-43) and subsequent proficiency phase (cases 44-91). Operative duration and estimated blood loss were significantly greater during the learning phase compared to the proficiency phase. Among patients scheduled for spleen-preserving RDP, while overall spleen preservation rates were comparable between phases, proficiency phase cases demonstrated significantly superior splenic vessel preservation rates. Our RDP-specific SOP demonstrates safety and efficacy, with assistant proficiency significantly improving after 43 cases under expert supervision. Quantified learning thresholds provide validated benchmarks for structured robotic surgery training programs.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"381"},"PeriodicalIF":2.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620848","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":"AI-driven robotic surgery in oncology: advancing precision, personalization, and patient outcomes.","authors":"Jack Ng Kok Wah","doi":"10.1007/s11701-025-02555-3","DOIUrl":"10.1007/s11701-025-02555-3","url":null,"abstract":"<p><p>Artificial intelligence (AI) integrated with robotic systems is transforming oncologic surgery by significantly improving precision, safety, and personalization. The review critically explores the current landscape of AI-powered robotic technologies in tumor resection across various specialties, including urology, neurosurgery, orthopedics, pediatrics, and head and neck oncology. Despite rapid advancements, challenges remain in tumor boundary detection, real-time intraoperative navigation, motion compensation, and seamless data integration. Drawing on evidence from 22 recent clinical studies, pilot trials, and simulation-based research, the review identifies key innovations such as image-free robotic palpation, sensor-assisted feedback, 3D anatomical modeling, and adaptive motion management in radiotherapy. These technologies contribute to enhanced surgical accuracy, reduced invasiveness, and improved intraoperative decision-making. However, barriers such as inconsistent clinical protocols, limited cost-effectiveness data, and variability in performance across tumor types continue to hinder widespread adoption. Challenges persist in complex fields such as pediatric and neurosurgical oncology, where anatomical variability and safety concerns demand more advanced solutions. The review emphasizes the need for interoperable AI-robotic platforms, robust real-time analytics, and standardized safety frameworks. It also highlights the importance of ethical governance and clinician training in ensuring responsible implementation. In conclusion, AI-powered robotic surgery represents a major shift in oncology, offering the potential to improve long-term outcomes and reduce recurrence through data-driven, minimally invasive interventions. Realizing the potential will require interdisciplinary collaboration, longitudinal clinical validation, and strategic integration into healthcare systems.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"382"},"PeriodicalIF":2.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620882","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 outcomes of multi-port versus single-port robotic-assisted partial nephrectomy with same-day discharge: impact of surgical approach.","authors":"Raghav Gupta, Ahmed Eraky, Yuval Elkun, Kyra Gassmann, Reza Mehrazin","doi":"10.1007/s11701-025-02522-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02522-y","url":null,"abstract":"<p><p>Same-day discharge robotic-assisted partial nephrectomy (SDS-RAPN) is increasingly adopted due to emerging evidence supporting its safety and feasibility. However, comparative data evaluating perioperative, renal, and oncologic outcomes between multi-port (MP) and single-port (SP) robotic platforms, particularly across extraperitoneal and transperitoneal surgical approaches, remain limited. We sought to evaluate and compare these outcomes in patients undergoing SDS-RAPN. We retrospectively analyzed 70 consecutive SDS-RAPN procedures performed by a single surgeon at our institution. Patients were stratified by robotic platform (MP vs. SP), with a secondary sub-analysis comparing extraperitoneal and transperitoneal approaches. Outcomes included perioperative parameters, renal function, oncologic outcomes, complications, and readmissions. MP-RPN was associated with longer follow-up (516 vs. 22 days, p = 0.001). At discharge, serum creatinine levels were lower in SP patients (0.84 vs. 0.99 mg/dL; p = 0.04),but similar at last follow-up (p = 0.14). The SP cohort more frequently had lower pole tumors (59% vs. 28%, p = 0.008). Extraperitoneal access was more common in SP (65% vs. 46%), while transperitoneal access was predominant in MP (54% vs. 35%, p = 0.02). No significant differences were observed in ischemia time, operative time, or complication rates. No readmissions or mortality occurred within 90 days. SDS-RAPN is feasible, safe, and effective using either MP or SP robotic systems, with comparable short-term outcomes and no increase in complications or readmissions. Surgical platform and approach choice should be individualized, considering tumor characteristics and patient anatomy. Prospective studies are needed to validate our analysis.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"374"},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609891","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":"Best practices in telesurgery: framework and recommendations from the society of robotic surgery (SRS) for safe and effective implementation.","authors":"Vipul Patel, Shady Saikali, Louis Kavoussi, Raymond Leveillee, David Albala, Eduardo Parra-Davila, Travis Rogers, Yu Ozawa, Rohan Sharma, Kenneth Palmer, Jeff Marquinez, Marcelo Orvieto, Adnan Siddiqui, Jacques Marescaux, Ajit Sachdeva, Riccardo Oliva, Rafael Ferreira Coelho, Bernardo Rocco, Chiara Sighinolfi, Martin Roche, Martin Martino, Sharona Ross, Andrew Hung, Antonello Forgione, Ghulam Abbas, Xu Zhang, Saad Aldousari, Younes Ahallal, Vanessa Alvarenga-Bezerr, Cathy Corder, Marcio Moschovas","doi":"10.1007/s11701-025-02523-x","DOIUrl":"https://doi.org/10.1007/s11701-025-02523-x","url":null,"abstract":"<p><p>This framework from the Society of Robotic Surgery offers best practices for safe, effective, and ethical telesurgery. It is based on a comprehensive literature review, Delphi consensus process, and an international meeting in Orlando, Florida, in February 2024, involving experts from a variety of domains including surgery, engineering, telecommunications, hospital administration, law, and regulatory affairs. Key areas covered include the global landscape and new models of remote surgical care, technological needs like connectivity and cybersecurity, safety standards, training and credentialing for surgical teams, and scalable implementation models. It also addresses legal and ethical issues, clinical indications, and regional and international regulatory comparisons. This framework aims to be a key reference for institutions, surgical societies, policymakers, and technology developers to promote safe, equitable, and sustainable telesurgery worldwide.