{"title":"Perioperative Outcomes of Robot-Assisted Partial Nephrectomy Using Hinotori Compared With da Vinci Xi: A Propensity Score-matched Analysis.","authors":"Mitsugu Kanehira, Yasushi Nozaki, Keita Ogasawara, Moe Toyoshima, Mizuki Hisano, Ayato Ito, Ei Shiomi, Masakazu Abe, Daiki Ikarashi, Shigekatsu Maekawa, Renpei Kato, Wataru Obara","doi":"10.1002/rcs.70173","DOIUrl":"10.1002/rcs.70173","url":null,"abstract":"<p><strong>Introduction: </strong>Robot-assisted partial nephrectomy (RAPN) using the da Vinci Surgical System (DVSS) is broadly performed globally. In Japan, the Hinotori Surgical Robot System (HSRS) has recently been developed. However, few studies have compared perioperative outcomes between HSRS-RAPN and DVSS-RAPN. This study aimed to compare perioperative outcomes between these two robotic platforms.</p><p><strong>Methods: </strong>Clinical data from 86 patients who underwent RAPN from April 2023 to November 2025 were prospectively collected and retrospectively analysed. Propensity score matching (1:1) based on preoperative variables yielded 31 matched pairs. Perioperative outcomes, including trifecta achievement, were compared.</p><p><strong>Results: </strong>Following matching, baseline characteristics were well balanced. Operative parameters, perioperative complications, positive surgical margins, postoperative renal function, and trifecta rates did not significantly differ between the groups.</p><p><strong>Conclusions: </strong>HSRS-RAPN can be safely and effectively performed, achieving perioperative outcomes comparable to those of DVSS-RAPN. These findings suggest that HSRS is a feasible alternative robotic platform for RAPN.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70173"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Design and Preliminary Evaluation of a Hand-Held Surgical Robot for Enhanced Intuitive Control in Laparoscopy.","authors":"Kang Kong, Zidong Qiang, Yingkan Yang, He Su","doi":"10.1002/rcs.70176","DOIUrl":"10.1002/rcs.70176","url":null,"abstract":"<p><strong>Background: </strong>Surgical robots offer improved precision and stability for laparoscopy; nevertheless, their limited portability and high cost impede broader clinical applications.</p><p><strong>Methods: </strong>This paper proposes a hand-held surgical robot with an ergonomic handle and isomorphic kinematics to enhance intuitive operability and portability. A preliminary evaluation was conducted through simulated suture tasks, assessing operation time, precision, muscle activity, and cognitive load.</p><p><strong>Results: </strong>Compared to conventional instruments, the hand-held robot enabled novices (n = 8) to suture significantly faster (p = 0.036) with reduced cognitive demand, while showing a non-significant trend towards higher precision (p = 0.206). For surgeons (n = 3), performance and ergonomics were similar between the two instruments. Notably, muscle fatigue did not significantly increase when using the robot.</p><p><strong>Conclusions: </strong>The proposed hand-held surgical robot provides a feasible, intuitive, and convenient solution for minimally invasive surgery (MIS), particularly beneficial for less experienced operators.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70176"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zi-Shan Wang, Wen-Tao Hu, Chen-Wei Li, Ze Hong, Jian-Guang Shi, Jing Guo, Jian Chen, Kai-Min Li
{"title":"Comparative Study of Postoperative Recovery and Pain Between Da Vinci Robotic Surgery and Video-Assisted Thoracoscopic Surgery.","authors":"Zi-Shan Wang, Wen-Tao Hu, Chen-Wei Li, Ze Hong, Jian-Guang Shi, Jing Guo, Jian Chen, Kai-Min Li","doi":"10.1002/rcs.70185","DOIUrl":"10.1002/rcs.70185","url":null,"abstract":"<p><strong>Background: </strong>Comparative data on postoperative outcomes between da Vinci robotic surgery and video-assisted thoracoscopic surgery (VATS) remain limited. This study compared pain, recovery, quality of life, and cost-effectiveness between these approaches.</p><p><strong>Methods: </strong>This propensity score-matched retrospective study included 60 patients (30 per group) undergoing thoracic surgery (January 2022-December 2024). Outcomes included VAS pain scores, morphine equivalents, SF-36 quality of life, 3-month chronic pain assessment, and cost-utility analysis.