Journal of Robotic Surgery最新文献

{"title":"Global research trends and hotspots of robot-assisted urological telesurgery: a bibliometric analysis.","authors":"Biao Zhang, Xuan Li, Shujun Yang, Cheng Wang, Can Li, Hong Chang, Panfeng Shang, Su Zhang","doi":"10.1007/s11701-026-04043-8","DOIUrl":"10.1007/s11701-026-04043-8","url":null,"abstract":"<p><p>With the integration of telecommunication and intelligent robotic technology, robot-assisted urological telesurgery has progressively evolved from early technical exploration toward broader clinical applications and procedural optimization, yet the global knowledge architecture, collaborative patterns and thematic evolution of this field remain unsystematically characterized. This study adopted bibliometric methodologies to systematically map the global research landscape, thematic evolutionary trends, and collaborative patterns of robot-assisted urological telesurgery over the period 2005-2025. The results demonstrated an overall increase in cumulative publication output from 2005 to 2025, accompanied by fluctuating annual productivity. China surpassed the United States in publication output in 2023, whereas the United States retained the highest citation impact and a central position in international collaboration. Qingdao University was the most productive affiliation, and author productivity was led by Patel V, followed by Moschovas MC, Niu HT and Yang XC. Journal of Robotic Surgery was the most productive source, whereas Surgical Endoscopy and European Urology occupied prominent positions in the local citation structure. Keyword co-occurrence, clustering, burst detection and timeline analyses revealed a progressive transition from early system development and feasibility exploration toward broader minimally invasive and robot-assisted urological applications. \"Minimally invasive surgical procedures\" remained an active burst term from 2023 to 2025, while current thematic clusters prominently involved minimally invasive surgery, robotic surgical procedures, robot-assisted surgery and remote surgery. Despite increasing research activity, international and inter-institutional collaboration remained geographically clustered. This bibliometric research summarizes the global knowledge framework and hotspot transitions within this discipline, and underscores the requirements for extensive international collaboration, standardized training programmes, high-end communication infrastructure and accessible remotesurgical care services.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138846","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":"Learning curve and short-term outcomes of our first 150 consecutive robotic Roux-en-Y gastric bypass procedures using the Hugo™ RAS system: a single-centre, single-surgeon experience.","authors":"Mehrdad Biglari, Mathias Sioen, Maxime Bossuyt","doi":"10.1007/s11701-026-04042-9","DOIUrl":"10.1007/s11701-026-04042-9","url":null,"abstract":"<p><p>Robotic-assisted Roux-en-Y gastric bypass (RYGB) is increasingly being adopted as an alternative to conventional laparoscopic surgery. However, data on the learning curve and short-term outcomes of RYGB using the Hugo™ robotic-assisted surgery (RAS) system remain limited. This study assessed the technical feasibility, console-time learning curve, and short-term postoperative outcomes of robotic-assisted RYGB using the Hugo™ RAS system. We conducted a retrospective, single-centre case series of the first 150 consecutive robotic-assisted RYGB procedures performed by a single experienced bariatric surgeon using the Hugo™ RAS system between May 2023 and July 2026. Patient characteristics, console time, postoperative complications, and length of hospital stay were recorded. Complications were classified according to the Clavien-Dindo classification. Segmented regression analysis was used to characterize the console-time learning curve and estimate the breakpoint. Of 150 procedures, 147 were included in the clinical series; three converted to laparoscopy were excluded from statistical analyses. Console-time data were available for 139 cases. Mean console time was 104.6 min and decreased across the sequential series. Segmented regression identified a breakpoint at approximately case 17, after which the decline in console time became less pronounced. The documented complication rate during available follow-up was 7.5%. Mean hospital stay was 2.03 days. No mortality occurred. Robotic-assisted RYGB using the Hugo™ RAS system was technically feasible and associated with a progressive reduction in console time. These findings provide further clinical data on the implementation of Hugo™ RAS for RYGB. Prospective comparative multicentre studies are needed to assess clinical outcomes, reproducibility, and generalizability.