Based on the Bismuth-Corlette classification of hilar cholangiocarcinoma,the patients with types I,II,and III can undergo radical resection in the absence of extensive intrahepatic metastasis and vascular invasion[1]....Based on the Bismuth-Corlette classification of hilar cholangiocarcinoma,the patients with types I,II,and III can undergo radical resection in the absence of extensive intrahepatic metastasis and vascular invasion[1].Depending on the scope of tumor invasion in bile duct,a combined resection of parts of the liver,hepatic ducts,common bile ducts,regional lymph nodes,and even parts of the duodenum and pancreas is necessary,along with biliary and gastrointestinal reconstructions[2].The surgical plan is complex,involving a large resection area and significant trauma.In recent years,laparoscopic or robot assisted radical resection of hilar cholangiocarcinoma has been applied clinically[3,4].With the advanced laparoscopic equipment,many patients undergo hepatopancreatoduodenectomy successfully[5].The limitations of traditional laparoscopic techniques restrict their wide application in clinical practice.However,the Da Vinci robot has been widely applied due to its clear field of vision and flexible manipulation.However,its utilization in hepato-pancreatoduodenectomy for hilar cholangiocarcinoma is still relatively rare.Here,we report a case with hilar cholangiocarcinoma at clinical stage IIIb who underwent robot-assisted hepato-pancreatoduodenectomy.展开更多
Robotic inguinal hernia repair remains in the early stages of implementation,and its potential advantages over the laparoscopic approach are still a matter of debate.This narrative review aims to summarize the finding...Robotic inguinal hernia repair remains in the early stages of implementation,and its potential advantages over the laparoscopic approach are still a matter of debate.This narrative review aims to summarize the findingsof major systematic reviews and randomized controlled trials and explore variables not adequately addressed in those studies.The literature review indicates that robotic inguinal hernia repair is associated with longer operative times but has improved ergonomics compared with laparoscopy.It is a safe procedure that results in a reduced inflammatory response,similar complication rates,and no significantdifference in acute postoperative pain.Although it involves higher direct costs,its cost-effectiveness remains unclear owing to a lack of analysis including indirect costs.Ongoing controversy continues regarding long-term benefits.The most recent systematic review pointed towards lower recurrence rates with robotic surgery,although randomized controlled trials have not validated this finding.Data on chronic pain are currently insufficientto draw firmconclusions.Further studies are needed to assess its use in complex cases and the role of novel techniques.展开更多
Objective:Robotic colorectal surgery(RCS)provides a stable,magnifiedthree-dimensional visual field and enhanced ergonomics enabling precise dissection and tremor suppression.We postulate that this technique is associa...Objective:Robotic colorectal surgery(RCS)provides a stable,magnifiedthree-dimensional visual field and enhanced ergonomics enabling precise dissection and tremor suppression.We postulate that this technique is associated with less tissue trauma and improved postoperative outcomes than laparoscopic colorectal surgery(LCS).This study aimed to explore the inflammatoryresponse following RCS by measuring postoperative C-reactive protein(CRP)levels and compare them with LCS data reported in the literature.Methods:This single centre retrospective study included consecutive elective robotic colon and rectum resections via the da Vinci®Xi platform for benign and malignant colorectal tumours,performed by a single surgeon between January 2017 and December 2023 at the Sydney Adventist Hospital,Sydney.CRP values were measured on post-operative days(PODs)3 and 5.A narrative review of the literature was performed via EMBASE,MEDLINE via PubMed and Google Scholar from inception to December 2024 for comparative CRP values following LCS.Descriptive statistical comparisons were performed between the RCS and LCS.Results:One hundred ninety-three patients were identifiedin the RCS cohort.The median age was 73 y(range:62–83 y).Most colectomies were performed for adenocarcinoma(90.2%),with right hemicolectomy being the most common type of procedure(49.3%).The median CRP levels on PODs 3 and 5 were 83.10 mg/L(IQR:49.80–124.12 mg/L)and 26.20 mg/L(IQR:17.70–80.00 mg/L),respectively.The reported CRP after LCS was heterogeneous,with mean POD 3 values ranging from 69 mg/L to 99.5 mg/L,and mean POD 4–5 values ranging from 62.4 mg/L to 72.85 mg/L.Conclusions:There were similar,if not lower,POD 3 and 5 CRP values,suggesting that RCS was probably non-inferior to LCS regarding postoperative tissue trauma.In particular,there appeared to be a quicker recovery of the inflammatory response with RCS.展开更多
The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which...The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.展开更多
Trajectory tracking for nonlinear robotic systems remains a fundamental yet challenging problem in control engineering,particularly when both precision and efficiency must be ensured.Conventional control methods are o...Trajectory tracking for nonlinear robotic systems remains a fundamental yet challenging problem in control engineering,particularly when both precision and efficiency must be ensured.Conventional control methods are often effective for stabilization but may not directly optimize long-term performance.To address this limitation,this study develops an integrated framework that combines optimal control principles with reinforcement learning for a single-link robotic manipulator.The proposed scheme adopts an actor–critic structure,where the critic network approximates the value function associated with the Hamilton–Jacobi–Bellman equation,and the actor network generates near-optimal control signals in real time.This dual adaptation enables the controller to refine its policy online without explicit system knowledge.Stability of the closed-loop system is analyzed through Lyapunov theory,ensuring boundedness of the tracking error.Numerical simulations on the single-link manipulator demonstrate that themethod achieves accurate trajectory followingwhile maintaining lowcontrol effort.The results further showthat the actor–critic learning mechanism accelerates convergence of the control policy compared with conventional optimization-based strategies.This work highlights the potential of reinforcement learning integrated with optimal control for robotic manipulators and provides a foundation for future extensions to more complex multi-degree-of-freedom systems.The proposed controller is further validated in a physics-based virtual Gazebo environment,demonstrating stable adaptation and real-time feasibility.展开更多