</p><p><strong>Results: </strong>The da Vinci group had lower VAS scores at 4 h, 12 h, 24 h and 48 h (p < 0.001), with 33.6% less morphine consumption. Chest tube duration (4.55 ± 2.06 vs. 6.23 ± 2.41 days, p = 0.005) and hospital stay (5.69 ± 2.46 vs. 7.87 ± 2.83 days, p = 0.002) were shorter. SF-36 physical scores favoured robotic surgery at discharge (p = 0.006). Chronic pain at 3 months trended lower (10.7% vs. 25.0%, p = 0.168). The incremental cost-effectiveness ratio was 570,000 CNY/QALY.</p><p><strong>Conclusions: </strong>Da Vinci robotic surgery is associated with reduced postoperative pain and faster recovery compared with VATS, though cost-effectiveness and long-term benefits require further investigation.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70185"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Portable Moxibustion Robot With Intelligent Acupoint Positioning Guided by Visual Sensing.","authors":"Lanhui Wang, Pengcheng Zhang, Ziqi Wang, Mingrui Hao, Zhaokun Deng, Ling Guan, Ying Li, Taizhong Wang, Kairou Guo, Shuangyi Wang","doi":"10.1002/rcs.70177","DOIUrl":"10.1002/rcs.70177","url":null,"abstract":"<p><strong>Background: </strong>To overcome key challenges in traditional moxibustion, such as the shortage of skilled practitioners, time-consuming and labour-intensive procedures, this study developed an intelligent robotic system for automated acupoint positioning and moxibustion execution.</p><p><strong>Methods: </strong>The system established a standardised acupoint coordinate map utilising DensePose-based body normalisation and statistical modelling from 50 subjects. A hybrid serial-parallel robot design enabled large workspace and high precision for bedside application. Safety was ensured by a Model Predictive Controller utilising real-time thermal feedback for dynamic distance adjustment.</p><p><strong>Results: </strong>Experimental validation demonstrated precise spatial positioning, with mean errors of <math> <semantics><mrow><mn>5.8</mn> <mo>±</mo> <mn>2.9</mn></mrow> <annotation>$5.8pm 2.9$</annotation></semantics> </math> mm (back), <math> <semantics><mrow><mn>6.4</mn> <mo>±</mo> <mn>3.7</mn></mrow> <annotation>$6.4pm 3.7$</annotation></semantics> </math> mm (abdomen), <math> <semantics><mrow><mn>4.3</mn> <mo>±</mo> <mn>2.7</mn></mrow> <annotation>$4.3pm 2.7$</annotation></semantics> </math> mm (upper limbs), and <math> <semantics><mrow><mn>9.4</mn> <mo>±</mo> <mn>6.2</mn></mrow> <annotation>$9.4pm 6.2$</annotation></semantics> </math> mm (lower limbs). The system responded to temperature changes within 0.25 s, limiting overshoot to below 0.8°C.</p><p><strong>Conclusions: </strong>This integrated robotic system provides a precise and scalable solution for automated moxibustion, particularly valuable for resource-limited clinical environments.</p><p><strong>Trial registration: </strong>It was an investigational clinical study, not a registrational clinical trial.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70177"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multi-Information Fuzzy Fusion for Position and Orientation Prediction in Robot-Assisted Vascular Intervention Surgery.","authors":"Zhi Hu, Wenan Zhang, Shaozong Xin, Shufan Li","doi":"10.1002/rcs.70189","DOIUrl":"10.1002/rcs.70189","url":null,"abstract":"<p><strong>Background: </strong>The absence of force feedback limits efficiency and operational safety in robot-assisted vascular surgery. Precise modelling of the contact between catheter and vascular wall is important for achieving accurate force feedback. The flexible catheter forms dynamic multi-point line contact with the vascular wall and undergoes continuous bending and torsion, making accurate modelling and high-precision registration challenging. In addition, system time delay affects the transparency of the system.</p><p><strong>Methods: </strong>This study proposes a multi-information fuzzy fusion prediction method that incorporates prior surgical experience to enable real-time estimation of catheter position and orientation. More specifically, an extended formulation of Fitts' law in a dual-motion collaborative mode is developed to estimate surgical movement time.</p><p><strong>Results: </strong>Experimental results demonstrate that the proposed method exhibits greater system transparency than that of the traditional extrapolation and Kalman prediction method. It can enhance force feedback fidelity.</p><p><strong>Conclusions: </strong>The proposed method can improve surgical safety.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70189"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chanwoo Kim, Sang Hyun Kim, JaeYoun Kim, Woocheol Shin, SeongHyeon Won, Junho Hong, Hyuk Soon Choi, Seongil Kwon, Daehie Hong
