Journal of Robotic Surgery最新文献

{"title":"Comparing the effect of laparoscopic and robotic stapling on clinical outcomes, efficiency, and costs of robot-assisted Roux-en-Y gastric bypass.","authors":"Juliane O Hafermann, Jarrod D Phelps, Mahmoud F El Tayash","doi":"10.1007/s11701-025-02223-6","DOIUrl":"10.1007/s11701-025-02223-6","url":null,"abstract":"<p><p>Roux-en-Y gastric bypass (RYGB) is a commonly used surgery to successfully and durably treat obesity that is increasingly performed robotically. The anastomoses created during robot-assisted RYGB are usually stapled, either using laparoscopic or robotic staplers. This study aimed to compare the peri-operative efficiency, costs, and clinical outcomes of laparoscopic and robotic staplers in robot-assisted RYGB. This retrospective study analyzed patients who underwent robot-assisted RYGB (with or without hiatal hernia repair) with the Da Vinci Xi robotic system in a private practice in the United States. The gastric pouch and anastomoses were created either with robotic SureForm™ staplers or laparoscopic Endo GIA™ staplers; enterotomies and incisions were closed with sutures. The primary outcome was procedure time. The secondary outcomes were instrument exchanges and reloads used, stapling costs, length of stay, and complications within 3 months. Of the 105 patients included, 50 patients were treated with robotic staplers and 55 with laparoscopic staplers. None were lost to follow-up. Laparoscopic staplers were more efficient than robotic ones: they significantly reduced procedure times across all analyzed categories as well as the number of instrument exchanges and reloads needed per surgery. There was no difference in the length of hospital stay, and no complications were reported. The higher number of reloads and the higher unit cost resulted in higher total stapling costs for robotic compared to laparoscopic staplers. While robotic staplers in robot-assisted RYGB are safe and feasible, laparoscopic staplers improve efficiency, reduce resource use, and lower costs without compromising patient safety.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"65"},"PeriodicalIF":2.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374851","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: \"3D Da Vinci robotic surgery: is it a risk to the surgeon's eye health?\" by Molle, et al.","authors":"Cheng Tang, Jin-Jin Chen, Jin Yuan, Jin-Jin Huang, Tao Yan","doi":"10.1007/s11701-025-02226-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02226-3","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"63"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366369","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: \"KangDuo surgical robot versus da Vinci robotic system in urologic surgery: a systematic review and meta‑analysis\".","authors":"Yi Liu, Hongjie Chen, Ninggang Yang","doi":"10.1007/s11701-025-02235-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02235-2","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"64"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366374","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":"Trends in adoption of robotics in arthroplasty: an analysis of the Indian landscape.","authors":"Praharsha Mulpur, Tarun Jayakumar, Rajeev Reddy Kikkuri, Adarsh Annapareddy, Kushal Hippalgaonkar, A V Gurava Reddy","doi":"10.1007/s11701-025-02224-5","DOIUrl":"https://doi.org/10.1007/s11701-025-02224-5","url":null,"abstract":"<p><p>Robotic-assisted technology in total joint arthroplasty (TJA) offers improved precision in component placement and alignment, addressing challenges, such as ligament imbalance, malalignment, and patient dissatisfaction. In India, where diverse healthcare settings exist, trends in robotic adoption remain underexplored. This study examines the adoption patterns and geographic distribution of robotic systems for TJA in India, highlighting market dynamics over the past 5 years. A cross-sectional observational study was conducted using data from manufacturers of robotic arthroplasty systems. Annual installations, tier-wise city classifications, and geographic distributions were analyzed. Statistical methods included descriptive analysis for installation trends, time-series visualization for adoption trajectories, and linear regression to forecast 2025 installations. As of September 2024, 290 robotic systems were installed across India. Among these, the CUVIS system (Meril) accounted for 89 installations (30.7%), followed by CORI (Smith and Nephew) with 66 installations (22.8%), and VELYS (DePuy) with 52 installations (17.9%). The MAKO system (Stryker) contributed 38 installations (13.1%), while MISSO (Meril) and ROSA (Zimmer) had 25 (8.6%) and 20 (6.9%) installations, respectively. Tier I hospitals dominated with 50% of installations, while Tier III and IV facilities accounted for only 10%. Linear regression predicts steady growth, with over 80 new robotic installations in 2025. Robotic technology adoption in Indian TJA has surged, with a strong preference for systems offering precision and versatility. However, barriers such as high costs and limited training impede penetration in lower tier facilities. Addressing these challenges could enhance equitable access and support the integration of robotics into diverse healthcare settings.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"62"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366383","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":"Telerobotics for the treatment of cardiovascular and stroke events.","authors":"Riccardo Oliva, Eduardo Fonseca, Jacques Marescaux","doi":"10.1007/s11701-025-02218-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02218-3","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"61"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190920","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 short-term outcomes of robotic versus laparoscopic right colectomy for patients ≥ 65 years of age: a systematic review and meta-analysis of prospective studies.","authors":"Konstantinos Kossenas, Olga Moutzouri, Filippos Georgopoulos","doi":"10.1007/s11701-025-02222-7","DOIUrl":"https://doi.org/10.1007/s11701-025-02222-7","url":null,"abstract":"<p><p>Robotic right colectomy (RRC) has been researched and compared in the past to the laparoscopic approach (LRC). However, it remains unclear whether RRC outperforms LRC in patients aged 65 or older with colon cancer or adenoma. Thus, this systematic review and meta-analysis aims to compare the short-term outcomes of RRC to LRC in this particular age group. PubMed, Scopus, and Cochrane Library were searched for related literature. Studies and data were extracted by two independent reviewers. Inverse variances weighted mean differences (WMD) with random effects model were used for continuous values, and odds ratios (OR) with random effects model using the Mantel-Haenszel's formula were used for dichotomous values. Heterogeneity using Higgins I² and p values were calculated. A sensitivity analysis was performed for operative duration and number of harvested lymph nodes. In total 382 patients, 157 in RRC and 225 in LRC, were included in this study. A statistically significant increase of 43.91 min [95%CI: 19.61, 68.22], P = 0.001, was observed regarding operative duration in the RRC group, compared to LRC, but with high heterogeneity, I² = 89%. However, a statistically significant decrease of 42% [OR = 0.58 (0.34, 0.98), P = 0.04, I²=2%] was observed with regard to overall complications in RRC compared to LRC. Non-significant differences between the two approaches were observed in the number of harvested lymph nodes [WMD = 0.44 (95%CI: -3.94, 4.82), P = 0.85, I² = 52%], wound infections [OR = 0.63 (95%CI: 0.11, 3.52), P = 0.60, I² = 13%], rate of ileus [OR = 0.29 (95%CI: 0.08, 1.00), P = 0.05, I² = 0%], length of hospitalization [WMD = 0.18 (95%CI: - 0.74, 1.11), P = 0.70, I² = 0%], and anastomotic leakage [OR = 0.52 (95%CI: 0.09, 3.11), P = 0.47, I² = 0%]. The results of the operative duration and number of harvested lymph nodes remained statistically significant and non-significant, respectively, after sensitivity analysis. Robotic right colectomy appears to require a longer operative duration, but possibly offers lower rates of overall complications, compared to laparoscopic right colectomy in patients ≥ 65 years of age. Due to the lack of studies identified in the literature, and the ones included being non-randomized, no solid conclusions can be drawn and cautious interpretation of the results is advised. Future studies are necessary to further examine both short- and long-term outcomes. Prospero registration: CRD42024603354.