Journal of Robotic Surgery最新文献

{"title":"Safety and diagnostic yield of robotic-assisted stereotactic biopsy for pediatric brainstem lesions: a systematic review and single-arm meta-analysis.","authors":"Jianqiang Zhao, Cheng Guo, Guolong Zhang","doi":"10.1007/s11701-025-02816-1","DOIUrl":"10.1007/s11701-025-02816-1","url":null,"abstract":"<p><p>Pediatric brainstem lesions pose significant diagnostic challenges due to their deep-seated location and critical neuroanatomical surroundings. Robotic-assisted stereotactic biopsy has emerged as a promising minimally invasive strategy, yet its safety and efficacy in this vulnerable population remain incompletely defined. We conducted a systematic review and single-arm meta-analysis in accordance with PRISMA guidelines (PROSPERO registration: CRD420251135743). PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to May 2025. Eligible studies included pediatric patients (≤ 18 years) with radiologically confirmed brainstem lesions who underwent robot-assisted stereotactic biopsy with reported histopathological and postoperative outcomes. Data were pooled using either a fixed-effects or random-effects model (DerSimonian-Laird) with Freeman-Tukey double arcsine transformation, depending on the degree of heterogeneity. From 72 records, 15 studies comprising 215 pediatric patients were included. Robotic systems evaluated included Neuromate, ROSA, Sino-Precision, and Autoguide, using both frameless and frame-based approaches. The pooled rate of technically efficacious biopsy was 99% (95% CI 98-100%), and the conclusive diagnostic yield was 98% (95% CI 93-98%). Molecular profiling was feasible, with an H3 K27-altered positivity rate of 77% (95% CI 54-94%). The pooled rate of temporary complications was 6% (95% CI 2-11%), mainly transient cranial nerve palsies or mild weakness, while permanent morbidity occurred in only 2 patients (1 hemiparesis and 1 cranial nerve XI/XII palsy), both following frameless procedures. No procedure-related mortality was reported. Subgroup analyses confirmed comparable diagnostic yield between frameless and frame-based systems, though permanent morbidity was observed only in the frameless cohort. The mean hospital stay was 2.08 days (95% CI 1.91-2.25 days), reflecting rapid postoperative recovery. Robotic-assisted stereotactic biopsy of pediatric brainstem lesions provides near-universal diagnostic yield with a favorable safety profile, supporting its role as a reliable minimally invasive approach in this high-risk setting. Both frameless and frame-based systems are effective, although rare permanent deficits have been reported with frameless techniques. Future multicenter randomized trials are warranted to directly compare robotic and conventional stereotactic methods, standardize perioperative outcome reporting, and further evaluate the contribution of robotic biopsy to molecular diagnostics and precision medicine in pediatric neuro-oncology.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"629"},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132257","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":"Prognostic factors for urinary incontinence after robot-assisted radical prostatectomy: a systematic review and meta-analysis.","authors":"Haoxin Huang, Keke Cai","doi":"10.1007/s11701-025-02803-6","DOIUrl":"https://doi.org/10.1007/s11701-025-02803-6","url":null,"abstract":"<p><p>The risk factors for urinary incontinence (UI) in individuals diagnosed with prostate cancer receiving robot-assisted radical prostatectomy (RARP) remain uncertain. This study aimed to systematically review urinary incontinence-related prognostic factors after RARP. Systematic searches were performed in the PubMed, Embase, and Web of Science databases through May 6, 2025. English-language studies investigating potential predictors of postoperative UI in RARP cases were considered. The Quality In Prognosis Studies (QUIPS) tool was utilized to evaluate the quality of the studies included. A random-effects meta-analysis was conducted to pool the odds ratios (ORs) extracted from the available studies on UI and its prognostic factors. Forty-eight studies comprising 12,620 participants were incorporated. The QUIPS assessment indicated a high risk of bias in study participation and confounding. Within the first 3 months following RARP, several variables were linked to postoperative UI, including age (OR per year: 1.04, 95% CI: 1.03-1.05), membranous urethral length (MUL; OR per mm: 0.83, 95% CI: 0.76-0.91), International Prostate Symptom Score (IPSS; OR per point: 1.03, 95% CI: 1.01-1.05), body mass index (BMI; OR per point: 1.019, 95% CI: 1.000-1.039), and prostate volume (PV; OR per ml: 1.009, 95% CI: 1.004-1.013). Between 3 and 12 months after surgery, age (OR per year: 1.05, 95% CI: 1.03-1.06), MUL (OR per mm: 0.81, 95% CI: 0.71-0.94), and IPSS (OR per point: 1.023, 95% CI: 1.001-1.046) remained independent predictors of UI. Increasing age, larger PV, higher BMI, shorter MUL, and higher IPSS were linked to worse UI within 3 months after surgery, with age, IPSS, and MUL remaining predictive at 3-12 months.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"628"},"PeriodicalIF":3.