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138851","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":"Student and surgeon perceptions of a robotic theatre live-link within the undergraduate curriculum.","authors":"Lewis Blenkinsop, Kenneth Campbell, Neil Harrison, Ross Dolan","doi":"10.1007/s11701-026-04055-4","DOIUrl":"10.1007/s11701-026-04055-4","url":null,"abstract":"<p><p>Explore student and surgeon perceptions of robotic theatre live-links as part of an undergraduate medical degree programme. During the surgical block, in the fourth year of a five-year medical programme at the University of Dundee, a robotic live-link session was introduced. Students undertook a pre-session case discussion and targeted anatomy revision before linking in to view the live operation. During the live-link session, the operating surgeon facilitated group discussion and answered questions via a headset. Following the session, 12 students and four participating surgeons completed a questionnaire exploring their experience of the session. The data collected was analysed descriptively to assess the acceptability of this teaching method to the staff and students as well as the students' perceived benefits of the learning environment. The session was well received, with 92% (11/12) of students describing it as relevant or very relevant to their learning. Students also reported fewer barriers to learning compared with their experiences in theatre, such as feeling unable to ask questions. Surgeons felt the quality of the teaching delivered was as good as or better than that normally delivered in theatre. They also reported that the live-link did not impact negatively on their ability to undertake the clinical case. This appears to be the first instance of a robotic theatre live-link being timetabled within an undergraduate curriculum. Student and faculty feedback is positive, and it may provide a way to introduce students to theatre without the usual barriers to learning.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128863","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":"A comparison of perioperative outcomes for da Vinci robotic-assisted, laparoscopic and open surgery in oncologic procedures: a systematic literature review and meta-analysis of evidence from China.","authors":"Xuefeng Hu, Usha Seshadri-Kreaden, Ana Yankovsky, Danni Xiao, Haoran Zhan, Neera M Patel, Yifan Xu, Yu-Hsiang Kao, Ben Forrest, Ziting Wu, Beini Lyu","doi":"10.1007/s11701-026-04021-0","DOIUrl":"10.1007/s11701-026-04021-0","url":null,"abstract":"<p><p>The use of robot-assisted surgery (RAS) has increased markedly in China, but comparative evidence on its perioperative performance in cancer care is dispersed across specialties and study designs. This review synthesized Chinese evidence to examine the safety and effectiveness of da Vinci robot-assisted surgery (dV-RAS) relative to laparoscopic/video-assisted thoracoscopic surgery (LAP/VATS) and open surgery across seven oncologic procedures. We systematically reviewed comparative studies published from 2010 to 2024 and pooled estimates for dV-RAS versus LAP/VATS or open surgery. Prespecified perioperative outcomes were conversion to open surgery, operative time, estimated blood loss, blood transfusion, hospital length of stay, postoperative complications, readmission, reoperation, and 30-day mortality. The review included 116 studies. Relative to LAP/VATS, dV-RAS was associated with lower odds of conversion to open surgery (odds ratio [OR] 0.26; 95% confidence interval [CI] 0.21-0.33; p < 0.01), less blood loss (mean difference [MD] - 32.48 mL; 95% CI - 40.86 to - 24.11; p < 0.01), lower odds of transfusion (OR 0.61; 95% CI 0.51-0.73; p < 0.01), a shorter hospital stay (MD - 1.06 days; 95% CI - 1.30 to - 0.82; p < 0.01), fewer 30-day postoperative complications (OR 0.67; 95% CI 0.61-0.73; p < 0.01), and fewer reoperations (OR 0.62; 95% CI 0.40-0.96; p = 0.03). Comparisons with open surgery likewise favored dV-RAS for blood loss, transfusion, length of stay, and postoperative complications. Operative time, readmission, and 30-day mortality did not differ significantly between approaches. Across seven oncologic procedures, pooled evidence from China indicated that dV-RAS was associated with better outcomes on several perioperative measures than LAP/VATS or open surgery. Because between-study heterogeneity was substantial and most included studies were retrospective, the findings should be interpreted cautiously and confirmed in higher-quality prospective research.