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

{"title":"Short-Term Outcomes of Upper-Dome Overlap Single-Flap Valvuloplasty Versus Kamikawa Anastomosis in Robotic Proximal Gastrectomy","authors":"Fengyuan Li,&nbsp;Shenglong Xu,&nbsp;Zhongyuan He,&nbsp;Weizhi Wang,&nbsp;Wasit Ahmad Rahmani,&nbsp;Yiwen Xia,&nbsp;Bowen Li,&nbsp;Dinghua Yang,&nbsp;Lei Qian,&nbsp;Yuxin Xu,&nbsp;Tianyu Liu,&nbsp;Wenxing Zhou,&nbsp;Fei Zhang,&nbsp;Zekuan Xu,&nbsp;Yan Wang,&nbsp;Wei Huang,&nbsp;Hongda Liu,&nbsp;Hao Xu","doi":"10.1002/rcs.70200","DOIUrl":"10.1002/rcs.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This retrospective study compared two reconstruction techniques in 50 patients undergoing robotic proximal gastrectomy: the novel Upper-Dome Overlap Single-flap valvuloplasty (UDOS) and the conventional Kamikawa anastomosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Perioperative data, anastomotic time, complication rates, nutritional outcomes, lower oesophageal sphincter pressures, and health-related quality of life scores were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with Kamikawa, the UDOS technique significantly reduced anastomosis time by 39.8% (25.9 vs. 43.0 min). Perioperative safety and early complication rates were comparable. The UDOS group demonstrated a favourable trend in reducing late complications, with a lower incidence of anastomotic stenosis (4.0% vs. 16.0%) and no cases of reflux oesophagitis (0% vs. 8.0%). Both groups achieved similar post-operative nutritional outcomes, lower oesophageal sphincter pressures, and health-related quality of life scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>UDOS offers a technically more efficient alternative to Kamikawa anastomosis with equivalent perioperative safety and potential benefits for reducing long-term complications, meriting further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371289","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":"Adaptive Admittance Control for Robotic Ultrasound Examination Based on a Breast Biomechanical Model","authors":"Dong Guo,&nbsp;Yongde Zhang,&nbsp;Fujun Zhang,&nbsp;Letao Lin,&nbsp;Tao Huang","doi":"10.1002/rcs.70197","DOIUrl":"10.1002/rcs.70197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autonomous Robotic Ultrasound Systems (ARUS) enable standardized breast cancer screening, but accurate breast localization and the nonlinear deformation of soft tissue hinder stable contact-force control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We propose a framework integrating visual perception with compliant control. An adaptive gradient-based edge detector extracts the nipple position, and a Variable Damping Admittance Control based on a Breast Biomechanical Model (VDAC-BBM) is developed, which compensates for tissue deformation via a biomechanical prior and dynamically tunes the damping parameter in real time to suppress force error.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Phantom and human experiments showed force tracking error ≤ 0.4 N, with disturbance recovery speed improved by 16.5%–21.3% over conventional admittance control across the tested target forces.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Embedding a biomechanical prior into the control strategy enhances force compliance and stability during robotic scanning of deformable soft tissue, providing a technical basis for clinical translation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363827","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":"Robotic Choledochal Cyst Excision With Intracorporeal Roux-en-Y Hepaticojejunostomy in Adolescent and Adult Patients: Clinical and Quality-of-Life Outcomes","authors":"Lokesh Agarwal,&nbsp;Ankit Rai,&nbsp;Vaibhav Kumar Varshney,&nbsp;Subhash Soni,&nbsp;B. Selvakumar,&nbsp;Peeyush Varshney,&nbsp;Ayushi Agarwal,&nbsp;Binit Sureka,&nbsp;Taruna Yadav","doi":"10.1002/rcs.70199","DOIUrl":"https://doi.org/10.1002/rcs.