In Human–Robot Interaction(HRI),generating robot trajectories that accurately reflect user intentions while ensuring physical realism remains challenging,especially in unstructured environments.In this study,we devel...In Human–Robot Interaction(HRI),generating robot trajectories that accurately reflect user intentions while ensuring physical realism remains challenging,especially in unstructured environments.In this study,we develop a multimodal framework that integrates symbolic task reasoning with continuous trajectory generation.The approach employs transformer models and adversarial training to map high-level intent to robotic motion.Information from multiple data sources,such as voice traits,hand and body keypoints,visual observations,and recorded paths,is integrated simultaneously.These signals are mapped into a shared representation that supports interpretable reasoning while enabling smooth and realistic motion generation.Based on this design,two different learning strategies are investigated.In the first step,grammar-constrained Linear Temporal Logic(LTL)expressions are created from multimodal human inputs.These expressions are subsequently decoded into robot trajectories.The second method generates trajectories directly from symbolic intent and linguistic data,bypassing an intermediate logical representation.Transformer encoders combine multiple types of information,and autoregressive transformer decoders generate motion sequences.Adding smoothness and speed limits during training increases the likelihood of physical feasibility.To improve the realism and stability of the generated trajectories during training,an adversarial discriminator is also included to guide them toward the distribution of actual robot motion.Tests on the NATSGLD dataset indicate that the complete system exhibits stable training behaviour and performance.In normalised coordinates,the logic-based pipeline has an Average Displacement Error(ADE)of 0.040 and a Final Displacement Error(FDE)of 0.036.The adversarial generator makes substantially more progress,reducing ADE to 0.021 and FDE to 0.018.Visual examination confirms that the generated trajectories closely align with observed motion patterns while preserving smooth temporal dynamics.展开更多
Accurate mechanical modeling is essential for robotic belt grinding(RBG), a process characterized by compliant contact mechanisms that make force prediction particularly challenging. However, existing mechanical model...Accurate mechanical modeling is essential for robotic belt grinding(RBG), a process characterized by compliant contact mechanisms that make force prediction particularly challenging. However, existing mechanical models predominantly focus on macroscale compliance while neglecting grain-scale compliant motion. Moreover, abrasive grains are typically idealized as regular shapes, overlooking the inherent stochasticity of real grain geometries. This study proposes a shapeequivalence method for modeling stochastic abrasive grains and develops a multiscale compliant force model for RBG. Specifically, an individual grain is represented as a polygonal pyramid with stochastic edges that is mathematically equivalent to a cone;this method unifies the treatment of grain geometries and streamlines the modeling process. The mathematical equivalence relationship for random grain shapes is further derived based on a grain-compliant contact model. By integrating grain geometric characteristics and progressive grain wear, an analytical mechanical model that captures both the static contact force and dynamic grinding force is established, thereby describing the transition from grain-workpiece compliant interaction to belt-workpiece elastic contact. Grinding experiments were conducted using abrasive belts with different grain shape distributions to validate the model. The results demonstrated reliable predictions of the tangential grinding force and its component characteristics. Additional analyses were performed to reveal how the tangential grinding force varies with wear time and grinding parameters.展开更多
Background:The Da Vinci Single-Port Robotic System(Da Vinci-SP),introduced by Intuitive(CA,USA)in 2018 in the USA and in 2024 in Europe,integrates advanced features like a flexible camera and articulating instruments....Background:The Da Vinci Single-Port Robotic System(Da Vinci-SP),introduced by Intuitive(CA,USA)in 2018 in the USA and in 2024 in Europe,integrates advanced features like a flexible camera and articulating instruments.It has garnered significant interest in urology.Our report presents the first described European series of Radical Prostatectomies using the Da Vinci SP at the leading Italian center,Istituto Nazionale Tumori di Napoli,IRCCS“G.Pascale”Foundation,detailing the technical differences and challenges faced by experienced multiport robotic surgeons.Methods:Sixteen patients have been enrolled and underwent Single-Port(SP)Robot-Assisted Radical Prostatectomy(SP-RARP).Baseline characteristics of the patients were collected.We provided a step-by-step description of the surgical technique.Oncological outcomes have been evaluated and compared with magnetic resonance imaging(MRI)and biopsy results.Intraoperative,perioperative,and postoperative complications,surgical outcomes,functional outcomes,and technical issues of the new system were also documented.Results:All surgeries were successfully performed without the need for conversion.An extraperitoneal approach was used for all patients.Median Console time was 110 min.No complications were reported.The estimated median blood loss was 175 cc.Discharge from the hospital was on the first post-operative day for all patients.Bladder catheter removal was on day 7 without the need for cystography.Conclusions:We presented the first European case series of SP-RARP,reporting our experience and confirming the procedure’s feasibility for a highly experienced robotic surgeon.Experience with an extraperitoneal approach using the multiport(MP)platform,combined with well-conducted training for the SP system,may facilitate the transition to SP surgery.Further procedures and studies are needed to evaluate the oncological and functional outcomes.展开更多
Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited ...Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited research directly comparing open and robotic RPLND.The objective of this systematic review is to identify all the literature with direct comparisons between the open and robotic techniques for RPLND and to compare the two techniques.The primary outcome was peri-operative outcomes,and the secondary outcomes included oncological outcomes and patient demographics.Methods:This systematic review was prospectively registered and was conducted in accordance with the PRISMA statement.The PubMed,Embase and MEDLINE databases were searched for relevant publication from January 2006 to August 2024.Results:Eight studies,totaling 3995 patients,are included in this systematic review,with 3521 patients who underwent open RPLND and 474 who underwent robotic RPLND.For open RPLND,the mean operative duration,blood loss and length of stay were 267.8 min,475 mL and 7.3 d,respectively.For robotic RPLND,the mean operative duration,blood loss and length of stay were 334.5 min,94.6 mL and 3.7 d,respectively.Teratoma was the most common RPLND specimen pathology from both open and robotic surgeries.For open RPLND,the specimens have 13–23 nodes(26–32 mm),whereas the robotic RPLND specimens have 13–28 nodes(18–20 mm).Conclusion:This systematic review suggests that the benefitsof robotic RPLND may be associated with reduced blood loss,shorter hospitalisation and an overall lower risk of minor and major complications while maintaining oncological safety.展开更多
