Journal of Robotic Surgery最新文献

{"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}

{"title":"Economic sustainability of a newly established robotic thoracic surgery programme in a public healthcare system: early experience from a high-volume latin American centre.","authors":"Francina Valezka Bolaños-Morales, Jesús Carrranza-Zarmina, Edgar Castro-Santamaría, Carmen Margarita Hernández, Edtih Paramo, Mario Casas, Zeyda Juárez, Ricardo Eli Guido-Guerra, Pablo Gomes-da Silva de Rosenzweig, Alma Lilia Juarez-Armenta, Justino Regalado-Pineda, Jorge Salas-Hernández, Patricio Santillán-Doherty","doi":"10.1007/s11701-026-04029-6","DOIUrl":"10.1007/s11701-026-04029-6","url":null,"abstract":"<p><p>Robotic-assisted thoracic surgery (RATS) has emerged as an important advancement in minimally invasive thoracic surgery; however, concerns regarding its economic impact continue to limit its broad adoption. We evaluated the early clinical outcomes and economic performance of a newly established robotic thoracic surgery programme in a tertiary referral centre in Mexico. A retrospective observational study was conducted, including consecutive patients undergoing RATS between October 2023 and June 2024. Clinical outcomes of the robotic cohort were analysed descriptively. Economic comparisons with conventional thoracic surgery were performed using institutional administrative costing data. A total of 116 patients underwent RATS. Median postoperative hospital stay was 5 (2-10) days, with a 90-day mortality of 1.7%. Economic performance differed according to procedure. Mediastinal tumour resection demonstrated lower overall institutional costs than conventional surgery, representing a dominant economic strategy. Thymectomy and bronchoplasty achieved favourable cost-effectiveness profiles below the two-times gross domestic product per capita willingness-to-pay threshold, whereas bullectomy remained cost-effective only under the three-times threshold. The implementation of a robotic thoracic surgery programme within a public healthcare institution was clinically feasible and demonstrated favourable economic performance in selected thoracic procedures. The economic sustainability of robotic thoracic surgery appears to be procedure-specific and may be facilitated by innovative implementation strategies and appropriate case selection.</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":"149116385","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":"Correction: KangDuo surgical robot KD-SR-01 versus da Vinci Xi in robot-assisted colorectal cancer resection: oncologic outcomes at three years in a multicenter randomized trial.","authors":"Zhanpeng Cen, Zhen Sun, Tianyi Ma, Donglin Du, Lai Xu, Junyang Lu, Zhengqiang Wei, Guiyu Wang, Yi Xiao","doi":"10.1007/s11701-026-03998-y","DOIUrl":"https://doi.org/10.1007/s11701-026-03998-y","url":null,"abstract":"","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":"149116701","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 single-port robotic platform for minimally invasive cardiac surgery: system functionality and initial preclinical feasibility.","authors":"Chengcheng Cai, Tong Ren, Zhikang Ma, Kailun Dong, Baoyue Lu, Wenze Sun, Jianchang Zhao, Jianmin Li, Rong Wang, Lizhi Pan","doi":"10.1007/s11701-026-04027-8","DOIUrl":"10.1007/s11701-026-04027-8","url":null,"abstract":"<p><p>Conventional robotic cardiac approaches generally require multiple intercostal access sites to establish instrument triangulation. This study presents an in-house-developed single-port robotic platform designed around cardiac manipulation requirements and evaluates its initial task-specific feasibility in one pig. The system integrates a common entry guide, three-dimensional endoscopic visualization, articulated instruments, and master-slave teleoperation. Robot-assisted internal mammary artery (IMA) dissection was performed on the beating heart through retractor-assisted intercostal access. Mitral annular suture placement was performed after planned terminal euthanasia, incision enlargement, and manual atrial exposure maintained with suspension sutures. Cardiopulmonary bypass was not used. A 115-mm IMA segment was skeletonized robotically during a 49-min dissection interval within an 87-min IMA phase, followed by manual clipping and division. No additional robotic port was required, and no macroscopic IMA injury or major bleeding was observed during dissection. Mitral annular suture placement was completed at nine positions in 46 min using coordinated bimanual manipulation. These observations provide preliminary evidence that intrathoracic deployment and distal articulation can support the selected cardiac tasks under the reported conditions. The findings provide a basis for technical refinement and further preclinical evaluation but do not establish reproducibility, procedural safety, or the feasibility of a complete single-port mitral valve procedure.</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":"149116642","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":"When every product works but the case fails, the need for system performance readiness in connected surgery.","authors":"Binita S Ashar","doi":"10.1007/s11701-026-03993-3","DOIUrl":"10.1007/s11701-026-03993-3","url":null,"abstract":"<p><p>Connected procedural care is increasingly evaluated product by product, although performance emerges from interactions across technologies, organizations, and clinical workflows. This paper proposes System Performance Readiness (SPR) as a capability for understanding system performance across product boundaries. Its defining requirement is that a connected procedural episode be reconstructable, so that any legitimate participant, whether a health system, manufacturer, clinician, or regulator, can understand how the connected system performed. Rather than creating a new regulatory layer or data platform, the framework specifies what a system should be able to know, who is responsible for the relevant evidence, and how learning can occur across platforms and sites. A reconstructable record of the connected episode makes it possible to understand how the system performed, so that learning, not blame, drives improvement.