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Objectives To evaluate the feasibility and safety of a new modular robotic surgical platform ‐ Carina Platform (Ronovo Surgical, Shanghai, China) in prostate and renal surgeries. Methods We performed 11 robot‐assisted radical prostatectomies (RARP) and 7 robot‐assisted partial nephrectomies (RAPN) using the novel Carina Platform at Fudan University Shanghai Cancer Center (Shanghai, China). The port placements, operating space setting, cart distances and patient positions for all surgeries were recommended according to the procedure cards developed by Ronovo Surgical. Outcomes include success rate (completion without conversion to laparoscopy or open surgery), docking time, total surgery time and safety evaluations such as estimated blood loss (EBL) and complications. Results The age of the patients ranged from 37 to 73 years, and the BMI ranged from 19.9 to 29.1 kg/m2. All operations were successfully completed without conversion to laparoscopy or extra port placement. For RARP, the mean docking time was 6.8 ± 5.6 min; the mean total surgery time was 156.3 ± 27.8 min; and mean EBL was 67.3 ± 39.2 ml. For RAPN, the mean docking time was 8.9 ± 1.6 min; the mean total surgery time was 146.0 ± 38.0 min; and mean EBL was 47.1 ± 7.6 ml. The mean warm ischemia time was 23.9 ± 6.7 min. There were no severe intraoperative or postoperative complications in 1‐month follow‐up. Conclusions This is the first clinical reporting outcomes of the Carina Platform in urologic procedures. The study provides evidence of feasibility and safety when performing RARP and RAPN with acceptable perioperative outcomes and minimal complications.

Although some surgeons prefer anterolateral thigh and latissimus dorsi flap for soft tissue reconstruction in the head and neck area because it minimizes donor site complications, the radial forearm flap remains the workhorse for soft tissue reconstruction due to its reliability. To reduce donor site morbidity, the authors developed a novel technique for radial forearm flap harvesting using a robotic device. 42 radial forearm free flap reconstruction cases were studied, consisting of 31 conventional and 11 robot-assisted cases. 1:1 propensity score matching was done according to age, sex, previous and postoperative radiation therapy history and method used for vein anastomosis. There was no significant difference in flap outcome, which was 100% vitality in the robot-assisted group and 90.9% vitality in the conventional group. The robot-assisted group showed significantly longer mean harvesting time than did the conventional group, being 107.2 min and 67.0 min, respectively. Robot-assisted radial forearm flap harvesting can reduce donor site complications by minimizing incision. When more surgical experience is gained under appropriate case selection, we expect our robot-assisted method will yield a harvesting time similar to that of the conventional method and thus become more reliable and feasible.

The gold standard treatment for non-metastatic upper tract urothelial cancer (UTUC) is represented by radical nephroureterectomy (RNU). The choice of surgical technique in performing UTUC surgery continues to depend on several factors, including the location and extent of the tumor, the patient’s overall health, and very importantly, the surgeon’s skill, experience, and preference. Although open and laparoscopic approaches are well-established treatments, evidence regarding robot-assisted radical nephroureterectomy (RANU) is growing. Aim of our study was to perform a critical review on the evidence of the last 5 years regarding surgical techniques and outcomes of minimally invasive RNU, mostly focusing on RANU. Reported oncological and function outcomes suggest that minimally invasive RNU is safe and effective, showing similar survival rates compared to the open approach.

Background Stroke survivors often experience upper‐limb motor deficits and achieve limited motor recovery within six months after the onset of stroke. We aimed to systematically review the effects of robot‐assisted therapy (RT) in comparison to usual care on the functional and health outcomes of subacute stroke survivors. Methods Randomized controlled trials (RCTs) published between January 1, 2000 and December 31, 2019 were identified from six electronic databases. Pooled estimates of standardized mean differences for five outcomes, including motor control (primary outcome), functional independence, upper extremity performance, muscle tone, and quality of life were derived by random effects meta‐analyses. Assessments of risk of bias in the included RCTs and the quality of evidence for every individual outcomes were conducted following the guidelines of the Cochrane Collaboration. Results Eleven RCTs involving 493 participants were included for review. At post‐treatment, the effects of RT when compared to usual care on motor control, functional independence, upper extremity performance, muscle tone, and quality of life were nonsignificant (all ps ranged .16 to .86). The quality of this evidence was generally rated as low‐to‐moderate. Less than three RCTs assessed the treatment effects beyond post‐treatment and the results remained nonsignificant. Conclusion Robot‐assisted therapy produced benefits similar, but not significantly superior, to those from usual care for improving functioning and disability in patients diagnosed with stroke within six months. Apart from using head‐to‐head comparison to determine the effects of RT in subacute stroke survivors, future studies may explore the possibility of conducting noninferiority or equivalence trials, given that the less labor‐intensive RT may offer important advantages over currently available standard care, in terms of improved convenience, better adherence, and lower manpower cost. PRISMA flow chart of study selection. Articles included in the review met all inclusion criteria and with satisfactory methodological validity and clarity (n = 11).

