International Journal of Medical Robotics and Computer Assisted Surgery最新文献

{"title":"Single-Port Robotic Resection of Recurrent Hepatocellular Carcinoma in the Right Anterior Lobe: A Case Report","authors":"Zesheng Jiang,&nbsp;Zhoubin Feng,&nbsp;Yuyan Xu,&nbsp;Jiasheng Qin,&nbsp;Jianan Feng,&nbsp;Haiyan Liu,&nbsp;Zhiping Wang,&nbsp;Luhao Chi,&nbsp;Wenxuan Liu,&nbsp;Lei Cai,&nbsp;Mingxin Pan","doi":"10.1002/rcs.70092","DOIUrl":"https://doi.org/10.1002/rcs.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We report the first case of single-port robotic liver tumour resection in a patient with recurrent hepatocellular carcinoma in the right anterior lobe of the liver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 65-year-old male with recurrent hepatocellular carcinoma in the right anterior lobe underwent robotic liver tumour resection using the EDGE SP1000, a single-port laparoscopic surgical robot. The procedure involved resection of a 2.7-cm-diameter tumour in segment five of the liver via adhesiolysis, partial hepatectomy, suturing, ligation, and an innovative suction technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The surgery lasted 120 min with 30 mL of blood loss. The patient's postoperative vital signs were stable. EDGE SP1000 use for robotic liver tumour resection is safe for older patients who require minimally invasive surgery and those with severe abdominal adhesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The EDGE SP1000 has superior capabilities that enable precise manipulation within the confined space of the abdomen and allow minimally invasive single-port surgery with aesthetic benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624550","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":"Robot-Assisted Laparoscopic Nephrectomy for Wilms' Tumour in Children","authors":"Min He,&nbsp;Shuangai Liu,&nbsp;Xiaohui Ma,&nbsp;Jiabin Cai,&nbsp;Xuan Wu,&nbsp;Junqin Mao,&nbsp;Linjie Li,&nbsp;Lifeng Zhang,&nbsp;Meidan Ying,&nbsp;Ziqi He,&nbsp;Ting Tao,&nbsp;Jinhu Wang,&nbsp;Xiang Yan","doi":"10.1002/rcs.70088","DOIUrl":"https://doi.org/10.1002/rcs.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this study was to share our experiences with robot-assisted laparoscopic nephrectomy (RALN) for WT in children and to discuss the technical points and indications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with WT undergoing RALN between May 2020 and December 2022 were retrospectively analysed. Patient demographics, operative details, postoperative outcomes and follow-up were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 10 patients with WT who underwent RALN were enrolled in this study. The tumour diameter at operation was 70.2 ± 26.1 mm. The median tumour-abdominal volume ratio (TAVR) was 6.8% (range, 1.9%–14.8%). RALN was successfully performed in all the 10 patients without conversion, tumour rupture or operative complications. No local recurrence or death occurred during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RALN for the treatment of WT in children appears to be safe and feasible in selected patients. Robotic surgery offers an effective alternative to laparoscopic surgery, appropriately expanding indications when performed by experienced surgeons.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598249","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":"Physiological Detection of Intraoperative Errors During Robot-Assisted Surgery","authors":"Christopher D'Ambrosia,&nbsp;Estella Y. Huang,&nbsp;Nicole H. Goldhaber,&nbsp;Henrik Christensen,&nbsp;Ryan C. Broderick,&nbsp;Lawrence G. Appelbaum","doi":"10.1002/rcs.70090","DOIUrl":"https://doi.org/10.1002/rcs.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study tested the measurement of operator physiology during performance on robot-assisted surgery simulations to determine if these signals can identify errors and classify high and low performers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>57 participants performed digital simulations on da Vinci Xi system. Simulation videos, electrocardiogram (EKG), and electroencephalography (EEG) were analysed using linear mixed effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative to non-error intervals, errors elicited significant differences in EKG and EEG measures, including high-frequency power, interbeat interval and ratio of theta-to-alpha EEG power. High and low performers differed significantly in several of these measures, while classification models were accurate for the detection of errors (85.7%) and performance groups (96.3%), and using physiological signals leading up to errors, could accurately predict upcoming errors (85.