Journal of Robotic Surgery最新文献

{"title":"Comment on: \"Enhanced short-term outcomes after full robotic-assisted minimally invasive Ivor Lewis procedure compared to the hybrid approach\".","authors":"Sihui Zhang, Shanxun Yu","doi":"10.1007/s11701-025-02441-y","DOIUrl":"https://doi.org/10.1007/s11701-025-02441-y","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"266"},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227234","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 mediastinal lymphadenectomy in lung cancer: a narrative review.","authors":"Dávid Adamica, Lubomír Tulinský, Markéta Kepičová, Paula Dzurňáková, Peter Ihnát, Marcel Mitták, Adam Varga, Čestmír Neoral, Lubomír Martínek","doi":"10.1007/s11701-025-02392-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02392-4","url":null,"abstract":"<p><p>The objective of this study is to undertake a narrative review of the oncological adequacy of mediastinal lymphadenectomy performed via robot-assisted thoracic surgery (RATS) in comparison with video-assisted thoracic surgery (VATS) and thoracotomy for non-small cell lung cancer (NSCLC). The focus of the review is on lymph node yield, nodal station dissection, and nodal upstaging rates. A narrative review of literature published in the last decade was conducted using PubMed, Cochrane, and Web of Science databases. Studies examining mediastinal lymphadenectomy outcomes for RATS, VATS, or thoracotomy were included in the discussion. The analysis of 19 studies from diverse geographical regions showed that in six out of nine comparative studies, RATS demonstrated superior lymph node retrieval compared to VATS, with statistically significant differences. RATS achieved comparable or superior nodal station dissection rates and showed particular advantages in upstaging from clinical N0 to pathological N2 status. Additionally, RATS demonstrated favourable perioperative outcomes with reduced morbidity and mortality rates compared to conventional approaches. RATS represents a reliable and oncologically sound approach to mediastinal lymphadenectomy, with potential advantages over conventional techniques. Its enhanced visualization and precision make it an increasingly utilised option for NSCLC treatment in centres with robotic capabilities.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"263"},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217218","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":"Risk factors and risk-stratification model of biochemical failure in patients with positive surgical margin after robot-assisted radical prostatectomy.","authors":"Yuta Yamada, Yuji Hakozaki, Naohiro Makise, Jimpei Miyakawa, Yoichi Fujii, Naoki Kimura, Kazuma Sugimoto, Jun Kaneko, Kazuki Maki, Taketo Kawai, Shigenori Kakutani, Aya Niimi, Jun Kamei, Satoru Taguchi, Daisuke Yamada, Haruki Kume","doi":"10.1007/s11701-025-02426-x","DOIUrl":"10.1007/s11701-025-02426-x","url":null,"abstract":"<p><p>The purpose of this study was investigating the risk factors of biochemical failure in cases with positive surgical margins after robot-assisted radical prostatectomy (RARP). We identified 630 cases of RARP that had been performed in a single institution from November 2011 to December 2017. A total of 145 cases showed positive surgical margin after RARP. After excluding patients that had undergone adjuvant therapies (androgen deprivation or radiation), 114 cases were evaluated. Clinical and pathological parameters were investigated in this cohort and were analyzed to identify factors predicting biochemical failure. Subsequently, we developed a risk classification based on these risk factors. The median values of PSA, age, preoperative prostate volume, were 67 (internal quartile range [IQR]: 65-72) years, 9.3 (6.5-12.0) ng/mL, and 37 (25-45) cm³, respectively. There were 53 and 61 patients with pT2 and pT3, respectively. The International Society of Urological Pathology grade group at surgical margin (SM) ≥ 5 (hazard ratio [HR] 3.37, 95% confidence interval [CI] 1.48-7.68), and max length of cancer at SM ≥ 4 mm (HR 2.59, 95% CI 1.27-5.32), and nadir PSA ≥ 0.03 (HR 8.66, 95% CI 4.66-16.1) were identified as factors predicting biochemical failure. Subsequently, a risk-stratification model was developed using these factors. The model showed a C index of 0.801. This study identified risk factors predicting biochemical failure in patients with positive surgical margins after RARP.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"261"},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217217","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":"Quality over quantity-current challenges of robotic surgery in Poland.","authors":"Marcin Kubiak, Jacek Doniec, S Vincent Grasso, Andrew Gumbs, Amir Nour Mohammadi, Katarzyna Sędłak, Zuzanna Pelc, Stanisław Góźdź, Wojciech Załuska, Artur Bachta, Paweł Rybojad, Kamil Torres, Timothy M Pawlik, Marek Zawadzki, Andrzej Budzyński, Karol Rawicz-Pruszyński","doi":"10.1007/s11701-025-02423-0","DOIUrl":"10.1007/s11701-025-02423-0","url":null,"abstract":"<p><p>Since its introduction in 2010, a dynamic growth of robotic-assisted surgery (RAS) has been observed in Poland. The number of healthcare institutions implementing RAS has tripled in the last 36 months, with 80 surgical robots currently utilized on a national scale. While urological procedures dominate RAS utilization (73%), adoption in gynecology (12.2%) and gastrointestinal surgery (8.5%) is rising, driven by recent National Health Fund reimbursement policies. However, significant fragmentation and alarmingly low numbers of individual RAS procedures were identified: 47.7% of surgeons perform less than 40 cases annually. Parallel to expanding the robotic surgery reimbursement program, several standardized actions are warranted to further facilitate and optimize modern surgical practices in Poland. Regional disparities in access and underutilization of robotic systems, followed by a lack of a centralized and standardized registry to evaluate surgical and oncological outcomes, represent the main challenges to integrating robotic surgery nationally. Addressing these, followed by implementing structured training and uniform evaluation frameworks for clinical and oncological outcomes, are critical to maximizing the potential of surgical robotic systems in Poland.