The evolution of robotic surgery in urologic oncology has led to the emergence of single-port (SP) robotic systems as a potential alternative to the widely adopted multi-port (MP) platforms. This narrative review provides a comprehensive comparison between SP and MP robotic systems, the former of which received FDA approval in 2018 and CE marking in 2024, focusing on their application across radical prostatectomy, partial and radical nephrectomy, and radical cystectomy. Drawing from the most current literature, we examine perioperative outcomes, oncologic efficacy, postoperative recovery, and complication rates. The review highlights the technical challenges unique to SP surgery, including restricted triangulation, limited instrumentation, and a defined learning curve, while also emphasizing innovations such as transvesical prostatectomy and the Supine Anterior Retroperitoneal Access (SARA) approach. Additionally, we explore the potential impact of emerging technologies—such as artificial intelligence, augmented reality, and telesurgery—on the future of SP platforms. Despite early limitations, SP systems have demonstrated comparable safety and effectiveness in selected cases and may offer unique advantages in specific anatomical scenarios. Continued innovation, structured training, and robust long-term outcome data will be essential for the broader adoption and integration of SP robotic surgery in clinical practice.

Background: Robot-assisted partial nephrectomy (RAPN) is increasingly being employed in the management of renal cell carcinoma (RCC) and it is expanding in the field of complex renal tumors. The aim of this systematic review was to consolidate and assess the results of RAPN when dealing with entirely central hilar masses and to examine the various methods used to address the surgical difficulties associated with them. Methods: A thorough literature search in September 2023 across various databases focused on RAPN for renal hilar masses, adhering to PRISMA guidelines. The primary goal was to evaluate RAPN’s surgical and functional outcomes, with a secondary aim of examining different surgical techniques. Out of 1250 records, 13 full-text manuscripts were reviewed. Results: Evidence is growing in favor of RAPN for renal hilar masses. Despite a predominance of retrospective studies and a lack of long-term data, RAPN shows positive surgical outcomes and preserves renal function without compromising cancer treatment effectiveness. Innovative suturing and clamping methods are emerging in surgical management. Conclusions: RAPN is a promising technique for managing renal hilar masses in RCC, offering effective surgical outcomes and renal function preservation. The study highlights the need for more long-term data and prospective studies to further validate these findings.