Single-cell biomechanics and electrophysiology measuring tools have transformed biological research over the last few decades,which enabling a comprehensive and nuanced understanding of cellular behavior and function....Single-cell biomechanics and electrophysiology measuring tools have transformed biological research over the last few decades,which enabling a comprehensive and nuanced understanding of cellular behavior and function.Despite their high-quality information content,these single-cell measuring techniques suffer from laborious manual processing by highly skilled workers and extremely low throughput(tens of cells per day).Recently,numerous researchers have automated the measurement of cell mechanical and electrical signals through robotic localization and control processes.While these efforts have demonstrated promising progress,critical challenges persist,including human dependency,learning complexity,in-situ measurement,and multidimensional signal acquisition.To identify key limitations and highlight emerging opportunities for innovation,in this review,we comprehensively summarize the key steps of robotic technologies in single-cell biomechanics and electrophysiology.We also discussed the prospects and challenges of robotics and automation in biological research.By bridging gaps between engineering,biology,and data science,this work aims to stimulate interdisciplinary research and accelerate the translation of robotic single-cell technologies into practical applications in the life sciences and medical fields.展开更多
Soft robotic manipulators represent a rapidly evolving field characterized by inherent compliance,adaptability,and safe interactions within unstructured environments.Over the past decade(2015-2025),significant advance...Soft robotic manipulators represent a rapidly evolving field characterized by inherent compliance,adaptability,and safe interactions within unstructured environments.Over the past decade(2015-2025),significant advancements have trans-formed their capabilities through novel designs inspired by biological systems,advanced modeling frameworks,sophisti-cated control strategies,and integration into diverse real-world applications.Recent innovations in multifunctional mate-rials and emerging actuation technologies have markedly expanded manipulator performance,reliability,and dexterity.Concurrently,developments in modeling have progressed from simplified geometric methods toward highly accurate physics-based and hybrid data-driven approaches,substantially improving real-time prediction and controllability.Coupled with these developments,adaptive and robust control strategies-including learning-based techniques-have enabled unprec-edented autonomy and precision in challenging application domains such as Minimally Invasive Surgery(MIS),precision agriculture,deep-sea exploration,disaster recovery,and space missions.Despite these remarkable strides,key challenges remain,notably regarding scalability,long-term material durability,robust integrated sensing,and standardized evaluation procedures.This review comprehensively synthesizes recent advances,critically evaluates state-of-the-art methodologies,and systematically identifies existing gaps to provide a clear roadmap and targeted research directions,guiding future developments toward the broader adoption and optimal utilization of soft robotic manipulators.展开更多
BACKGROUND Median sternotomy has been considered the gold standard approach for anterior mediastinal tumor resection.However,recent advances in video-assisted thoracoscopic surgery and robotic-assisted thoracoscopic s...BACKGROUND Median sternotomy has been considered the gold standard approach for anterior mediastinal tumor resection.However,recent advances in video-assisted thoracoscopic surgery and robotic-assisted thoracoscopic surgery with carbon dioxide insufflation have allowed minimally invasive approaches even for large and locally invasive tumors of the upper-anterior mediastinum.The subxiphoid robotic optical approach is a recently developed technique for accessing the mediastinum.The trans-subxiphoid technique offers excellent exposure of the surgical field,reduces postoperative pain,facilitates specimen retrieval even for large tumors,and potentially improves early surgical outcomes.AIM To evaluate the safety,feasibility,and outcomes of a robotic subxiphoid approach for the resecting of large/invasive mediastinal tumors.METHODS Between July 2024 and September 2025,12 patients underwent subxiphoid robotic mediastinal resection.The diameter of the operated lesions ranged from 30 mm to 70 mm.A 3 cm subxiphoid incision was made at the subxiphoid level for GelPort placement,allowing for optical port access.Two operating ports were placed at the sixth intercostal space bilaterally.Carbon dioxide insufflations(8-10 mmHg)enlarged the surgical field,improving visualization of critical anatomical landmarks,such as the internal mammary arteries and phrenic nerves.This approach allowed complete resection of large or invasive tumors,preserving thoracic stability and reducing the risk of postoperative myasthenic crisis.RESULTS The mean operating time was 170.2 minutes,and the median hospital stay was 3.5 days.No major postoperative complications occurred.Two conversions were necessary:One with a lateral robotic approach due to previous abdominal surgery,and one with a sternotomy for tumor invasion of the aortic arch.Histopathological analysis identified nine thymomas and one solitary fibrous tumor.CONCLUSION Subxiphoid robotic approach is a safe,effective technique for extended thymectomy,fulfilling both oncological and myasthenia gravis surgical objectives.展开更多
Embodied intelligence is redefining policing On the first day of 2026 chunyun,a period of high mobility associated with the Chinese New Year,the city of Jingzhou in Hubei Province welcomed new participants in road saf...Embodied intelligence is redefining policing On the first day of 2026 chunyun,a period of high mobility associated with the Chinese New Year,the city of Jingzhou in Hubei Province welcomed new participants in road safety:police robots capable of moving autonomously and interacting with passengers.Deployed on a trial basis on 2 February,these robots quickly demonstrated their usefulness in various urban settings.展开更多