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"258"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209887","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":"Computer vision for evaluating retraction of the neurovascular bundle during nerve-sparing prostatectomy.","authors":"Umar Ghaffar, Rikke Olsen, Atharva Deo, Cherine Yang, Jonathan Varghese, Randy G Tsai, John Heard, Eman Dadashian, Carter Prentice, Peter Wager, Runzhuo Ma, Christian Wagner, Geoffrey A Sonn, Alvin C Goh, Graciela Gonzalez-Hernandez, Andrew J Hung","doi":"10.1007/s11701-025-02412-3","DOIUrl":"10.1007/s11701-025-02412-3","url":null,"abstract":"<p><p>The nerve-sparing step of prostatectomy is crucial for post-operative sexual recovery, and excessive countertraction on the neurovascular bundle (NVB) during retraction has been associated with adverse sexual function outcomes. Our objective is to utilize computer vision to quantitatively assess the degree of this countertraction to study its impact on post-operative sexual recovery. Sixty-four nerve-sparing prostatectomy videos were used to extract snapshots prior to and at the maximum point of retraction gestures on the NVB. Semantic image segmentation, conducted with the Computer Vision Annotation Tool (CVAT), was used to label features such as the proportion of tissue grasped relative to retractor size and tissue stretch (measured by percent area increase and angular deviation from baseline). Supervised machine learning models, including Random Forest, Multi-layer Perceptron, and XGBoost, were then developed to predict the likelihood of erections sufficient for intercourse at a 12-month post-operative follow-up. Predictions were based on clinical and surgical gesture features (age, PSA, extent of nerve sparing, and post-operative Gleason scores, number of NVB retractions) alone and in combination with segmentation-derived features. One thousand one hundred four instances of NVB retraction were labeled. For patients with insufficient erectile function for intercourse at the 12-month follow-up, the mean angular deviation, percent area increase, and proportion of tissue grasped were 25.80° (SD 13.1), 41.81% (SD 33.3), and 0.310 (SD 0.093), respectively. In contrast, for patients with sufficient erectile function, these values were 21.07° (SD 7.4), 20.10% (SD 12.5), and 0.206 (SD 0.127), respectively. Integrating segmentation-derived features into the models enhanced predictive performance, with the AUC increasing from 0.78 (IQR 0.56-0.98) to 0.83 (IQR 0.63-1.00) for the Random Forest model, from 0.61 (IQR 0.35-0.85) to 0.74 (IQR 0.50-0.94) for the Multi-layer Perceptron, and from 0.70 (IQR 0.44-0.92) to 0.78 (IQR 0.58-0.97) for XGBoost. Delicate handling of the neurovascular bundle is crucial for better post-operative sexual recovery, and computer vision can provide an objective assessment of retraction on the NVB, offering insights beyond clinical and gesture features alone.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"257"},"PeriodicalIF":2.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Robot-assisted simple prostatectomy for men with benign prostatic hyperplasia and bothersome LUTS-a retrospective cohort study\".","authors":"Angelo Cormio, Daniele Castellani","doi":"10.1007/s11701-025-02431-0","DOIUrl":"https://doi.org/10.1007/s11701-025-02431-0","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"256"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200517","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 \"A registry-based modified IDEAL stage 2b evaluation of urological procedures performed using the Versius robotic surgical system\".","authors":"Saraswati Sah, Renu Sah","doi":"10.1007/s11701-025-02438-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02438-7","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"254"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200516","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":"Postoperative feedback-oriented health education in ambulatory robot-assisted adrenalectomy: a single-center nursing intervention cohort study.","authors":"Xue Yao, Yanghao Tai, Xiaoyan Luo, Kang Wang, Jiwen Shang","doi":"10.1007/s11701-025-02416-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02416-z","url":null,"abstract":"<p><p>To explore the application effect of feedback health education in the care of patients after robot-assisted adrenal tumor resection in ambulatory mode. 100 patients who underwent robot-assisted adrenal tumor resection in the ambulatory surgery department of our hospital from June 2022 to June 2024 were randomly selected as the study subjects and were divided into the observation group (n = 50 cases) and