Objective To compare the clinical efficacy between robot‐assisted minimally invasive transforaminal lumbar interbody fusion (robot‐assisted MIS‐TLIF) and traditional open TLIF surgery in the treatment of lumbar spondylolisthesis. Methods According to the inclusion and exclusion criteria, 48 cases with lumbar spondylolisthesis who received surgical treatment from June 2016 to December 2017 in the spinal surgery department of Beijing Jishuitan Hospital were analyzed in this study, including 23 patients who received robot‐assisted MIS‐TLIF and 25 patients who received traditional open TLIF surgery. The two groups were compared in terms of pedicle screw accuracy evaluated by Gertzbein‐Robbins classification on postoperative computed tomography (CT), operation time, blood loss, postoperative drainage, hospitalization, time to independent ambulation, low back pain evaluated by visual analog scale (VAS), lumbar function evaluated by Oswestry Disability Index (ODI), paraspinal muscles atrophy on magnetic resonance imaging (MRI), and complications. Results Postoperative CT showed that the rate of Grade A screws in the robot‐assisted MIS‐TLIF group was significantly more than that in the open surgery group (χ2 = 4.698, P = 0.025). Compared with the open surgery group, the robot‐assisted MIS‐TLIF group had significantly less intraoperative blood loss, less postoperative drainage, shorter hospitalization, shorter time to independent ambulation, and lower VAS at 3 days post‐operation (P < 0.05). However, the duration of surgery was longer. The VAS of the robot‐assisted MIS‐TLIF group decreased from 6.9 ± 1.8 at pre‐operation to 2.1 ± 0.8 at post‐operation, 1.8 ± 0.7 at 6‐month follow‐up and 1.6 ± 0.5 at 2‐year follow‐up. The VAS of the open surgery group decreased from 6.5 ± 1.7 at pre‐operation to 3.7 ± 2.1 at post‐operation, 2.1 ± 0.6 at 6‐month follow‐up and 1.9 ± 0.5 at 2‐year follow‐up. The ODI of the robot‐assisted MIS‐TLIF group decreased from 57.8% ± 8.9% at pre‐operation to 18.6% ± 4.7% at post‐operation, 15.7% ± 3.9% at 6‐month follow‐up and 14.6% ± 3.7% at 2‐year follow‐up. The ODI of the open surgery group decreased from 56.9% ± 8.8% at pre‐operation to 20.8% ± 5.1% at post‐operation, 17.3% ± 4.2% at 6‐month follow‐up and 16.5% ± 3.8% at 2‐year follow‐up. Paraspinal muscle cross‐sectional area in 2‐year follow‐up in patients of the open surgery group decreased significantly compared to patients of robotic‐assisted MIS‐TLIF group (P = 0.016). Conclusion In the treatment of lumbar spondylolisthesis, robot‐assisted MIS‐TLIF may lead to more precise pedicle screw placement, less intraoperative blood loss, less postoperative drainage, less postoperative pain, quicker recovery, and less paraspinal muscle atrophy than traditional open surgery. Compared to the open surgery group, the robot‐assisted MIS‐TLIF group had achieved a better clinical result of significantly more precise pedicle screw placement, less intraoperative blood loss, less postoperative drainage, shorter hospitalization, shorter time to independent ambulation, lower VAS at 3 days post‐operation, and less paraspinal muscle atrophy.

The Hinotori™ surgical robot system (HSRS) (Medicaroid, Kobe, Japan), a newly launched domestic platform in Japan, has already been utilized in many robot-assisted surgeries. This study aimed to assess the perioperative outcomes of the first series of seven cases that underwent robot-assisted radical prostatectomy (RARP) with an extraperitoneal approach (EP) using HSRS. A total of seven consecutive patients with localized prostate cancer who underwent RARP with EP using the HSRS between January and May 2025 at our institution were included in this study. Their comprehensive perioperative outcomes were retrospectively analyzed. The median age and the body mass index (BMI) of the patients were 69 years and 21.9 kg/m², respectively. RARP with EP could be completely performed on all patients without conversion to either a transperitoneal approach or open surgery. The median operative time, the time using the robotic system, the estimated blood loss, and the length of the indwelling urethral catheter were 180 min, 96 min, 100 mL, and seven days, respectively. No patient experienced major perioperative complications requiring invasive treatment or blood transfusion.  Despite being a small case series, this is the first report of the perioperative finding that RARP with EP using the HSRS is expected to provide equivalent perioperative outcomes compared to RARP with transperitoneal (TP).

Uterine fibroids are the most common benign tumors of the female reproductive system. Their treatment can be medicinal, with a more limited effect, or surgical. While operative treatment in elderly women is most often performed by hysterectomy, myomectomy with maximal preservation of the functional integrity of the uterine body is of utmost importance for future reproductive plans in women with reproductive intentions. Choosing the optimal operative approach, both in terms of efficiency and quality of life, is a key point in the operative treatment of uterine fibroid disease.

Subretinal injection is a complicated task for retinal surgeons to operate manually. In this paper we demonstrate a robust framework for needle detection and localisation in robot‐assisted subretinal injection using microscope‐integrated Optical Coherence Tomography with deep learning. Five convolutional neural networks with different architectures were evaluated. The main differences between the architectures are the amount of information they receive at the input layer. When evaluated on ex‐vivo pig eyes, the top performing network successfully detected all needles in the dataset and localised them with an Intersection over Union value of 0.55. The algorithm was evaluated by comparing the depth of the top and bottom edge of the predicted bounding box to the ground truth. This analysis showed that the top edge can be used to predict the depth of the needle with a maximum error of 8.5 μm.