Laparoscopic rectal surgery has demonstrated its superiority over the open approach,however it still has some technical limitations that lead to the development of robotic platforms.Nevertheless the literature on this...Laparoscopic rectal surgery has demonstrated its superiority over the open approach,however it still has some technical limitations that lead to the development of robotic platforms.Nevertheless the literature on this topic is rapidly expanding there is still no consensus about benefits of robotic rectal cancer surgery over the laparoscopic one.For this reason a review of all the literature examining robotic surgery for rectal cancer was performed.Two reviewers independently conducted a search of electronic databases(Pub Med and EMBASE)using the key words"rectum","rectal","cancer","laparoscopy","robot".After the initial screen of 266 articles,43 papers were selected for review.A total of 3013 patients were included in the review.The most commonly performed intervention was low anterior resection(1450 patients,48.1%),followed by anterior resections(997 patients,33%),ultra-low anterior resections(393 patients,13%)and abdominoperineal resections(173 patients,5.7%).Robotic rectal surgery seems to offer potential advantages especially in low anterior resections with lower conversions rates and better preservation of the autonomic function.Quality of mesorectum and status of and circumferential resection margins are similar to those obtained with conventional laparoscopy even if robotic rectal surgery is undoubtedly associated with longer operative times.This review demonstrated that robotic rectal surgery is both safe and feasible but there is no evidence of its superiority over laparoscopy in terms of postoperative,clinical outcomes and incidence of complications.In conclusion robotic rectal surgery seems to overcome some of technical limitations of conventional laparoscopic surgery especially for tumors requiring low and ultralow anterior resections but this technical improvement seems not to provide,until now,any significant clinical advantages to the patients.展开更多
In recent years,robotic arm grasping has become a pivotal task in the field of robotics,with applications spanning from industrial automation to healthcare.The optimization of grasping strategies plays a crucial role ...In recent years,robotic arm grasping has become a pivotal task in the field of robotics,with applications spanning from industrial automation to healthcare.The optimization of grasping strategies plays a crucial role in enhancing the effectiveness,efficiency,and reliability of robotic systems.This paper presents a novel approach to optimizing robotic arm grasping strategies based on deep reinforcement learning(DRL).Through the utilization of advanced DRL algorithms,such as Q-Learning,Deep Q-Networks(DQN),Policy Gradient Methods,and Proximal Policy Optimization(PPO),the study aims to improve the performance of robotic arms in grasping objects with varying shapes,sizes,and environmental conditions.The paper provides a detailed analysis of the various deep reinforcement learning methods used for grasping strategy optimization,emphasizing the strengths and weaknesses of each algorithm.It also presents a comprehensive framework for training the DRL models,including simulation environment setup,the optimization process,and the evaluation metrics for grasping success.The results demonstrate that the proposed approach significantly enhances the accuracy and stability of the robotic arm in performing grasping tasks.The study further explores the challenges in training deep reinforcement learning models for real-time robotic applications and offers solutions for improving the efficiency and reliability of grasping strategies.展开更多
The integration of artificial intelligence(AI)into the realm of robotic urologic surgery represents a remarkable paradigm shift in the field of urology and surgical healthcare.AI,with its advanced data analysis and ma...The integration of artificial intelligence(AI)into the realm of robotic urologic surgery represents a remarkable paradigm shift in the field of urology and surgical healthcare.AI,with its advanced data analysis and machine learning capabilities,has not only expedited the evolution of robotic surgical procedures but also significantly improved diagnostic accuracy and surgical outcomes.展开更多
Dear Editor,Robotic-assisted laparoscopic varicocelectomy(RALV)has been recently described in the pediatric field[1].Although the learning curve of surgical procedures is flattened by a robotic approach[2],complicatio...Dear Editor,Robotic-assisted laparoscopic varicocelectomy(RALV)has been recently described in the pediatric field[1].Although the learning curve of surgical procedures is flattened by a robotic approach[2],complications may occur especially at the beginning of experience.We herein describe an unexpected severe case of parietal blood dripping in a boy who underwent RALV.The study was approved by the institutional review board of Federico Il University Hospital in Naples,Italy(approval number:Fll/2024-PL149).All procedures performed were in accordance with the ethical standards of the institution and/or national research committee.The written informed consent was obtained by his parents to agree the treatment and publish this paper.展开更多
Robotic surgery has emerged as a new frontier in liver transplantation.Given the novelty of its application to recipient procedures,a comprehensive overview is crucial.This narrative review synthesizes the fragmented,...Robotic surgery has emerged as a new frontier in liver transplantation.Given the novelty of its application to recipient procedures,a comprehensive overview is crucial.This narrative review synthesizes the fragmented,foundational data on fully robotic recipient adult living donor liver transplantation(LDLT)on the basis of an appraisal of initial case reports and preliminary comparative studies.The literature was identifiedvia PubMed.The literature demonstrates the technical feasibility and favorable safety profileof the robotic approach.A significantreduction in morbidity was observed,as evidenced by a lower comprehensive complication index,reduced blood loss and transfusion need,and a lower incidence of postoperative infections.These benefitswere reflected in significantlyshorter intensive care unit and hospital stays.While the robotic approach was associated with prolonged operative and ischemia times,the studies revealed that these approaches did not compromise outcomes,with higher 6-month recipient survival noted in the robotic group.Fully robotic recipient LDLT is a groundbreaking technique,although the current evidence consists of initial case reports and non-randomized comparative data from a single center.The available literature suggests a promising safety profileand significantshort-term benefits,but these preliminary findingsrequire validation through multicenter,high-level research.展开更多
As robotic surgery provides clinical benefits and increases on a global scale,it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation.The digital c...As robotic surgery provides clinical benefits and increases on a global scale,it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation.The digital coupling between human control inputs and surgical motion replaces the previous physical link.Robotic surgery is therefore in effect‘surgery-by-wire’,the term capturing the engineering phenomenon that has also occurred in the‘fly-by-wire’of aviation and‘drive-by-wire’of cars.This paper reviews the fundamental commonality across domains.Intrinsic to‘by-wire’control is digital processing,which generates the control signal to the effector.This processing enables a progressive spectrum of motion modulation,from precision and stability of motion,through assistance and envelope protection,to automation.Precision now manifests in all three domains.In modern aircraft and cars,higher-order assistance is commonplace,such as flight envelope protection,with analogous support in driving,as well as significant automation.In robotic surgery,such assistance and automation have not yet entered wider clinical practice,with concepts such as envelope protection requiring further definition.The digital interface combined with telecommunication has also enabled teleoperation in all domains.Therefore,motion‘by-wire’has enhanced performance across industries.A cross-domain perspective will be increasingly useful to facilitate technology transfer and catalyse progress in robotic surgery.As the pan-industry digital transformation evolves,important principles can be derived for application in robotic surgery.展开更多