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study evaluates clinical and health-related-quality-of-life (HRQOL) outcomes following robotic choledochal cyst (CDC) excision with intracorporeal Roux-en-Y hepaticojejunostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Prospectively maintained data from 17 consecutive patients undergoing robotic CDC excision with the da Vinci Xi system (January 2017–October 2024) were retrospectively analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients were female; median age was 22 year. Cyst types included Ia(6), Ic(3), IVa(5), II(1), and VIb(2). Median operative time was 360 min, blood loss 50 mL, and hospital stay 4 days. Postoperative complications occurred in three patients, including one clinically-relevant grade-B postoperative-pancreatic-fistula requiring image-guided drainage (Clavien–Dindo IIIa), one biochemical POPF, and one episode of mild acute-pancreatitis. At a median follow-up of 36.5-month (IQR 35–43), no anastomotic strictures, malignancy, or biliary complications were noted. At 12-month, the median Gastrointestinal-Quality-of-Life-Index (GIQLI) score was 135 (IQR 133.5–136).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Robotic CDC excision with intracorporeal reconstruction appears feasible and safe in selected patients, with favourable perioperative and functional outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324779","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":"Dual-Modal Safety Framework for Robotic-Assisted Bronchoscopy via Endoscopic Vision and Haptic Feedback","authors":"Bodong Fan,&nbsp;Luhao Xie,&nbsp;Lifeng Zhu,&nbsp;Xiaoliang Jin,&nbsp;Jian Lu,&nbsp;Gaojun Teng,&nbsp;Aiguo Song","doi":"10.1002/rcs.70198","DOIUrl":"https://doi.org/10.1002/rcs.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Teleoperated flexible bronchoscopy lacks distal haptic feedback, increasing the risk of unobservable iatrogenic tissue trauma during endoluminal exploration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study proposes a robot-assisted bronchoscopy system integrated with a dual-modal safety framework. A visual module utilises image moments to provide predictive alerts for collision avoidance. Concurrently, a Transformer-based network estimates distal interaction torques from proximal actuation, enabling real-time haptic perception at the leader console.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Phantom validations across fragile tissue rupture, sidewall approximation, and luminal exploration tasks demonstrated the framework's efficacy. The visual warnings helped decrease excessive force contacts, while the learning-based estimator delivered reliable distal force perception.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed dual-modal teleoperated safety architecture resolves the trade-off between operational dexterity and safety in flexible bronchoscopy. By integrating predictive visual warnings and real-time haptic feedback, the system improves the operator's situational awareness, decreasing the risk of iatrogenic trauma during the operation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324494","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":"Short-Term Outcomes and Quality of Life After Robotic Versus Laparoscopic Double-Flap Technique for Proximal Gastrectomy: A Retrospective Cohort Study","authors":"Zhongyuan He,&nbsp;Hongda Liu,&nbsp;Fengyuan Li,&nbsp;Wasit Ahmad Rahmani,&nbsp;Weizhi Wang,&nbsp;Sen Wang,&nbsp;Bowen Li,&nbsp;Yawei Qian,&nbsp;Dinghua Yang,&nbsp;Mengqin Dong,&nbsp;Ruirui Sun,&nbsp;Li Yang,&nbsp;Linjun Wang,&nbsp;Zekuan Xu,&nbsp;Hao Xu","doi":"10.1002/rcs.70201","DOIUrl":"https://doi.org/10.1002/rcs.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic systems may facilitate the double-flap technique (DFT) after proximal gastrectomy (PG), yet the superiority of robotic DFT following PG (RPG-DFT) over laparoscopic PG with DFT (LPG-DFT) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-three gastric cancer patients (28 RPG-DFT, 45 LPG-DFT) were compared for baseline characteristics, perioperative outcomes, and 3-month postoperative data. Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) and weight loss are postoperative primary endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RPG-DFT had significantly longer operative time (308.3 vs. 204.5 min, <i>p</i> &lt; 0.0001) but shorter postoperative hospital stay (6.21 vs. 8.13 days, <i>p</i> &lt; 0.0001). By postoperative day 3, RPG-DFT showed faster decline in inflammatory markers (NLR, PLR, MLR, SII). No significant differences were observed in reflux symptoms or anastomotic stenosis rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to LPG-DFT, RPG-DFT facilitates accelerated patient recovery, as evidenced by a rapid decline in inflammatory markers and reduced length of hospital stay.