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"60"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190918","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":"Evaluating the safety of robotic total gastrectomy with D2 lymphadenectomy for gastric cancer against the conventional laparoscopic approach: a systematic review and meta-analysis.","authors":"Konstantinos Kossenas, Olga Moutzouri, Filippos Georgopoulos","doi":"10.1007/s11701-025-02219-2","DOIUrl":"https://doi.org/10.1007/s11701-025-02219-2","url":null,"abstract":"<p><p>Gastric cancer poses a significant global health challenge, necessitating effective surgical interventions. A critical gap in the literature exists, as most studies do not differentiate between various surgical approaches, i.e., total, distal, and subtotal gastrectomy, and level of lymphadenectomy, when comparing robotic to conventional laparoscopic gastrectomy. This leads to a lack of clear evidence regarding the safety and efficacy of robotic total gastrectomy (RTG) specifically in the context of total gastrectomy with D2 lymphadenectomy.This systematic review and meta-analysis evaluates the safety of RTG with D2 lymphadenectomy compared to conventional laparoscopic total gastrectomy (LTG). A literature search was conducted up to November 1, 2024, following PRISMA guidelines. Eligible studies included studies comparing RTG and LTG, focusing on anastomotic leakage, Clavien-Dindo Grade ≥ III complications, conversion rates, mortality, overall complications, and reoperation rates. Data were synthesized using odds ratios (OR) and weighted mean differences (WMD), with statistical heterogeneity assessed using the I² statistic. Five studies comprising 1131 patients (432 RTG, 700 LTG) were included. No significant differences were found in the following outcomes: anastomotic leakage (OR = 0.79 [95% CI: 0.35, 1.78], I² = 0%, P = 0.57), Clavien-Dindo Grade ≥ III complications (OR = 0.86 [95% CI: 0.51, 1.45], I² = 0%, P = 0.56), conversion to open surgery (OR = 0.34 [95% CI: 0.10, 1.18], I² = 0%, P = 0.09), mortality (OR = 1.78 [95% CI: 0.23, 13.48], I² = 0%, P = 0.58), overall complications (OR = 0.84 [95% CI: 0.62, 1.14], I² = 0%, P = 0.26), and reoperation rates (OR = 0.88 [95% CI: 0.29, 2.67], I² = 0%, P = 0.82). Sensitivity analysis proves the robustness of the findings. The analysis shows no significant differences in safety outcomes between RTG and LTG for gastric cancer, indicating both techniques are comparable. RTG may be a viable alternative to LTG, especially in centers with appropriate robotic capabilities. Further research is warranted to investigate long-term outcomes and the learning curve of robotic surgery.PROSPERO Registration: CRD42024606570.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"59"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-surgeon training of 14 novice surgeons in robotic cholecystectomy: a study of 300 consecutive cases, assessing training outcomes and surgical performance.","authors":"Danilo Coco, Silvana Leanza, Massimo Giuseppe Viola","doi":"10.1007/s11701-024-02166-4","DOIUrl":"https://doi.org/10.1007/s11701-024-02166-4","url":null,"abstract":"<p><p>Robotic-assisted surgery (RAS) is a rapidly evolving field, requiring comprehensive training for widespread adoption. The aim of this study was to analyze the effectiveness of RAS cholecystectomy training in improving the technical skills and confidence of novice surgeons. Furthermore, the study examined the transferability of RAS skills to laparoscopic skills, the role of RAS cholecystectomies in reducing errors and improving patient outcomes, and identified factors that predict a successful transition from traditional laparoscopic surgery to RAS surgery. The RAST curriculum includes multimodal learning content delivered through a cloud-based platform, with three steps: basic training, simulation exercises, and structured on-patient training in the operating room. One general surgeon was trained on the Intuitive Surgical da Vinci system and assisted in performing 10 da Vinci-assisted laparoscopic cholecystectomies. In the first 300 patients who underwent robotic cholecystectomy, there were no major complications, conversions to laparoscopy, or open surgeries. The RAST curriculum demonstrates feasibility in providing a comprehensive and effective RAS training experience for surgical residents, reducing the need for extensive travel and high costs. The RAST curriculum is a promising solution for training surgical residents in RAS, with potential for widespread adoption and scalability.