Robotic distal pancreatectomy(RDP)is being increasingly used in centres with access to the robot and offers technological improvements over conventional laparoscopy.Some studies have also shown superior outcomes compa...Robotic distal pancreatectomy(RDP)is being increasingly used in centres with access to the robot and offers technological improvements over conventional laparoscopy.Some studies have also shown superior outcomes compared with laparoscopic and open approaches.However,robotic technology is not widely available currently.This review aims to compare RDP with open and laparoscopic distal pancreatectomy,covering the basics of the RDP technique and highlighting the current nuances of the evidence pertaining to RDP with respect to clinical effectiveness and cost‒benefit analysis.展开更多
文摘Based on the Bismuth-Corlette classification of hilar cholangiocarcinoma,the patients with types I,II,and III can undergo radical resection in the absence of extensive intrahepatic metastasis and vascular invasion[1].Depending on the scope of tumor invasion in bile duct,a combined resection of parts of the liver,hepatic ducts,common bile ducts,regional lymph nodes,and even parts of the duodenum and pancreas is necessary,along with biliary and gastrointestinal reconstructions[2].The surgical plan is complex,involving a large resection area and significant trauma.In recent years,laparoscopic or robot assisted radical resection of hilar cholangiocarcinoma has been applied clinically[3,4].With the advanced laparoscopic equipment,many patients undergo hepatopancreatoduodenectomy successfully[5].The limitations of traditional laparoscopic techniques restrict their wide application in clinical practice.However,the Da Vinci robot has been widely applied due to its clear field of vision and flexible manipulation.However,its utilization in hepato-pancreatoduodenectomy for hilar cholangiocarcinoma is still relatively rare.Here,we report a case with hilar cholangiocarcinoma at clinical stage IIIb who underwent robot-assisted hepato-pancreatoduodenectomy.
文摘Robotic inguinal hernia repair remains in the early stages of implementation,and its potential advantages over the laparoscopic approach are still a matter of debate.This narrative review aims to summarize the findingsof major systematic reviews and randomized controlled trials and explore variables not adequately addressed in those studies.The literature review indicates that robotic inguinal hernia repair is associated with longer operative times but has improved ergonomics compared with laparoscopy.It is a safe procedure that results in a reduced inflammatory response,similar complication rates,and no significantdifference in acute postoperative pain.Although it involves higher direct costs,its cost-effectiveness remains unclear owing to a lack of analysis including indirect costs.Ongoing controversy continues regarding long-term benefits.The most recent systematic review pointed towards lower recurrence rates with robotic surgery,although randomized controlled trials have not validated this finding.Data on chronic pain are currently insufficientto draw firmconclusions.Further studies are needed to assess its use in complex cases and the role of novel techniques.
文摘Objective:Robotic colorectal surgery(RCS)provides a stable,magnifiedthree-dimensional visual field and enhanced ergonomics enabling precise dissection and tremor suppression.We postulate that this technique is associated with less tissue trauma and improved postoperative outcomes than laparoscopic colorectal surgery(LCS).This study aimed to explore the inflammatoryresponse following RCS by measuring postoperative C-reactive protein(CRP)levels and compare them with LCS data reported in the literature.Methods:This single centre retrospective study included consecutive elective robotic colon and rectum resections via the da Vinci®Xi platform for benign and malignant colorectal tumours,performed by a single surgeon between January 2017 and December 2023 at the Sydney Adventist Hospital,Sydney.CRP values were measured on post-operative days(PODs)3 and 5.A narrative review of the literature was performed via EMBASE,MEDLINE via PubMed and Google Scholar from inception to December 2024 for comparative CRP values following LCS.Descriptive statistical comparisons were performed between the RCS and LCS.Results:One hundred ninety-three patients were identifiedin the RCS cohort.The median age was 73 y(range:62–83 y).Most colectomies were performed for adenocarcinoma(90.2%),with right hemicolectomy being the most common type of procedure(49.3%).The median CRP levels on PODs 3 and 5 were 83.10 mg/L(IQR:49.80–124.12 mg/L)and 26.20 mg/L(IQR:17.70–80.00 mg/L),respectively.The reported CRP after LCS was heterogeneous,with mean POD 3 values ranging from 69 mg/L to 99.5 mg/L,and mean POD 4–5 values ranging from 62.4 mg/L to 72.85 mg/L.Conclusions:There were similar,if not lower,POD 3 and 5 CRP values,suggesting that RCS was probably non-inferior to LCS regarding postoperative tissue trauma.In particular,there appeared to be a quicker recovery of the inflammatory response with RCS.
文摘The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.
基金supported in part by the National Science and Technology Council under Grant NSTC 114-2221-E-027-104.
文摘Trajectory tracking for nonlinear robotic systems remains a fundamental yet challenging problem in control engineering,particularly when both precision and efficiency must be ensured.Conventional control methods are often effective for stabilization but may not directly optimize long-term performance.To address this limitation,this study develops an integrated framework that combines optimal control principles with reinforcement learning for a single-link robotic manipulator.The proposed scheme adopts an actor–critic structure,where the critic network approximates the value function associated with the Hamilton–Jacobi–Bellman equation,and the actor network generates near-optimal control signals in real time.This dual adaptation enables the controller to refine its policy online without explicit system knowledge.Stability of the closed-loop system is analyzed through Lyapunov theory,ensuring boundedness of the tracking error.Numerical simulations on the single-link manipulator demonstrate that themethod achieves accurate trajectory followingwhile maintaining lowcontrol effort.The results further showthat the actor–critic learning mechanism accelerates convergence of the control policy compared with conventional optimization-based strategies.This work highlights the potential of reinforcement learning integrated with optimal control for robotic manipulators and provides a foundation for future extensions to more complex multi-degree-of-freedom systems.The proposed controller is further validated in a physics-based virtual Gazebo environment,demonstrating stable adaptation and real-time feasibility.