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324493","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":"Soft Robots for Intestinal Applications: A Review on Actuation, Materials, Manufacture and Applications","authors":"Xuemei Xu,&nbsp;Fei Liu,&nbsp;Gongxin Li","doi":"10.1002/rcs.70192","DOIUrl":"10.1002/rcs.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Soft robots utilised for intestinal diagnosis and therapy use, compliant materials and novel actuation were employed to address the limitations of rigid endoscopic tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper systematically reviewed the literature (2000–present) on robotic systems explicitly developed for intestinal applications, organising findings across actuation, materials, fabrication and clinical use. Ethical approval: Not applicable because this study is a literature review and involved no human participants or animal experiments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fluidic, shape-memory alloy, electroactive polymer and magnetic actuation strategies were classified and compared by operating principles, advantages and limitations. Common material platforms (e.g., silicones and hydrogels) were analysed for flexibility, biocompatibility, responsiveness and fabrication methods (casting, 3D printing and shape deposition manufacturing) and were assessed for producing functional, complex structures. Applications clustered around examination, targeted drug delivery and minimally invasive interventions, with designs grouped by function and morphology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intestinal constraints (peristalsis, variable lumen geometry and biosafety) remain key barriers; interdisciplinary integration is central to clinical translation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310621","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 Thoracic Surgery Versus Video-Assisted Thoracic Surgery for Lung Resection: A Systematic Review and Meta-Analysis","authors":"Ashraf Maghrabi,&nbsp;Samar M. Altoukhi,&nbsp;Fouad Abdulsalam S. Alghamidi,&nbsp;Muath M. Alshammari,&nbsp;Waleed M. Alharbi,&nbsp;Mohammed A. Hanbazazah,&nbsp;Mohammed M. Almasoudi,&nbsp;Ghader Jamjoum","doi":"10.1002/rcs.70191","DOIUrl":"https://doi.org/10.1002/rcs.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung resection is a standard treatment for lung cancer. Video-assisted thoracoscopic surgery (VATS) is widely used as a minimally invasive approach. Recent advancements in robotic technology enhances the safety and efficacy of robot-assisted thoracic surgery (RATS). This systematic review and meta-analysis compared the clinical outcomes of RATS and VATS in lung resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, ClinicalTrials.gov, and the Cochrane Library were searched from inception to June 2025. Primary outcomes were lymph node yield and operative time. Secondary outcomes included R0 resection, postoperative complications, and recurrence. Data were analysed using Review Manager v5.4.1 with random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine studies involving 66,406 patients were included. RATS significantly improved lymph node yield (MD 4.54; 95% CI 2.91–6.17) and showed shorter operative time (MD −6.09; 95% CI −13.20–1.03). RATS was associated with higher R0 resection rates, fewer complications, and lower recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings support the safety and oncologic effectiveness of RATS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282423","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":"Hyperaccuracy Three-Dimensional Model and Augmented Reality/Mixed Reality for Robot-Assisted Retroperitoneal Lymph Node Dissection in Testicular Cancer","authors":"Markus Angerer,&nbsp;Mattis Franke,&nbsp;Klaus-Peter Dieckmann,&nbsp;Christian Wülfing","doi":"10.1002/rcs.70196","DOIUrl":"10.1002/rcs.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility of hyperaccuracy three-dimensional (HA3D) virtual models with augmented reality (AR) in robot-assisted retroperitoneal lymph node dissection (R-RPLND) for testicular cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 35-year-old male with 4 cm interaortocaval seminoma recurrence underwent unilateral template R-RPLND. A patient-specific HA3D model was generated from contrast-enhanced CT using Avatar Medical software and integrated into preoperative planning and intraoperative AR navigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HA3D modeling enabled precise preoperative identification of a critical renal