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"370"},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609890","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":"Correspondance: advantages of the Da Vinci robotic system in choledochal cyst surgery: a multi-dimensional comparative study with traditional laparoscopic techniques.","authors":"Muhammad Ismail, Sherbaz Khan, Shad Khan, Farman Ullah Khan, Muhammad Aamir Khan","doi":"10.1007/s11701-025-02567-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02567-z","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"371"},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609892","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 decade-long prospective analysis of the learning curve after 435 robotic pancreaticoduodenectomies from a single tertiary institution.","authors":"Maria Christodoulou, Tara M Pattilachan, Iswanto Sucandy, Jared Thompson, Sharona B Ross","doi":"10.1007/s11701-025-02553-5","DOIUrl":"10.1007/s11701-025-02553-5","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic pancreaticoduodenectomy (PD) has emerged as a leading approach in complex pancreatic surgery, but the path to proficiency is steep. While early learning curve assessments are available for simpler robotic procedures, few studies quantify the extended time and caseload needed to achieve consistency and mastery in robotic PD.</p><p><strong>Methods: </strong>With IRB approval, we prospectively followed 435 patients who underwent robotic PD between 2013 and 2024. The learning curve was assessed using Cumulative Sum (CUSUM) analysis based on operative time. Data are presented as median (mean ± SD), and statistical significance was set at p ≤ 0.05.</p><p><strong>Results: </strong>CUSUM analysis identified the turning point for consistent procedural proficiency at 88 cases. Patient characteristics included a median age of 70 (68 ± 10.9) years, BMI of 27 (27 ± 5.1) kg/m², and a predominance of males (54%). A total of 253 patients (58%) had previous abdominal surgery, 36 (8%) had undergone neoadjuvant therapy, and average ASA class and Charlson Comorbidity Index were 3 (± 3) and 5 (± 1.5), respectively. Over time, operative efficiency translated into improved outcomes: unplanned conversions to open surgery declined significantly (p < 0.0001), estimated blood loss decreased (p = 0.04), and hospital stays shortened (p = 0.008). Interestingly, despite growing proficiency, operative times increased (p < 0.0001), reflecting a shift toward more technically demanding cases. A significant rise was also observed in the proportion of patients with prior abdominal surgeries treated after the learning curve milestone (p = 0.007).</p><p><strong>Conclusions: </strong>True mastery in robotic PD demands extended experience, with significant procedural gains occurring after the 88-case mark. This extended learning curve should be acknowledged when designing training programs and evaluating surgical outcomes in robotic pancreatic surgery.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"376"},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609966","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":"Feasibility and surgical outcomes of robotic myomectomy for large and multiple uterine fibroids- insights from a decade of experience at a single centre.","authors":"Rooma Sinha, Rupa Bana, Shilpa Chowdary Peddappolla","doi":"10.1007/s11701-025-02538-4","DOIUrl":"10.1007/s11701-025-02538-4","url":null,"abstract":"<p><p>There is limited data on the safety and effectiveness of robotic-assisted myomectomy (RM) for large (≥ 8 cm) and multiple (≥ 5) fibroids. This study aims to assess the feasibility and perioperative outcomes of RM in these cases. A retrospective chart review was performed on 260 patients who underwent RM at a single institution between January 2013 and May 2024. Demographic information, primary symptoms, and operative outcomes were extracted from the patients' medical records. Large myomas were defined as those with a diameter of ≥ 8 cm, while multiple myomas were considered to be ≥ 5 fibroids. Data from 260 patients, with a mean age of 34.18 ± 5.55 years, were collected and analyzed. On average, 2.37 ± 0.31 fibroids were removed, with a mean weight of 294.0 ± 290.25 g. The average operative time was 144.6 ± 55.3 min, including a console time of 100.3 ± 47.13 min. The estimated blood loss (EBL) averaged 189.05 ± 296.65 mL, with 6.9% (18 patients) requiring transfusions. The mean hospital stay was 23.46 ± 6.42 h, with 87 patients staying more than 24 h. No conversions to laparotomy, reoperations, or major complications were reported. Patients with fibroids ≥ 8 cm experienced significantly higher EBL (p = 0.019), transfusion rates (p = 0.041), and longer hospital stays (p = 0.009). Although total operative time was not significantly affected by the number of fibroids, docking (p = 0.036) and console times (p < 0.001) were longer in patients with ≥ 5 fibroids. Additionally, blood transfusions were more frequently required in this group. Drawing on ten years of experience, this study highlights the feasibility and efficacy of RM in treating uterine myomas larger than 8 cm and in cases involving five or more fibroids.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"377"},"PeriodicalIF":2.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620845","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}