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128794","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":"National survey of GERGIN-affiliated Spanish gynecologic robotic surgeons of the perceived clinical, educational and professional impact of robotic surgery.","authors":"Sara García Álvarez, Santiago Domingo, Alberto Muñoz, Sergi Fernandez-Gonzalez, Anna Torrent, Laura Cánovas, Jordi Ponce, María Caballer, Víctor Lago","doi":"10.1007/s11701-026-04036-7","DOIUrl":"10.1007/s11701-026-04036-7","url":null,"abstract":"<p><p>Robotic surgery is reshaping minimally invasive gynecology; however, systematic characterisation of how GERGIN-affiliated Spanish gynecologic robotic surgeons perceive its clinical, educational, and professional implications has been lacking. We aimed to describe these perceptions and identify training gaps and professional attitudes in this national surgical community. A cross-sectional anonymous online survey was distributed in November 2025 by GERGIN (Grupo Español de Robótica Ginecológica), a working group of the Spanish Society of Obstetrics and Gynaecology (SEGO), to all 120 registered members. Two thematic blocks were analysed: (1) professional profile and surgical activity (items 1-10); and (2) clinical, educational, and professional impact (items 11-22), assessed with 7-point Likert scales and categorical responses. Descriptive statistics were applied. The study is reported according to the CHERRIES checklist. Of 120 eligible members, 82 responded (68.3%). The cohort was gender-balanced (50% female), mean age 44.7 ± 7.9 years, 44.4% with more than five years of robotic experience, 42.7% having performed more than 100 cases. Da Vinci Xi was used by 98.8%. Perceived patient recovery benefit was rated positively (mean 5.20/7; 76.8% ≥5). Near-unanimous consensus endorsed clear ergonomic improvement (98.8%). A dichotomy emerged in training: robotic surgery enhanced anatomical education (mean 5.07/7) but reduced residents' intraoperative exposure (mean 2.66/7) and did not accelerate the learning curve (mean 2.44/7). Cost (80.5%) and OR availability (70.7%) were the dominant perceived limitations. GERGIN-affiliated Spanish gynecologic robotic surgeons endorse the perceived clinical and ergonomic benefits of robotic surgery while acknowledging an educational paradox: anatomical teaching improves but operative exposure for trainees is reduced. Structured robotic residency curricula, dual-console availability, and simulation-based competency frameworks are urgently needed.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128755","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":"Surgeon task load, ergonomics, and clinical outcomes in laparoscopic versus robotic-assisted inguinal hernia repair: a systematic review and meta-analysis of randomized controlled trials.","authors":"Anna Rümmele-Vogt, Julian Süsstrunk, Marie-Thérèse Böttcher, Johannes Baur, Beat P Müller, Daniel C Steinemann, Fiorenzo V Angehrn","doi":"10.1007/s11701-026-03805-8","DOIUrl":"10.1007/s11701-026-03805-8","url":null,"abstract":"<p><p>Conventional laparoscopic inguinal hernia repair (LIHR) is common and robotic-assisted techniques (RIHR) are increasingly being implemented. Current literature is indecisive on whether RIHR offers clinical and ergonomical benefits. This systematic review compares LIHR and RIHR specifically focusing on surgeon workload and ergonomics. A literature search was performed in four databases to find randomized controlled trials comparing RIHR and LIHR. A risk of bias assessment was conducted using the Cochrane Tool and results were synthesized as pooled estimate, odds ratio or narrative review. Four trials were identified, encompassing 482 patients. The groups showed similar baseline characteristics across studies. A broad range of surgeon experience could be observed between trials. All studies showed a significant difference in operative time, but while three studies found RIHR to take longer, one study reported shorter operative time with RIHR, altogether leading to a non-significant pooled estimate (MD 17.14; 95% CI -3.22 to 37.49). While one study showed significantly better ergonomics with RIHR, the other study reporting on that topic found ergonomics between the two approaches to be comparable. Surgeon task load varied substantially between the trials. The pooled estimate slightly favored RIHR but did not reach statistical significance (MD -4.50; 95% CI -16.78 to 7.78). Postoperative complication rate was not significantly different overall (OR 0.89, 95% CI 0.42 to 1.90), although one study reported significantly less complications after RIHR. RIHR shows comparable patient-centered outcomes to LIHR. At the moment, there is no evidence for significant benefits regarding task load and ergonomics.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128900","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":"The robotic PIANO: a critical narrative review of surgeon-controlled operative polyphony, human factors, and robotic training.","authors":"Luigi Marano, Mirko Barone, Mehmet Mahir Özmen, Bojan Jovanovic, Francesco Paolo Prete, Silvia Malerba, Edmundo Inga-Zapata, Panagiotis Lainas, Elena Ruiz-Úcar, Miguel Angel Cáceres Yap, Vikas Jain, Beniamino Pascotto, Juan Santiago Azagra, Salaam Sadi, Ruslan Duka, Robert Molchanov, Adolfo Perez-Bonet, Nicolas Zucchini, Luis Osvaldo Suárez Carreón, Jaroslaw Skokowski, Adébusola Adenike Owokole, Archil Aladashvili, Miljana Vladimirov, Mahmoud Al-Balas, Cesar Santiago, Sharona Ross, Sharique Nazir, Yogesh Vashist, Adel Abou-Mrad, Mario Testini, Ludovico Docimo, David Albala, Rodolfo J Oviedo","doi":"10.1007/s11701-026-04035-8","DOIUrl":"10.1007/s11701-026-04035-8","url":null,"abstract":"<p><p>Robotic