基金The authors extend their appreciation to Prince Sattam bin Abdulaziz University for funding this research work through the project number(PSAU/2024/01/32082).
文摘In Human–Robot Interaction(HRI),generating robot trajectories that accurately reflect user intentions while ensuring physical realism remains challenging,especially in unstructured environments.In this study,we develop a multimodal framework that integrates symbolic task reasoning with continuous trajectory generation.The approach employs transformer models and adversarial training to map high-level intent to robotic motion.Information from multiple data sources,such as voice traits,hand and body keypoints,visual observations,and recorded paths,is integrated simultaneously.These signals are mapped into a shared representation that supports interpretable reasoning while enabling smooth and realistic motion generation.Based on this design,two different learning strategies are investigated.In the first step,grammar-constrained Linear Temporal Logic(LTL)expressions are created from multimodal human inputs.These expressions are subsequently decoded into robot trajectories.The second method generates trajectories directly from symbolic intent and linguistic data,bypassing an intermediate logical representation.Transformer encoders combine multiple types of information,and autoregressive transformer decoders generate motion sequences.Adding smoothness and speed limits during training increases the likelihood of physical feasibility.To improve the realism and stability of the generated trajectories during training,an adversarial discriminator is also included to guide them toward the distribution of actual robot motion.Tests on the NATSGLD dataset indicate that the complete system exhibits stable training behaviour and performance.In normalised coordinates,the logic-based pipeline has an Average Displacement Error(ADE)of 0.040 and a Final Displacement Error(FDE)of 0.036.The adversarial generator makes substantially more progress,reducing ADE to 0.021 and FDE to 0.018.Visual examination confirms that the generated trajectories closely align with observed motion patterns while preserving smooth temporal dynamics.
基金supported by the National Natural Science Foundation of China (Grant Nos.52505554,52575571)the Postdoctoral Fellowship Program of CPSF (Grant No.GZB20250348)。
文摘Accurate mechanical modeling is essential for robotic belt grinding(RBG), a process characterized by compliant contact mechanisms that make force prediction particularly challenging. However, existing mechanical models predominantly focus on macroscale compliance while neglecting grain-scale compliant motion. Moreover, abrasive grains are typically idealized as regular shapes, overlooking the inherent stochasticity of real grain geometries. This study proposes a shapeequivalence method for modeling stochastic abrasive grains and develops a multiscale compliant force model for RBG. Specifically, an individual grain is represented as a polygonal pyramid with stochastic edges that is mathematically equivalent to a cone;this method unifies the treatment of grain geometries and streamlines the modeling process. The mathematical equivalence relationship for random grain shapes is further derived based on a grain-compliant contact model. By integrating grain geometric characteristics and progressive grain wear, an analytical mechanical model that captures both the static contact force and dynamic grinding force is established, thereby describing the transition from grain-workpiece compliant interaction to belt-workpiece elastic contact. Grinding experiments were conducted using abrasive belts with different grain shape distributions to validate the model. The results demonstrated reliable predictions of the tangential grinding force and its component characteristics. Additional analyses were performed to reveal how the tangential grinding force varies with wear time and grinding parameters.
文摘Background:The Da Vinci Single-Port Robotic System(Da Vinci-SP),introduced by Intuitive(CA,USA)in 2018 in the USA and in 2024 in Europe,integrates advanced features like a flexible camera and articulating instruments.It has garnered significant interest in urology.Our report presents the first described European series of Radical Prostatectomies using the Da Vinci SP at the leading Italian center,Istituto Nazionale Tumori di Napoli,IRCCS“G.Pascale”Foundation,detailing the technical differences and challenges faced by experienced multiport robotic surgeons.Methods:Sixteen patients have been enrolled and underwent Single-Port(SP)Robot-Assisted Radical Prostatectomy(SP-RARP).Baseline characteristics of the patients were collected.We provided a step-by-step description of the surgical technique.Oncological outcomes have been evaluated and compared with magnetic resonance imaging(MRI)and biopsy results.Intraoperative,perioperative,and postoperative complications,surgical outcomes,functional outcomes,and technical issues of the new system were also documented.Results:All surgeries were successfully performed without the need for conversion.An extraperitoneal approach was used for all patients.Median Console time was 110 min.No complications were reported.The estimated median blood loss was 175 cc.Discharge from the hospital was on the first post-operative day for all patients.Bladder catheter removal was on day 7 without the need for cystography.Conclusions:We presented the first European case series of SP-RARP,reporting our experience and confirming the procedure’s feasibility for a highly experienced robotic surgeon.Experience with an extraperitoneal approach using the multiport(MP)platform,combined with well-conducted training for the SP system,may facilitate the transition to SP surgery.Further procedures and studies are needed to evaluate the oncological and functional outcomes.