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Noninvasive recording of physiology can differentiate error from non-error intervals and performance groups, leading to the possibility that online physiology can develop into training or early warning systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589957","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":"Minimally Invasive Spleen-Preserving Distal Pancreatectomy in Obese Patients: Factors Related to Clinically Relevant Pancreatic Fistula","authors":"Fabio Ausania,&nbsp;Filippo Landi,&nbsp;Carolina González-Abós,&nbsp;John B. Martinie,&nbsp;Dionisios Vrochides,&nbsp;Matthew Walsh,&nbsp;Shanaz M. Hossain,&nbsp;Steven White,&nbsp;Viswakumar Prabakaran,&nbsp;Laleh G. Melstrom,&nbsp;Yuman Fong,&nbsp;Giovanni Butturini,&nbsp;Laura Bignotto,&nbsp;Valentina Valle,&nbsp;Yuntao Bing,&nbsp;Dianrong Xiu,&nbsp;Gregorio Di Franco,&nbsp;Francisco Sanchez-Bueno,&nbsp;Nicola de'Angelis,&nbsp;Alexis Laurent,&nbsp;Giuseppe Giuliani,&nbsp;Graziano Pernazza,&nbsp;Alessandro Esposito,&nbsp;Roberto Salvia,&nbsp;Francesca Bazzocchi,&nbsp;Ludovica Esposito,&nbsp;Andrea Pietrabissa,&nbsp;Luigi Pugliese,&nbsp;José Rios,&nbsp;Andrea Coratti,&nbsp;Luca Morelli,&nbsp;Pier C. Giulianotti","doi":"10.1002/rcs.70091","DOIUrl":"https://doi.org/10.1002/rcs.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches. Perioperative outcomes and factors associated with clinically relevant POPF were analysed using univariate and multivariate methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 130 patients (57L-SPDP, 73R-SPDP), POPF incidence was significantly lower in the robotic group (15.1% vs. 42.1%; <i>p</i> = 0.001). The Comprehensive Complications Index was also lower (8% vs. 15%; <i>p</i> = 0.002). Laparoscopic approach (OR = 4.0), pancreatic body transection (OR = 2.6), and non-stapler stump closure (OR = 3.2) were independently associated with higher POPF rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Robotic MI-SPDP reduces POPF in obese patients. Transection at the pancreatic neck and stapler-based closure can improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581876","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 Silent Transformation of Stereotactic Brain Biopsies After the Introduction of Robotics","authors":"Eliane Weinbrenner,&nbsp;Mykola Gorbachuk,&nbsp;Kathrin Machetanz,&nbsp;Florian Grimm,&nbsp;Linda Oberle,&nbsp;Sophie S. Wang,&nbsp;Marcos Tatagiba,&nbsp;Georgios Naros","doi":"10.1002/rcs.70087","DOIUrl":"https://doi.org/10.1002/rcs.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In frame-based stereotaxy, the design of the frame limits trajectory selection, e.g., to the temporal lobe and posterior fossa. We hypothesise that frame-less neuronavigation and robotic technology might have expanded these stereotactic corridors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed 376 frame-based, neuronavigated and robotic brain biopsies. We analysed entry (EP) and target (TP) point coordinates, trajectory lengths (TL) and angles (<i>α</i>₁,<i>α</i>₂), skin-to-skin time (STS), diagnostic yield and morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Robotics liberated <i>TP</i> and <i>EP</i> selection, enabling trajectories not applicable with the frame. There was an increased application of lateral trajectories (reducing <i>α1</i>) while decreasing <i>TL</i>. There was a significant <i>STS</i> reduction attributable to a modification of the surgical approach (twist drill vs. burr hole).