surgery can concentrate control of several technical functions at the console, but such concentration does not itself confer clinical independence, reduce dependence on the perioperative team, or improve patient outcomes. We define surgeon-controlled operative polyphony as the phase-bounded coordination of multiple partially independent technical control streams by one console operator within a distributed perioperative system. This critical narrative review and conceptual synthesis asks which technical functions can be concentrated coherently, where human-factors and team dependencies set limits, and how evaluation, training, and governance should respond. The piano is used as a question-generating model, not as evidence of clinical benefit. PubMed/MEDLINE was searched from inception through 18 August 2026; targeted engineering, educational, neuroscientific, human-factors, and musicological searches and backward citation tracking supplemented retrieval. To analyze this control configuration, we propose the PIANO framework: Phase-specific control, Interface fidelity, Agency allocation, Neuromotor integration, and Orchestrated teamwork. Its scientific novelty lies in linking this control architecture to the PIANO framework: Phase-specific control, Interface fidelity, Agency allocation, Neuromotor integration, and Orchestrated teamwork. PIANO is an analytic and hypothesis-generating framework, not a score or credentialing standard. Concentrated control may shorten selected action loops, but any benefit depends on feedback, workload, shared situation awareness, explicit authority, and rescue capacity. The Competency-Based Assessment of Robotic Surgery Skills (CARS) curriculum provides initial validation evidence for domain-specific assessment of performer competence; repeated cases and use-specific evidence remain necessary for high-stakes decisions. Artificial intelligence (AI) may support phase recognition, feedback, assessment, and personalised training within a human-in-the-loop system. One surgeon may coordinate many operative voices; safe surgery remains a collective, patient-centered performance.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128876","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":"Automated CT-based quantification of knee osteophytes for robotic-assisted total knee arthroplasty: a multi-cohort study.","authors":"Zhiqian Zheng, Do Weon Lee, Sewon Jeon, Hong Yeol Yang, Jong Keun Seon, Ho-Jung Jung, Joong Il Kim, Byung Sun Choi, Hyuk-Soo Han, Du Hyun Ro","doi":"10.1007/s11701-026-04015-y","DOIUrl":"10.1007/s11701-026-04015-y","url":null,"abstract":"<p><p>Preoperative computed tomography (CT) is routinely acquired for planning robotic-assisted total knee arthroplasty (TKA), yet osteophyte burden is not quantitatively characterized. We developed automated CT-based osteophyte quantification and evaluated it against blinded de novo expert-consensus annotations and an intraoperative accessible resected osteophyte volume reference. A human-in-the-loop 3-dimensional U-Net was developed using 387 knee CT scans. The frozen model was evaluated against blinded de novo expert-consensus annotations in two independent external cohorts (100 knees each). Spatial and volume agreement were assessed using Dice coefficient, surface Dice at 1-mm tolerance, 95th-percentile Hausdorff distance (HD95), intraclass correlation coefficient (ICC), mean absolute error, and Bland-Altman analysis. In a prospective cohort of 66 robotic-assisted TKAs, CT-derived total osteophyte volume was compared with the water-displacement volume of accessible osteophytes that were resected and recovered intraoperatively (accessible resected osteophyte volume reference). In the external cohorts, median total Dice was 0.913 and 0.909, surface Dice was 0.944 and 0.945, HD95 was 1.16 and 1.09 mm, and volume ICC was 0.977 and 0.972, respectively. Automated estimates showed conservative volume bias relative to expert consensus (- 0.499 and - 0.365 cc). In the surgical cohort, automated CT-derived volume showed cohort-level agreement with the accessible resected osteophyte volume reference (ICC, 0.876; mean absolute error, 1.224 cc; mean difference, + 0.401 cc; 95% limits of agreement, - 2.785 to + 3.586 cc). Automated CT-based osteophyte quantification showed consistent spatial and volumetric agreement with blinded de novo expert-consensus annotations across two external cohorts and cohort-level agreement with the accessible resected osteophyte volume reference. This scalable method provides a preoperative measure of osteophyte burden for arthroplasty research.