文摘Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited research directly comparing open and robotic RPLND.The objective of this systematic review is to identify all the literature with direct comparisons between the open and robotic techniques for RPLND and to compare the two techniques.The primary outcome was peri-operative outcomes,and the secondary outcomes included oncological outcomes and patient demographics.Methods:This systematic review was prospectively registered and was conducted in accordance with the PRISMA statement.The PubMed,Embase and MEDLINE databases were searched for relevant publication from January 2006 to August 2024.Results:Eight studies,totaling 3995 patients,are included in this systematic review,with 3521 patients who underwent open RPLND and 474 who underwent robotic RPLND.For open RPLND,the mean operative duration,blood loss and length of stay were 267.8 min,475 mL and 7.3 d,respectively.For robotic RPLND,the mean operative duration,blood loss and length of stay were 334.5 min,94.6 mL and 3.7 d,respectively.Teratoma was the most common RPLND specimen pathology from both open and robotic surgeries.For open RPLND,the specimens have 13–23 nodes(26–32 mm),whereas the robotic RPLND specimens have 13–28 nodes(18–20 mm).Conclusion:This systematic review suggests that the benefitsof robotic RPLND may be associated with reduced blood loss,shorter hospitalisation and an overall lower risk of minor and major complications while maintaining oncological safety.
基金the National Natural Science Foundation of China[62525301,62127811,62433019]the New Cornerstone Science Foundation through the XPLORER PRIZEthe financial support by the China Postdoctoral Science Foundation[GZB20240797].
文摘Single-cell biomechanics and electrophysiology measuring tools have transformed biological research over the last few decades,which enabling a comprehensive and nuanced understanding of cellular behavior and function.Despite their high-quality information content,these single-cell measuring techniques suffer from laborious manual processing by highly skilled workers and extremely low throughput(tens of cells per day).Recently,numerous researchers have automated the measurement of cell mechanical and electrical signals through robotic localization and control processes.While these efforts have demonstrated promising progress,critical challenges persist,including human dependency,learning complexity,in-situ measurement,and multidimensional signal acquisition.To identify key limitations and highlight emerging opportunities for innovation,in this review,we comprehensively summarize the key steps of robotic technologies in single-cell biomechanics and electrophysiology.We also discussed the prospects and challenges of robotics and automation in biological research.By bridging gaps between engineering,biology,and data science,this work aims to stimulate interdisciplinary research and accelerate the translation of robotic single-cell technologies into practical applications in the life sciences and medical fields.
基金Open access funding provided by The Science,Technology&Innovation Funding Authority(STDF)in cooperation with The Egyptian Knowledge Bank(EKB).
文摘Soft robotic manipulators represent a rapidly evolving field characterized by inherent compliance,adaptability,and safe interactions within unstructured environments.Over the past decade(2015-2025),significant advancements have trans-formed their capabilities through novel designs inspired by biological systems,advanced modeling frameworks,sophisti-cated control strategies,and integration into diverse real-world applications.Recent innovations in multifunctional mate-rials and emerging actuation technologies have markedly expanded manipulator performance,reliability,and dexterity.Concurrently,developments in modeling have progressed from simplified geometric methods toward highly accurate physics-based and hybrid data-driven approaches,substantially improving real-time prediction and controllability.Coupled with these developments,adaptive and robust control strategies-including learning-based techniques-have enabled unprec-edented autonomy and precision in challenging application domains such as Minimally Invasive Surgery(MIS),precision agriculture,deep-sea exploration,disaster recovery,and space missions.Despite these remarkable strides,key challenges remain,notably regarding scalability,long-term material durability,robust integrated sensing,and standardized evaluation procedures.This review comprehensively synthesizes recent advances,critically evaluates state-of-the-art methodologies,and systematically identifies existing gaps to provide a clear roadmap and targeted research directions,guiding future developments toward the broader adoption and optimal utilization of soft robotic manipulators.
文摘BACKGROUND Median sternotomy has been considered the gold standard approach for anterior mediastinal tumor resection.However,recent advances in video-assisted thoracoscopic surgery and robotic-assisted thoracoscopic surgery with carbon dioxide insufflation have allowed minimally invasive approaches even for large and locally invasive tumors of the upper-anterior mediastinum.The subxiphoid robotic optical approach is a recently developed technique for accessing the mediastinum.The trans-subxiphoid technique offers excellent exposure of the surgical field,reduces postoperative pain,facilitates specimen retrieval even for large tumors,and potentially improves early surgical outcomes.AIM To evaluate the safety,feasibility,and outcomes of a robotic subxiphoid approach for the resecting of large/invasive mediastinal tumors.METHODS Between July 2024 and September 2025,12 patients underwent subxiphoid robotic mediastinal resection.The diameter of the operated lesions ranged from 30 mm to 70 mm.A 3 cm subxiphoid incision was made at the subxiphoid level for GelPort placement,allowing for optical port access.Two operating ports were placed at the sixth intercostal space bilaterally.Carbon dioxide insufflations(8-10 mmHg)enlarged the surgical field,improving visualization of critical anatomical landmarks,such as the internal mammary arteries and phrenic nerves.This approach allowed complete resection of large or invasive tumors,preserving thoracic stability and reducing the risk of postoperative myasthenic crisis.RESULTS The mean operating time was 170.2 minutes,and the median hospital stay was 3.5 days.No major postoperative complications occurred.Two conversions were necessary:One with a lateral robotic approach due to previous abdominal surgery,and one with a sternotomy for tumor invasion of the aortic arch.Histopathological analysis identified nine thymomas and one solitary fibrous tumor.CONCLUSION Subxiphoid robotic approach is a safe,effective technique for extended thymectomy,fulfilling both oncological and myasthenia gravis surgical objectives.
文摘Embodied intelligence is redefining policing On the first day of 2026 chunyun,a period of high mobility associated with the Chinese New Year,the city of Jingzhou in Hubei Province welcomed new participants in road safety:police robots capable of moving autonomously and interacting with passengers.Deployed on a trial basis on 2 February,these robots quickly demonstrated their usefulness in various urban settings.