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robotics modified trajectory selection and the surgical approach. Duration and invasiveness of brain biopsies were decreased without affecting diagnostic yield or morbidity. This may represent a clinical benefit of robotics compared with frame-based and frame-less stereotaxy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564134","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":"UK-YOLOv10: Deep Learning-Based Detection of Surgical Instruments","authors":"Li Zhang,&nbsp;Guanqun Guo,&nbsp;Wenjie Wang","doi":"10.1002/rcs.70083","DOIUrl":"https://doi.org/10.1002/rcs.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate detection of surgical instruments is essential for robot-assisted surgery. Existing methods face challenges in both accuracy and real-time performance, limiting their clinical applicability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We propose UK-YOLOv10, a novel framework that integrates two innovations: the uni-fusion attention module (UFAM) for enhanced multi-scale feature representation, and the C2fKAN module, which employs KAN convolution to improve classification accuracy and accelerate training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On the M2CAI16-Tool-Locations dataset, UK-YOLOv10 achieves detection accuracy of 96.7%, an [email protected] of 96.4%, and an [email protected]:0.95 of 0.605, outperforming YOLOv10 by 3%, 2.2% and 3.6%, respectively. Generalisation on COCO2017 resulted in an [email protected]:0.95 of 0.386.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UK-YOLOv10 significantly improves surgical instrument detection and demonstrates strong potential for robot-assisted surgeries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492887","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 to “Robotic Assisted Minimally Invasive Coronary Revascularisation: Midterm Results”","authors":"","doi":"10.1002/rcs.70086","DOIUrl":"https://doi.org/10.1002/rcs.70086","url":null,"abstract":"<p>Arslanhan, G., Özcan, Z. S., Şenay, Ş., Baştopçu, M., Karaağaç, A., Koçyiğit, M., Değirmencioğlu, A., Alis, D., and Alhan, C. 2025. “Robotic Assisted Minimally Invasive Coronary Revascularisation: Midterm Results.” <i>The International Journal of Medical Robotics and Computer Assisted Surgery</i>, 21(3): e70071. https://doi.org/10.1002/rcs.70071.</p><p>Dr. Halim Ulugöl who has contributed to the cases and to the article writing process was mistakenly not added to the initial author list. This was corrected and the correct author list is as follows:</p><p>Gökhan Arslanhan, Zeynep Sıla Özcan, Şahin Şenay, Murat Baştopçu, Anıl Karaağaç, Muharrem Koçyiğit, Halim Ulugöl, Aleks Değirmencioğlu, Deniz Alis, Cem Alhan</p><p>In Table 3, the reoperation for bleeding is given as 1 patient out of 150 patients and its respective ratio was given as 0.006% instead of 0.66%. This was also corrected.</p><p>We apologize for this error.</p>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482318","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":"Robotic Versus Total Laparoscopic Splenectomy With Pericardial Devascularisation for Portal Hypertension: A Retrospective Cohort Study","authors":"Zhen Ma,&nbsp;Hongbin Cui,&nbsp;Lei Gaoi,&nbsp;Bin Ma,&nbsp;Puyi He,&nbsp;Yang Yu,&nbsp;Yunpeng Wang,&nbsp;Yanling Ma,&nbsp;Hao Chen","doi":"10.1002/rcs.70085","DOIUrl":"https://doi.org/10.1002/rcs.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study compared the feasibility, efficacy, and safety of robotic splenectomy with pericardial devascularisation (TRSPD) versus total laparoscopic splenectomy with pericardial devascularisation (TLSPD) in patients with portal hypertension (PHT) complicated by splenomegaly, hypersplenism, and oesophagogastric varices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis was conducted on 17 patients undergoing minimally invasive splenectomy with pericardial devascularisation between 2022 and 2024. Outcomes included operative metrics, postoperative recovery, and portal hypertension resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TRSPD significantly reduced intraoperative blood loss (175 vs. 436 mL, <i>p</i> = 0.004) despite longer operative duration (400 vs. 256 min, <i>p</i> = 0.001). Zero conversions occurred with TRSPD versus 3 conversions with TLSPD (<i>p</i> = 0.02). Postoperatively, TRSPD accelerated gastrointestinal recovery (2.1 vs. 3.5 days, <i>p</i> = 0.02) and shortened drainage duration (4.0 vs. 6.2 days, <i>p</i> = 