</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":"149116630","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":"Correction: Feasibility and clinical outcomes of same-day discharge after robot-assisted partial nephrectomy at an ambulatory surgery center.","authors":"Ivan Kirche-Duarte, Arie Carneiro, Salvador Jaime-Casas, Oluwatimilehin Okunowo, Anjaney Kothari, Ahmad Imam, Daniel Jiang, Rodrigo A Fribourg-Liendo, Kelvin Zheng, Kevin G Chan, Ali Zhumkhawala, Jonathan Yamzon, Wesley Yip, Bertram Yuh, Clayton S Lau","doi":"10.1007/s11701-026-03999-x","DOIUrl":"10.1007/s11701-026-03999-x","url":null,"abstract":"","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/PMC13638705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116676","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":"Targeted pelvic lymph node dissection using magnetic resonance imaging - ultrasonography fusion technique and indocyanine green injection in robot-assisted radical prostatectomy.","authors":"Yuta Yamada, Naoki Kimura, Yuji Hakozaki, Masaki Nakamura, Koki Sugano, Kazuma Sugimoto, Shigenori Kakutani, Jimpei Miyakawa, Jun Kamei, Aya Niimi, Satoru Taguchi, Haruki Kume","doi":"10.1007/s11701-026-03939-9","DOIUrl":"10.1007/s11701-026-03939-9","url":null,"abstract":"<p><p>This study assessed the diagnostic accuracy and potential therapeutic value in performing targeted pelvic lymph node dissection (PLND) guided by magnetic resonance imaging (MRI)-ultrasonography (US) fusion combined with Indocyanine green (ICG) injection (tPLND-MUI). This study was retrospectively designed and included 72 patients who underwent robotic radical prostatectomy (RARP) combined with PLND. The inclusion criteria were: (1) prostate cancer with a Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) category 4 or 5 lesion on MRI, (2) Patients who had clinical records of ICG fluorescence or surgical videos of PLND. The clinical impact of the tPLND-MUI was assessed based on its diagnostic accuracy for identifying nodal metastasis and its potential therapeutic value in achieving complete removal of metastatic lymph nodes. A backup PLND using the super-extended template (sePLND) was performed, and outcomes of tPLND-MUI, limited-PLND (limPLND), extended-PLND (ePLND), and standard-PLND (sPLND) were compared against sePLND. A total of 72 patients were incorporated into the final analysis. tPLND-MUI resulted in a median removal of 29 lymph nodes which were fewer than those of sePLND and ePLND. For detecting at least one lymph node metastasis, sensitivity reached 100% with both ePLND and tPLND-MUI, 95.2% with sPLND, and 71.4% with lim-PLND. The ratios of complete removal of lymph node metastases were 81.0% for ePLND, 66.7% for sPLND, 33.3% for limPLND, and 95.2% for tPLND-MUI. tPLND-MUI may demonstrate excellent therapeutic and diagnostic performance despite the removal of fewer lymph nodes and fewer dissecting regions. Further prospective research is needed to validate these findings.</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":"149116691","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":"Institutional availability, training resources, and supervised participation in robot-assisted surgery among Polish urology residents: a nationwide survey.","authors":"Bartosz Brzoszczyk, Marcin Jarzemski, Rafał Brzóska, Bartosz Roś, Łukasz Mielczarek, Rafał Bogdan Drobot, Mateusz Władysław Jobczyk, Maciej Wojciech Przudzik, Magdalena Tarkowska, Piotr Jarzemski","doi":"10.1007/s11701-026-04014-z","DOIUrl":"10.1007/s11701-026-04014-z","url":null,"abstract":"<p><p>Robot-assisted surgery (RAS) has expanded rapidly in Poland, but its integration into resident education remains uncertain. In a nationwide anonymous 35-question survey sent to 390 Polish urology residents, 156 completed it (40.0%). Among respondents, 110 (70.5%) reported RAS availability in their training centre; 56 (35.9%) reported robotic training access, 43 (27.6%) a robotic course, 46 (29.5%) simulator availability, 76 (48.7%) assistant participation, and 16 (10.3%) a supervised robotic procedure or procedural step. All respondents with training access were in RAS centres. Among these 110 respondents, course attendance (aOR 5.38, 95% CI 2.05-14.14) and simulator availability (aOR 3.90, 95% CI 1.54-9.89) were associated with access. Training access was associated with assistant participation (aOR 6.66, 95% CI 3.06-14.50), higher current and expected self-rated skill (common aORs 12.30 and 12.15), and at least satisfactory training satisfaction (aOR 17.01, 95% CI 6.35-45.57). All 16 such reports occurred among residents with access; in an exploratory conditional Firth model, each additional residency year was associated with this outcome (aOR 2.11, 95% CI 1.30-3.97). Items were independent, not sequential stages. Institutional adoption exceeded reported training access and supervised participation. Broad survey content makes participation driven solely by robotics interest less likely, but the 40.0% completion proportion, self-report, unmeasured trainee selection, and rare supervised outcome limit inference.</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/PMC13638758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116377","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}