{"title":"Development of a Coaxial Over-the-Scope Bimanual Robot Enabling Lesion-Aligned Manipulation for ESD.","authors":"Chanwoo Kim, Sang Hyun Kim, JaeYoun Kim, Woocheol Shin, SeongHyeon Won, Junho Hong, Hyuk Soon Choi, Seongil Kwon, Daehie Hong","doi":"10.1002/rcs.70179","DOIUrl":"10.1002/rcs.70179","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic Submucosal Dissection (ESD) requires high expertise as conventional endoscopes cannot provide simultaneous traction and dissection, resulting in unstable visualisation and inconsistent cutting depth.</p><p><strong>Methods: </strong>A coaxial over-the-scope bimanual robotic system was developed to enable lesion-aligned traction and dissection while maintaining compatibility with commercial endoscopes. Engineering performance was evaluated, followed by a pre-clinical comparison between robot-assisted ESD (R-ESD) and conventional ESD (C-ESD) using synthetic tissue.</p><p><strong>Results: </strong>The forceps arm generated sufficient traction (0.581 N), and the coaxial mechanism provided hemispherical manipulation. In pre-clinical trials (n = 30), R-ESD significantly reduced total procedure time (9.20 vs. 11.80 min) and dissection time (2.99 vs. 8.35 min). Depth safety improved with shallower mean depth (2.48 vs. 4.06 mm) and a substantial reduction in muscle-invasion-risk regions (0.15 vs. 29.38%).</p><p><strong>Conclusions: </strong>The proposed coaxial bimanual robotic system improves procedural efficiency and depth safety through lesion-aligned manipulation. Its compatibility with existing endoscopes suggests clinical applicability without procedural complexity.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70179"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MRI-Compatible Brain Puncture Robot With Variable RCM: Design and Accuracy Assessment.","authors":"Xiang Li, Hui Li, Haozhe Fang, Zhihang Tan, Wenda Xu, Weidong Wang, Zhijiang Du","doi":"10.1002/rcs.70175","DOIUrl":"10.1002/rcs.70175","url":null,"abstract":"<p><strong>Background: </strong>MRI-guided neurosurgery requires high-precision puncture, but is challenged by magnetic field constraints and brain tissue deformation.</p><p><strong>Methods: </strong>The mechanism is constructed from non-magnetic materials (e.g., PEEK and ceramic bearings) and driven by ultrasonic piezoelectric actuators to ensure safety in strong magnetic fields. A composite swing-arc RCM design extends the RCM workspace to a hemispherical region, enabling dynamic adjustment within a 220 mm diameter. D-H parameters are refined through multimodal calibration, and RCM stability is experimentally validated.</p><p><strong>Results: </strong>After calibration, the end-effector absolute error is 2.16 mm with a repeatability of ± 1.02 mm, and the mean RCM deviation is 0.57 mm.</p><p><strong>Conclusions: </strong>The system supports autonomous puncture under real-time MRI, covers the cranial workspace and provides a precise, flexible solution for neurosurgical procedures.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70175"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Libin Liu, Yanfang Huang, Xiqing Li, Nuo Zheng, Nila Wang, Tingxiong Xiao, Xiaolong Lin, Haidun Chen, Qin Shi, Yuyin Le
{"title":"A Dual-Branch Cross-Attention Fusion Network for Multi-Subtype Lung Cancer Classification.","authors":"Libin Liu, Yanfang Huang, Xiqing Li, Nuo Zheng, Nila Wang, Tingxiong Xiao, Xiaolong Lin, Haidun Chen, Qin Shi, Yuyin Le","doi":"10.1002/rcs.70183","DOIUrl":"10.1002/rcs.70183","url":null,"abstract":"<p><strong>Background: </strong>Accurate lung cancer subtyping from CT images is essential for treatment planning. However, manual interpretation suffers from inter-observer variability across morphologically similar subtypes.</p><p><strong>Methods: </strong>To overcome this limitation, we propose a dual-branch cross-attention fusion network integrating ConvNeXt-Small and Swin Transformer-Small. Specifically, this architecture captures both local textures and global structural representations. A learnable cross-attention module then fuses these streams into a 512-dimensional unified descriptor. We train our network on a four-class dataset.