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"58"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075652","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":"Long-term outcomes of robotic inguinal hernia repair (r-TAPP): a retrospective review of 434 consecutive cases by a single surgeon with 3-8 years of follow-up.","authors":"Omar J Viera, Jorge L Florin, Kevin E Morales","doi":"10.1007/s11701-025-02220-9","DOIUrl":"10.1007/s11701-025-02220-9","url":null,"abstract":"<p><p>When evaluating the long-term follow-up of robotic-assisted transabdominal preperitoneal (r-TAPP) approach to inguinal hernias, research remains limited due to small patient cohorts and shorter follow-up durations. The most significant research on inguinal hernia repair utilizing r-TAPP procedure includes follow-up periods of up to 2 years and examines approximately 150 cases. This article presents data from 434 consecutive r-TAPP procedures conducted on 324 patients, with follow-up ranging from a minimum of 3 years to 8 years. These procedures were performed between April 2016 and February 2021. Patients were seen in person for a follow-up appointment 2 weeks after surgery, with additional follow-ups conducted via phone at half a year, a full year, and yearly thereafter up to 8 years. Among the 324 patients, 107 patients presented with left-sided inguinal hernias (33%), 107 presented with right-sided inguinal hernias (33%), and 110 presented with bilateral inguinal hernias (33.95%). Patients' ages varied between 25 and 96 years, and their BMI ranged from 17.7 to 50.2 (mean: 26.9, median: 26.2). Total procedure time varied from 35 to 191 min (mean: 62 min, median: 54 min). Within this, the docking time averaged 6 min, ranging from 3 to 15 min. The console time, which constitutes the primary operative phase, averaged 43 min, with a range of 11-183 min. The ASA scores varied between 1 and 3 (mean: 2, median: 2). None of the 324 patients experienced major blood loss, required conversion to open surgery, or had to stay overnight; every patient was sent home on the day of the procedure. Follow-up rates included 86.9% at 3 years, 87.1% at 4 years, 86.7% at 5 years, 86.4% at 6 years, 89.7% at 7 years, and 87.5% at 8 years. Two hernia recurrences were reported out of the 324 patients with 434 hernias performed, and no patients reported chronic pain between 3 and 8 years post-operation. The r-TAPP procedure provides a secure and efficient repair with a low recurrence rate (0.46%), reduced chronic pain, and competitive operative times. Compared to laparoscopic repair, which has a median operative time of 79 min, r-TAPP showed average times of 54 min for left-lateral hernias, 53 min for right-lateral hernias, and 79 min for bilateral cases (Kakiashvili et al.). While slightly longer than open repair (median time of 44 min), with differences of about 10 min for unilateral and 35 min for bilateral cases, r-TAPP offers superior precision and outcomes, making it a valuable option for inguinal hernia repair.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"57"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068836","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":"Transperitoneal vs retroperitoneal robotic partial nephrectomy: a meta-analysis and systematic review of propensity-matched studies.","authors":"Ruo-Zeng Rong, Pan Zhang, Mei Zhao, Cui-E He","doi":"10.1007/s11701-025-02217-4","DOIUrl":"https://doi.org/10.1007/s11701-025-02217-4","url":null,"abstract":"<p><p>The main aim of this meta-analysis is to assess and compare the impact of two different surgical approaches, transperitoneal and retroperitoneal, on perioperative outcomes in robotic partial nephrectomy. A systematic search of MEDLINE, PubMed, Google Scholar, and the Cochrane Database was conducted to identify relevant studies published between January 2000 and January 2025. Included were nine non-randomized controlled trials with a total of 2420 patients with matching propensity scores. Among these patients, 1321 had robotic TPPN and 1099 had robotic RPPN, the abbreviation for robotic partial nephrectomy. Shorter operating times, shorter hospital stays, less estimated intraoperative blood loss, and fewer total postoperative problems were related to RPPN compared to TPPN. There were no notable disparities between the two groups when comparing the duration of renal ischemia, the fall in postoperative glomerular filtration rate (GFR), the occurrence of serious postoperative sequelae, or the necessity for blood transfusions. Compared to TPPN, RPPN demonstrates certain advantages in perioperative metrics such as surgical time, hospital stay, and overall complication rates. However, further high-quality studies are needed to confirm these findings.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"56"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061034","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}