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132246","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":"Pioneering robotic surgery for complex gynecologic conditions: implementation beyond cancer care.","authors":"Alicia Hernández, Isabel Pascual, Jaime Siegrist, Ana López, Ignacio Zapardiel, Myriam Gracia, Ramón Usandizaga, María Del Mar Muñoz, Laura Pérez, Eloy R Ferreras, Eduardo Alonso, Alicia Carmona, Emanuela Spagnolo","doi":"10.1007/s11701-025-02581-1","DOIUrl":"10.1007/s11701-025-02581-1","url":null,"abstract":"<p><p>Minimally invasive surgery was introduced to minimize some of the issues associated with open surgery. Its benefits include fewer complications, less pain and blood loss, shorter hospital stays, quicker recovery, and less noticeable scars. While laparoscopy has been the gold standard for minimally invasive surgery, robot-assisted surgery has emerged as the latest major breakthrough for minimally invasive procedures, allowing surgeons to expand its use to more complex surgical procedures and operating with more precision, flexibility, control, and comfort than is possible with traditional procedures. Here we present the successful implementation of a robotic-assisted surgery program in the gynecology department of the Spanish tertiary hospital La Paz. This included the complete training of six surgeons from the three units in the department: oncology, pelvic floor, and benign organic pathology. By the end of 2024, 184 procedures had been conducted in the first year, including interventions for both cancer (N = 46) and benign pathologies (N = 138). In these, 2.2% of patients developed Clavien-Dindo grade 2 complications. The complexity of the procedures increased during implementation of the program, whereas hospitalization times and associated costs remained low.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"627"},"PeriodicalIF":3.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126258","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":"Critical appraisal of \"Robotic‑assisted surgery for acute abdominal emergencies: a systematic review of 1142 cases\".","authors":"Sameer Haider, Maiza Naseer, Touqeer Rehman, Kamran Mateen, Zain Ul Abideen","doi":"10.1007/s11701-025-02779-3","DOIUrl":"https://doi.org/10.1007/s11701-025-02779-3","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"626"},"PeriodicalIF":3.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126229","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":"Exploring the effects of closed-console vs. open-console robotic-assisted surgery systems on team dynamics in the operating room.","authors":"Kyi Phyu Nyein, Barry B McGuire, Emily Huang, Claire Condron, Jan B Schmutz","doi":"10.1007/s11701-025-02745-z","DOIUrl":"https://doi.org/10.1007/s11701-025-02745-z","url":null,"abstract":"<p><p>Using the input-mediator-output-input framework, this study aims to explore the effects of closed-console and open-console robotic-assisted surgery (RAS) systems on team dynamics in the operating room. RAS has been rapidly evolving, with several systems available on the market and in clinical use. While these RAS systems have distinct features and designs, the main distinction that impacts team dynamics during surgery is the console design. We conducted 10 semi-structured interviews with operating room team members who had experience using either or both of the RAS systems. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Participants reported better vision across the operating room and higher situational awareness in the open-console system than in the closed-console system. They also reported feeling the operating surgeon's presence and approachability more in the open-console system, whereas they tried not to disturb the surgeon in the closed-console system. Moreover, they reported being able to use more nonverbal cues and gestures in the open-console system than in the closed-console system. The console design was found to have little effect on coordination, but participants reported that compared with the closed console, the open console allowed the operating surgeon to see any issues at the bedside more quickly and provide assistance earlier. This study provides empirical evidence that the open-console system improves team dynamics in the operating room, reducing delays and enhancing operation efficiency. It offers guidance for RAS system selection, training, and optimizing team processes.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"625"},"PeriodicalIF":3.0,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103066","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":"Commentary on \"Adoption and perioperative outcomes of single-port (SP) robotic partial nephrectomy in the state of Michigan: a MUSIC-KIDNEY analysis\".","authors":"Hongquan Liu, Yicheng Guo, Jitao Wu","doi":"10.1007/s11701-025-02811-6","DOIUrl":"https://doi.org/10.1007/s11701-025-02811-6","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"624"},"PeriodicalIF":3.0,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103016","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 comparative analysis of pre-operative factors, intra-operative events and post-operative outcomes assessing transperitoneal and retroperitoneal approaches for robotic partial nephrectomy in T1 renal cancer: a multicenter international experience\".","authors":"Hongquan Liu, Shangjing Liu, Jitao Wu","doi":"10.1007/s11701-025-02808-1","DOIUrl":"https://doi.org/10.1007/s11701-025-02808-1","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"623"},"PeriodicalIF":3.