arterial branch adjacent to the tumor, facilitating safe dissection. R-RPLND was completed in 76 min with minimal blood loss (30 mL) and no complications. Pathology confirmed 4.5 cm viable seminoma metastasis. Nine-month follow-up showed no recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This proof-of-concept case demonstrates successful integration of HA3D virtual models and AR into R-RPLND workflow, potentially enhancing anatomical visualization, surgical planning, and procedural safety. Multicenter prospective studies are needed to validate reproducibility and clinical benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267512","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":"Robotic Intraoperative Imaging in Orthopaedic and Trauma Surgery: Initial Clinical Experience With a Self-Driving Mobile 3D C-Arm in the First 300 Cases","authors":"Benno Bullert,&nbsp;Luca Ruebel,&nbsp;Jula Gierse,&nbsp;Eric Mandelka,&nbsp;Fenna Brunken,&nbsp;Paul A. Gruetzner,&nbsp;Sven Y. Vetter","doi":"10.1002/rcs.70195","DOIUrl":"10.1002/rcs.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intraoperative C-arm imaging is essential in orthopaedic and trauma surgery, particularly with the increasing use of minimally invasive techniques. Conventional repositioning is performed by non-scrubbed staff, while robotic imaging systems are mainly limited to hybrid operating rooms. This study presents the first clinical experience with a fully motorised, self-driving mobile 3D-C-arm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective, single-center study, 300 procedures were analyzed using device log data and perioperative parameters to assess imaging workflow and system performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 300 procedures, 279 were included. Mean procedure time was 104.7 ± 57.4 min, with a C-arm operation time of 31.9 ± 29.1 min, corresponding to a C-arm operation ratio (COR) of 35.2%. Automated positioning accounted for 30.7% of movements, and 37.9% of images were acquired from stored positions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The system enabled sterile-field control and demonstrated potential to support intraoperative imaging workflow. Further comparative studies are required to evaluate its clinical impact.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254768","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":"Global Workflow of a Comanipulation-Based Robotic System for Cervical Spine Surgery","authors":"A. Koszulinski,&nbsp;J. Sandoval,&nbsp;C.-T. Wu,&nbsp;S.-H. Huang,&nbsp;S. K. Sahani,&nbsp;S.-L. Wu,&nbsp;T. Essomba,&nbsp;T. Vendeuvre,&nbsp;J.-P. Faure,&nbsp;S. Zeghloul,&nbsp;M. A. Laribi","doi":"10.1002/rcs.70193","DOIUrl":"https://doi.org/10.1002/rcs.70193","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cervical arthrodesis requires precise pedicle screw placement to ensure safety and effectiveness. Traditional planning and execution are time-consuming and prone to variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a robot-assisted system integrating three components: an AI-based preoperative planning module, adapted from previous work, to generate patient-specific screw trajectory from 3D CT point-clouds; an intraoperative registration and motion compensation system with optical tracking to align the trajectory with patient anatomy in real time; and a comanipulation control strategy enforcing virtual fixtures and depth limits to guide the robotic arm safely. The system was tested on 3D-printed models and cadaveric specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Robotic assistance significantly improved the geometric accuracy of drilling, reducing transverse positional deviations by a factor of two and orientation deviations by a factor of eight compared with freehand procedures. In addition, the average drilling depth overshoot was reduced by 50%. Perforation rates were found to be of the same order as those observed with freehand techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed workflow improves trajectory-following accuracy and depth control while preserving intuitive surgeon interaction. These results demonstrate the feasibility of integrating AI-based planning, intraoperative tracking, and collaborative robotics for cervical spine surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"22 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238190","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}