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116679","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":"Measurement of trainee autonomy in robotic-assisted lung resections using objective performance indicators.","authors":"Aaron Guo, Jad Elharake, Chandler Lowe, Mahmoud Abdel-Rasoul, Marissa Guo, Shi-Hao Lee, Mallory Shields, Daniel Oh, Ioana Baiu, Peter J Kneuertz, Robert E Merritt, Desmond M D'Souza","doi":"10.1007/s11701-026-03622-z","DOIUrl":"10.1007/s11701-026-03622-z","url":null,"abstract":"<p><p>Trainee autonomy in robotic-assisted thoracic surgery is critical for growth but difficult to quantify. Robotic platforms can log intraoperative kinematic and event data that can be transformed into metrics known as objective performance indicators (OPIs). This study sought to use OPIs obtained during robotic-assisted anatomic lung resections to assess trainee console autonomy at a high-volume robotic center. OPI data were obtained from 59 lobectomies and segmentectomies performed on a multi-port robotic platform between March 2022 and May 2023. Cases were divided into anatomic steps and annotated by a team of verified video reviewers. Console autonomy was assessed based on average path length (PL) of controllers and active time (AT) on the trainee console as a ratio compared to the overall PL and AT of the operation. Cases included 51 (86%) lobectomies and 8 (13%) segmentectomies. Average overall PL ratio was 0.15 (SD 0.17) and overall AT ratio was 0.23 (SD 0.23) for senior trainees. Autonomy was highest for inferior pulmonary ligament division (PL ratio = 0.39, AT ratio = 0.42) while lowest with pulmonary artery dissection (PL ratio = 0.10, AT ratio = 0.14). There was a significant association between AT and PL ratio with estimated blood loss (PL p = 0.036, AT p = 0.047). AT and PL ratios can provide objective surrogates of autonomy in thoracic surgery and can be stratified by individual case components. OPIs will offer valuable metrics for surgical education and assessment as national accrediting bodies shift graduation requirements towards case component proficiency over volume.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116439","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":"The evidence landscape, clinical role, and mechanisms of action of robot-assisted injury treatment: a systematic review.","authors":"Xi Ling, Hang Yin","doi":"10.1007/s11701-026-04032-x","DOIUrl":"10.1007/s11701-026-04032-x","url":null,"abstract":"<p><p>Robotic systems now appear at several points in injury care, but surgical navigation, fracture reduction, and neurorehabilitation are still reviewed largely within separate disciplines. This separation obscures how technical performance alters treatment delivery and whether those changes reach patient outcomes. We therefore mapped robotic applications across the injury-care pathway and examined the links among technological capability, treatment process, proximal mechanism, clinical outcome, and implementation context. We systematically searched the Web of Science Core Collection and Scopus for Articles and Reviews published from 1 January 2015 to 22 August 2026. The search retrieved 17,374 records (Scopus 10,584; WoSCC 6,790). A four-stage Python 3.12.14 deduplication audit reduced these to 12,304 unique records, after which publication-type restriction and title/abstract screening yielded 214 records (149 primary studies and 65 focused reviews/meta-analyses). Descriptive bibliometrics, structured coding with second-reviewer verification, and framework synthesis were used to map publication patterns, injury categories, robot roles, study designs, and proposed mechanism pathways. Among the 214 records, 151 (70.6%) were published during 2022-2026. The 32 records assigned to 2026 cover only the period through 22 August and were treated as a partial-year count. Most records concerned spinal cord injury (97 records) or fracture and orthopaedic trauma (95 records). Lower-limb or gait rehabilitation (93 records) and surgery or navigation (90 records) were the most frequent robot roles. The two pathways acted through different proximal processes: rehabilitation robots could modify training dose, assistance, and sensorimotor engagement, whereas surgical systems could modify localization, trajectory control, and execution error. Together, the studies described a clinical continuum, but evidence remained limited for patient-important outcomes, long-term follow-up, economic value, implementation conditions, and comparisons across platforms. Robotics research now extends from acute injury repair to longer-term functional reconstruction, although the link between technical performance and clinically meaningful benefit remains incompletely tested. The proposed framework follows this link across five levels: technological capability, treatment process, proximal mechanism, clinical outcome, and implementation context. It also sets out a research sequence from consistent terminology to scalable clinical use. Because clinical roles and study designs were classified from bibliographic records and title or abstract information, these findings describe the evidence landscape rather than indication-specific effectiveness. No pooled effect estimate or graded clinical recommendation was produced.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"20 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116644","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}