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102895","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":"Letter to the editor: interpretable machine learning model predicts 1‑year inguinal hernia risk after robot‑assisted radical prostatectomy.","authors":"Sana Iftikhar, Ahmad Furqan Anjum","doi":"10.1007/s11701-025-02801-8","DOIUrl":"https://doi.org/10.1007/s11701-025-02801-8","url":null,"abstract":"<p><p>We read with interest the recent article by Yu et al., \"Interpretable machine learning model predicts 1-year inguinal hernia risk after robot-assisted radical prostatectomy\" (DOI: 10.1007/s11701-025-02723-5) , which represents an important step in applying explainable machine learning to postoperative complication prediction. The authors should be commended for highlighting inguinal hernia as an underrecognized sequela of robot-assisted radical prostatectomy and for pioneering the use of SHAP-based interpretation in this context. Their findings offer valuable groundwork for risk stratification and personalized counseling. While the study acknowledges several limitations, we wish to highlight additional concerns that warrant consideration. First, the reliance on a single, ethnically homogeneous cohort may limit generalizability across diverse populations. Second, omission of intraoperative surgical technique variables-such as Retzius-sparing approaches, peritoneal closure, or extraperitoneal access-restricts the model's ability to account for modifiable surgical factors. Third, the use of symptom-driven ultrasonography risks underdetection of subclinical hernias, introducing potential bias. Fourth, the one-year follow-up period may underestimate true incidence, as many cases manifest within 2-3 years postoperatively. Finally, the feature set was confined to five predictors, overlooking biological and functional variables such as collagen metabolism, frailty indices, and continence recovery, which are known to influence hernia development.We suggest that future research incorporate multicenter, ethnically diverse cohorts, longer follow-up, standardized imaging, and expanded biological and surgical predictors. These steps will enhance predictive accuracy, clinical utility, and generalizability. Our critique aims to complement the authors' contribution and foster refinement of machine learning models for postoperative complication risk prediction.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"620"},"PeriodicalIF":3.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087709","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 novel robotic system based on heterogeneous master-slave control algorithm: design and its clinical application in endoscopic submucosal dissection.","authors":"Keshun Fan, Miko Lin Lv, Hongdong Tian, Luping Shen, Ang Ke, Long Chen, Huangtao Zhang, Yuanming Jing, Jialin Yang","doi":"10.1007/s11701-025-02686-7","DOIUrl":"10.1007/s11701-025-02686-7","url":null,"abstract":"<p><p>Endoscopic Submucosal Dissection (ESD) is the gold standard for early gastrointestinal tumor resection but remains technically demanding due to limitations in visualization, traction, and instrument control. A flexible auxiliary single-arm transluminal endoscopic robot (FASTER, EndoFaster) was therefore developed to provide real-time traction assistance. The EndoFaster system underwent a two-stage validation. Technical assessment confirmed real-time control performance, including motion latency, trajectory fidelity, and positional accuracy. Subsequently, a prospective, randomized multicenter trial across six hospitals enrolled 192 ESD patients, randomized 1:1 to robotic-assisted ESD or conventional ESD. Primary endpoint was en bloc (R0) resection rate; secondary endpoints included dissection time, submucosal visualization, intraprocedural complications, and operator workload. EndoFaster achieved stable, accurate motion performance, systems validation confirmed precise real-time motion mapping between master-slave controllers within clinically acceptable thresholds. In multicenter clinical trials, en bloc resection rates were comparable between the EndoFaster (98.84%) and control groups (98.13%), confirming non-inferiority. The system significantly reduced dissection time (P = 0.00435), improved submucosal visualization, and decreased muscular injury incidence and operator workload. The EndoFaster robotic assistance system serves as a dynamic \"third hand,\" effectively enhancing submucosal visualization and traction control. This improves the safety and efficiency of ESD while preserving standard clinical workflows.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"619"},"PeriodicalIF":3.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087741","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":"Attention to the Editor: \"Impact of preoperative diastolic dysfunction on short-term outcomes following robotic-assisted minimally invasive esophagectomy (RAMIE)\".","authors":"Saeed Torabi, Philipp Omuro, Dolores T Krauss, Sandra E Stoll, Tobias Kammerer, Georg Dieplinger, Thomas Schmidt, Fabian Dusse, Andrea U Steinbicker, Christiane J Bruns, Lars M Schiffmann, Hans F Fuchs","doi":"10.1007/s11701-025-02804-5","DOIUrl":"10.1007/s11701-025-02804-5","url":null,"abstract":"","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"621"},"PeriodicalIF":3.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087767","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}