0.02). Both techniques normalised haematologic indices, reduced portal vein diameter (<i>p</i> &lt; 0.05), and resolved varices without major complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TRSPD demonstrates superior intraoperative safety and faster recovery compared with TLSPD while achieving equivalent therapeutic efficacy for portal hypertension. Robotic approaches may optimise the minimally invasive management of complex portosplenic vascular pathologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473109","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":"Clinical and Economic Assessment of Robot-Assisted Radical Prostatectomy With the Hinotori Surgical System: Insights From a Japanese Single-Centre Study","authors":"Kotaro Obayashi,&nbsp;Jun Akatsuka,&nbsp;Takuya Nishino,&nbsp;Mami Takadate,&nbsp;Hiroya Hasegawa,&nbsp;Hikaru Mikami,&nbsp;Hayato Takeda,&nbsp;Yuki Endo,&nbsp;Yuka Toyama,&nbsp;Takeshi Yamada,&nbsp;Yoichiro Yamamoto,&nbsp;Go Kimura,&nbsp;Yukihiro Kondo","doi":"10.1002/rcs.70084","DOIUrl":"https://doi.org/10.1002/rcs.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We investigated the clinical and economic outcomes of robot-assisted radical prostatectomy (RARP) using the hinotori surgical system (H-RARP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The analysis was conducted on 76 and 68 patients who underwent RARP using the da Vinci surgical system (D-RARP) and H-RARP, respectively. Safety, oncological, and functional outcomes were compared between H-RARP and D-RARP. Risk factors influencing medical costs in RARP were identified via linear regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Except for longer operative time in H-RARP, clinical outcomes were comparable. The median medical costs per case were $12,426.8 for D-RARP and $12,548.9 for H-RARP. Operative time (coefficient: 0.0002, <i>p</i> &lt; 0.001), pathological T stage (coefficient: 0.023, <i>p</i> = 0.030), and postoperative hospital stay (coefficient: 0.028, <i>p</i> &lt; 0.001) were significant factors affecting medical costs; in contrast, the type of robot-assisted surgical system was not a significant factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>H-RARP offers clinical outcomes comparable to those of D-RARP while maintaining equivalent medical costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336066","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":"Paediatric Robotic Transperitoneal Heminephroureterectomy in Complete Duplicated Systems: Early and Long-Term Outcomes","authors":"Donatella Di Fabrizio,&nbsp;Thomas P. Cundy,&nbsp;Azad S. Najmaldin","doi":"10.1002/rcs.70082","DOIUrl":"https://doi.org/10.1002/rcs.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We present outcomes for paediatric robotic heminephroureterectomy from a prospective single-surgeon series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children who underwent this operation between July 2007 and March 2017 were reviewed from a prospective database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 32 heminephroureterectomy (28 upper, 4 lower) for ureterocele (13), reflux (7), ectopic ureter (11), ureteric atresia (1). Co-morbidities (urological anomalies, recurrent infection, previous abdominal scarring) were common. Concomitant non-robotic procedures took place in 50%. Mean console time was 101 ± 30.2 min, hospital stay 29.5 ± 10.3 h. There were no conversions, intraoperative complications, and no remnant moiety function loss. Excision of diseased moiety calyces was complete in 30 (94%), incomplete in 2 (6%) who subsequently developed asymptomatic small marginal cysts. Eleven (34%) had total-ureterectomy, the remaining 21 (66%) were left with a ureteric stump. Postoperatively 3 (9%) females with residual stump (2 ureterocele, 1 bladder neck ectopia) and other urological anomalies underwent surgery (stump excision + reimplant refluxing remnant moiety ureter) for recurrent infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In children, heminephroureterectomy is well suited to a robotic approach with favourable outcomes in our experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144323606","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}