</p><p><strong>Results: </strong>It achieves 98.46% accuracy and 98.45% F1-score on the test set. Ultimately, our method significantly outperforms state-of-the-art baselines.</p><p><strong>Conclusions: </strong>The proposed framework demonstrates massive clinical potential for non-invasive subtyping, offering a robust tool for personalised treatment planning while reducing diagnostic subjectivity.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70183"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dirk Arnold, Francesca Maule, Pablo Galeazzi, Mohannad Al-Qubaj, Orlando Guntinas-Lichius
{"title":"Feasibility of Minimally Invasive Robot-Assisted Retrofacial Access to the Stapedius Muscle for Applications in Objective Cochlear Implant Fitting: A Cadaveric Study.","authors":"Dirk Arnold, Francesca Maule, Pablo Galeazzi, Mohannad Al-Qubaj, Orlando Guntinas-Lichius","doi":"10.1002/rcs.70178","DOIUrl":"10.1002/rcs.70178","url":null,"abstract":"<p><strong>Background: </strong>Accurate setting of maximum comfort levels (MCL) during cochlear implant (CI) fitting is essential but subjective, especially in non-cooperative patients. The stapedius reflex (SR) correlates with the MCL and offers an objective measure. Surgical access to the stapedius muscle (SM) is challenging due to its proximity to the facial nerve and sigmoid sinus; a retrofacial approach is preferred. This study evaluated the feasibility of robotic-assisted SM access via this approach.</p><p><strong>Methods: </strong>Two cadaveric heads underwent robotic drilling using the HEARO system. Preoperative CT imaging and 3D planning with OTOPLAN defined patient-specific trajectories to the SM while maintaining safe distances from critical structures. Accuracy was assessed with postoperative CT and microscopic dissection.</p><p><strong>Results: </strong>The SM was successfully achieved in both specimens with high precision and minimal invasiveness.</p><p><strong>Conclusions: </strong>Robotic-assisted retrofacial access to the SM is feasible and safe, supporting future precision surgery and closed-loop CI systems with objective SR monitoring.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70178"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xuzhi Liang, Roufei Lu, Shuqi Wu, Huisi Lin, Hong Chen, Dan Sun, Jiangtao Fan
{"title":"Robot-Assisted Radical Trachelectomy With Sleeve Technique for Preventing Postoperative Cervical Adhesion.","authors":"Xuzhi Liang, Roufei Lu, Shuqi Wu, Huisi Lin, Hong Chen, Dan Sun, Jiangtao Fan","doi":"10.1002/rcs.70186","DOIUrl":"10.1002/rcs.70186","url":null,"abstract":"<p><strong>Background: </strong>To investigate the effect of robot-assisted radical trachelectomy (RRT) with the sleeve technique omitting anti-adhesion devices on postoperative cervical adhesion, perioperative, reproductive observations, and preliminary oncologic follow-up.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 8 early-stage cervical cancer patients who underwent RRT with the sleeve technique. No cervical anti-adhesion devices were used. Patients were followed up to assess the status of cervical adhesion, menstruation recovery, fertility, and recurrence.</p><p><strong>Results: </strong>The FIGO stages of the 8 patients were IA2 (n = 1), IB1 (n = 5), and IB2 (n = 2). All resumed menstruation without cervical adhesion or recurrence during follow-up. Three of them attempted conception, one of whom became pregnant and gave birth to a live singleton via cesarean section in early January 2026.</p><p><strong>Conclusion: </strong>Preliminary clinical observations suggest that RRT with the sleeve technique may help reduce postoperative cervical adhesion without the use of anti-adhesion devices, which implies that individualised cervical adhesion prevention strategies should be considered.</p><p><strong>Trial registration: </strong>This study is a case series and thus does not require clinical trial registration. It has been approved by the Research Ethics Committee of Guangxi Medical University First Affiliated Hospital with the approval number IRB No.2025-E0850.</p>","PeriodicalId":75029,"journal":{"name":"The international journal of medical robotics + computer assisted surgery : MRCAS","volume":"22 3","pages":"e70186"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}