the control group (n = 50 cases). The observation group used feedback health education, the control group used conventional health education, and the two groups were compared with regard to the patients' psychological status, medication adherence, life quality assessment, and patient satisfaction score. After the intervention, the SAD score of the observation group was significantly lower than that of the control group (42.14 ± 3.52 vs. 47.16 ± 4.60, P < 0.001). SAS scores were significantly lower in the observation group than in the control group (43.9 ± 5.06 vs. 48.36 ± 3.89, P < 0.001). Adherence scores were significantly higher in the observation group than in the control group (7.16 ± 0.71 vs. 6.56 ± 1.15, P = 0.002), and medication adherence was better in the observation group than in the control group (P = 0.008). ADL scores were significantly higher in the observation group than in the control group (85.4 ± 5.09 vs. 80.62 ± 5.70, P < 0.001). Nursing satisfaction scores were significantly higher in the observation group than in the control group (85.42 ± 4.79 vs. 81.12 ± 4.88, P < 0.001). Compared with traditional nursing education, the feedback health education method helps improve the psychological state of patients undergoing robotic-assisted adrenal tumor resection in the day mode, and improves medication adherence, quality of life, and nursing satisfaction.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"255"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200518","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":"Lariat knot: simple tying technique for robotic and endoscopic sutures.","authors":"Norihiko Ishikawa, Go Watanabe, Daiki Yoshiyama, Toru Koakutsu, Takafumi Horikawa, Shigeyuki Tomita, Toshiya Ohtsuka","doi":"10.1007/s11701-025-02419-w","DOIUrl":"https://doi.org/10.1007/s11701-025-02419-w","url":null,"abstract":"<p><p>Minimally invasive cardiac surgeries, including robot-assisted and other minimally invasive cardiac surgeries (MICS), have advanced, allowing procedures like mitral valve repair under robotic or video-assisted guidance. Ensuring complete closure of atrial orifices to prevent postoperative bleeding is crucial. This paper introduces the \"Lariat knot,\" a simple and effective technique for secure initial ligation. The Lariat Knot is created by double wrapping the suture to form a loose knot, and then passing the free end through this knot to create an additional loop. The initial loose knot is tightened by pulling the working end, securing the loop. This technique is applied using endoscope or robotic forceps, particularly in closing the left atrium and securing the left-ventricular vent tube. The Lariat Knot technique ensures secure and stable ligation, preventing postoperative bleeding. It is straightforward and applicable in both robotic and conventional endoscopic surgery, eliminating the need for extracorporeal ligation techniques. This method can be combined with other techniques, such as the \"Fig. 4 technique,\" for more stable secondary knots, making it a valuable addition to existing surgical maneuvers.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"251"},"PeriodicalIF":2.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192284","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 systematic review of ergonomic and muscular strain in surgeons comparing robotic to laparoscopic approaches.","authors":"Hedda Cooper, Hiu Ming Lau, Helen Mohan","doi":"10.1007/s11701-025-02401-6","DOIUrl":"10.1007/s11701-025-02401-6","url":null,"abstract":"<p><p>Robotic-assisted laparoscopic surgery has become more common in recent years with multiple benefits to patients. However, it poses musculoskeletal risks to surgeons, and given their long careers, it is vital to prolong surgeons' longevity. This review aims to evaluate ergonomic impact and methods of ergonomic assessment in surgeons performing traditional and robotic-assisted laparoscopic surgery. To evaluate the ergonomics and how different body areas were being affected by robotic and laparoscopic surgeons, we performed a systematic review of studies following PRISMA guidelines and focussing on muscular and ergonomic assessment of laparoscopic surgeons. Electronic Ovid Medline and Embase databases were searched on the 15th of June 2023. 16 studies were identified, involving 508 surgeons. 530 traditional laparoscopies and 535 robotic-assisted laparoscopies were included. Mixed methods, including surface electromyography (sEMG) and Borg CR10 physical exertion scale, were used to assess muscular activation and fatigue. Whilst individual studies produced conflicting results, overall sEMG and BORG CR10 scales showed that in TLS the deltoid, triceps, biceps and wrist muscles are most commonly activated. In addition, in RALs, lower back, trapezius and finger muscles were activated most commonly. Muscle activations as a whole were generally lower in robotic-assisted laparoscopy. Survey tools such as NASA-TLX confirmed that overall RALS was less fatiguing than TLS for the majority of surgeons. This review explored the ergonomic risks faced by surgeons performing both traditional laparoscopic and robotic surgery. Further research, including standardised methodology and continuous ergonomic assessment, are warranted to ensure robotic surgery remains safe.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"252"},"PeriodicalIF":2.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192283","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}