文摘Laparoscopic rectal surgery has demonstrated its superiority over the open approach,however it still has some technical limitations that lead to the development of robotic platforms.Nevertheless the literature on this topic is rapidly expanding there is still no consensus about benefits of robotic rectal cancer surgery over the laparoscopic one.For this reason a review of all the literature examining robotic surgery for rectal cancer was performed.Two reviewers independently conducted a search of electronic databases(Pub Med and EMBASE)using the key words"rectum","rectal","cancer","laparoscopy","robot".After the initial screen of 266 articles,43 papers were selected for review.A total of 3013 patients were included in the review.The most commonly performed intervention was low anterior resection(1450 patients,48.1%),followed by anterior resections(997 patients,33%),ultra-low anterior resections(393 patients,13%)and abdominoperineal resections(173 patients,5.7%).Robotic rectal surgery seems to offer potential advantages especially in low anterior resections with lower conversions rates and better preservation of the autonomic function.Quality of mesorectum and status of and circumferential resection margins are similar to those obtained with conventional laparoscopy even if robotic rectal surgery is undoubtedly associated with longer operative times.This review demonstrated that robotic rectal surgery is both safe and feasible but there is no evidence of its superiority over laparoscopy in terms of postoperative,clinical outcomes and incidence of complications.In conclusion robotic rectal surgery seems to overcome some of technical limitations of conventional laparoscopic surgery especially for tumors requiring low and ultralow anterior resections but this technical improvement seems not to provide,until now,any significant clinical advantages to the patients.
文摘In recent years,robotic arm grasping has become a pivotal task in the field of robotics,with applications spanning from industrial automation to healthcare.The optimization of grasping strategies plays a crucial role in enhancing the effectiveness,efficiency,and reliability of robotic systems.This paper presents a novel approach to optimizing robotic arm grasping strategies based on deep reinforcement learning(DRL).Through the utilization of advanced DRL algorithms,such as Q-Learning,Deep Q-Networks(DQN),Policy Gradient Methods,and Proximal Policy Optimization(PPO),the study aims to improve the performance of robotic arms in grasping objects with varying shapes,sizes,and environmental conditions.The paper provides a detailed analysis of the various deep reinforcement learning methods used for grasping strategy optimization,emphasizing the strengths and weaknesses of each algorithm.It also presents a comprehensive framework for training the DRL models,including simulation environment setup,the optimization process,and the evaluation metrics for grasping success.The results demonstrate that the proposed approach significantly enhances the accuracy and stability of the robotic arm in performing grasping tasks.The study further explores the challenges in training deep reinforcement learning models for real-time robotic applications and offers solutions for improving the efficiency and reliability of grasping strategies.
文摘The integration of artificial intelligence(AI)into the realm of robotic urologic surgery represents a remarkable paradigm shift in the field of urology and surgical healthcare.AI,with its advanced data analysis and machine learning capabilities,has not only expedited the evolution of robotic surgical procedures but also significantly improved diagnostic accuracy and surgical outcomes.
文摘Dear Editor,Robotic-assisted laparoscopic varicocelectomy(RALV)has been recently described in the pediatric field[1].Although the learning curve of surgical procedures is flattened by a robotic approach[2],complications may occur especially at the beginning of experience.We herein describe an unexpected severe case of parietal blood dripping in a boy who underwent RALV.The study was approved by the institutional review board of Federico Il University Hospital in Naples,Italy(approval number:Fll/2024-PL149).All procedures performed were in accordance with the ethical standards of the institution and/or national research committee.The written informed consent was obtained by his parents to agree the treatment and publish this paper.
文摘Robotic surgery has emerged as a new frontier in liver transplantation.Given the novelty of its application to recipient procedures,a comprehensive overview is crucial.This narrative review synthesizes the fragmented,foundational data on fully robotic recipient adult living donor liver transplantation(LDLT)on the basis of an appraisal of initial case reports and preliminary comparative studies.The literature was identifiedvia PubMed.The literature demonstrates the technical feasibility and favorable safety profileof the robotic approach.A significantreduction in morbidity was observed,as evidenced by a lower comprehensive complication index,reduced blood loss and transfusion need,and a lower incidence of postoperative infections.These benefitswere reflected in significantlyshorter intensive care unit and hospital stays.While the robotic approach was associated with prolonged operative and ischemia times,the studies revealed that these approaches did not compromise outcomes,with higher 6-month recipient survival noted in the robotic group.Fully robotic recipient LDLT is a groundbreaking technique,although the current evidence consists of initial case reports and non-randomized comparative data from a single center.The available literature suggests a promising safety profileand significantshort-term benefits,but these preliminary findingsrequire validation through multicenter,high-level research.
文摘As robotic surgery provides clinical benefits and increases on a global scale,it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation.The digital coupling between human control inputs and surgical motion replaces the previous physical link.Robotic surgery is therefore in effect‘surgery-by-wire’,the term capturing the engineering phenomenon that has also occurred in the‘fly-by-wire’of aviation and‘drive-by-wire’of cars.This paper reviews the fundamental commonality across domains.Intrinsic to‘by-wire’control is digital processing,which generates the control signal to the effector.This processing enables a progressive spectrum of motion modulation,from precision and stability of motion,through assistance and envelope protection,to automation.Precision now manifests in all three domains.In modern aircraft and cars,higher-order assistance is commonplace,such as flight envelope protection,with analogous support in driving,as well as significant automation.In robotic surgery,such assistance and automation have not yet entered wider clinical practice,with concepts such as envelope protection requiring further definition.The digital interface combined with telecommunication has also enabled teleoperation in all domains.Therefore,motion‘by-wire’has enhanced performance across industries.A cross-domain perspective will be increasingly useful to facilitate technology transfer and catalyse progress in robotic surgery.As the pan-industry digital transformation evolves,important principles can be derived for application in robotic surgery.
文摘Robotic distal pancreatectomy(RDP)is being increasingly used in centres with access to the robot and offers technological improvements over conventional laparoscopy.Some studies have also shown superior outcomes compared with laparoscopic and open approaches.However,robotic technology is not widely available currently.This review aims to compare RDP with open and laparoscopic distal pancreatectomy,covering the basics of the RDP technique and highlighting the current nuances of the evidence pertaining to RDP with respect to clinical effectiveness and cost‒benefit analysis.
