BACKGROUND: Traditional methods cannot clearly visualize esophageal cancer (EC) tumor contours and metastases, which limits the clinical application of da Vinci robot-assisted surgery.
OBJECTIVE: To investigate the efficacy of the da Vinci robot in combination with nanocarbon lymph node tracers in radical surgery of EC.
METHODS: In total, 104 patients with early-stage EC who were admitted to Liuzhou worker\'s Hospital from January 2020 to June 2023 were enrolled. The patients were assigned to an observation group (n = 52), which underwent da Vinci robot-assisted minimally invasive esophagectomy (RAMIE) with the intraoperative use of nanocarbon tracers, and a control group (n = 52), which underwent traditional surgery treatment. The operation time, intraoperative blood loss, postoperative drainage tube indwelling time, hospital stay, number of lymph nodes dissected, incidence of complications, and long-term curative effects were comparatively analyzed. The postoperative stress response C-reactive protein (CRP), cortisol, epinephrine (E) and inflammatory response interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α) were evaluated.
RESULTS: Compared with the control group, the observation group had significantly lower postoperative CRP, cortisol, and E levels (P < 0.05) with a milder inflammatory response, as indicated by lower IL-6, IL-10, and TNF-α levels (P < 0.05). Patients who underwent RAMIE had less intraoperative blood loss and shorter operation times and hospital stays than those who underwent traditional surgery. The average number of dissected lymph nodes, time of lymph node dissection, and mean smallest lymph node diameter were all significantly lower in the observation group (P < 0.05). The rate of postoperative complications was 5.77% in the observation group, significantly lower than the 15.38% observed in the control group. Furthermore, the lymphatic metastasis rate, reoperation rate, and 12- and 24-month cumulative mortality in the observation group were 1.92%, 0%, 0%, and 0%, respectively, all of which were significantly lower than those in the control group (P < 0.05).
CONCLUSIONS: The treatment of EC using the da Vinci robot combined with nanocarbon lymph node tracers can achieve good surgical outcomes and demonstrates promising clinical applications.

BACKGROUND: Splenic artery aneurysm (SAA) is characterized by a weakening and bulging of splenic artery. Robot-assisted (RA) laparoscopic surgery is a minimally invasive surgical technique. This systematic review aimed to assess the use of RA laparoscopic surgery to manage SAA.
METHODS: Five medical databases were used to identify studies that investigated the use of robotic devices in laparoscopic SAA management in humans. Original peer-reviewed articles were included. Two authors independently screened articles and extracted data on factors including patient demographics, surgical procedures, and outcomes.
RESULTS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses search identified 7 studies with a total of 28 patients who underwent RA laparoscopic surgery for SAA. The studies reported successful surgeries using various techniques, including end-to-end anastomosis, ligation, and graft placement. 3-dimensional printed models were used in 1 study as an aid for preoperative surgery planning. Mean operation time was 210 minutes, and 3 complications were reported (robotic arm failure during surgery and 2 conversions to open surgery).
CONCLUSIONS: RA laparoscopic surgery offers several advantages more than traditional open surgery for SAA management. However, more research is needed to confirm these potential benefits and establish RA laparoscopic surgery as a standard treatment option for SAA. Future studies should involve larger patient groups, compare this method to traditional techniques, and evaluate its cost-effectiveness. Additionally, incorporating advancements like mixed reality for preoperative planning and 3D printing to improve surgical planning and patient communication.

The \"double bipolar method\" (DBM) in robotic surgery has been widely used in Japanese general surgery and gynecology; however, it is not commonly used in the field of urology. A 55-year-old female was diagnosed with stage IA endometrial cancer. A 2-cm cystic lesion was incidentally observed at the dome of the bladder on magnetic resonance imaging. A simultaneous robot-assisted total hysterectomy and partial cystectomy using the da Vinci Xi system was planned. The gynecological procedure was first performed with the DBM, and the DBM was also used in the partial cystectomy without additional instruments to reduce surgical costs. Maryland bipolar forceps was used to excise the peritoneum, fat, and bladder wall without bleeding, enabling delicate and precise resection using the forceps\' tips. Robot-assisted partial cystectomy using the DBM was feasible. When performing combined surgeries with other departments, if the DBM is already being utilized, it is worthwhile to attempt to decrease surgical cost.

UNASSIGNED: To investigate the application value of complete laparoscopy and Da Vinci robot esophagogastric anastomosis double muscle flap plasty in radical resection of proximal gastric cancer.
UNASSIGNED: A retrospective descriptive study was used. The clinicopathological data of 35 patients undergoing radical operation for proximal gastric cancer admitted to Liaoning Cancer Hospital from January 2020 to December 2023 were collected. Variables evaluated: 1. Transoperative,2. Postoperative, 3. Follow-up. In relation to follow-up, esophageal disease status reflux, anastomosis, nutritional status score, serum hemoglobin, tumor recurrence, and metastasis were investigated. The trans and postoperative variables were obtained from the clinical records and the patients were followed up in outpatient department and by telephone.
UNASSIGNED: Among the 35 patients, 17 underwent robotic surgery and 18 underwent laparoscopic surgery. There were 29 males and 6 females. 1) Transoperative: Robotic surgery: The operation time was (305.59 ± 22.07) min, the esophagogastric anastomosis double muscle flap plasty time was (149.76 ± 14.91) min, the average number of lymph nodes cleared was 30, and the average intraoperative blood loss was 30 ml. Laparoscopic surgery: The mean operation time was 305.17 ± 26.92min, the operation time of esophagogastric anastomosis double muscle flap was (194.06 ± 22.52) min, the average number of lymph nodes cleared was 24, and the average intraoperative blood loss was 52.5 ml. 2) Postoperative: Robotic surgery: the average time for patients to have their first postoperative anal emission was 3 days, the average time to first postoperative feeding was 4 days, and the average length of hospitalization after surgery was 8 days. Laparoscopic surgery: the average time for patients to have their first postoperative anal emission was 5 days, the average time to first postoperative feeding was 6 days, the average length of hospitalization after surgery was 10 days. 3) Follow-up: The follow-up time ranged from 1 to 42 months, with a median follow-up time of 24 months.
UNASSIGNED: Complete Da Vinci robot and laparoscopic esophagogastric anastomosis double muscle flap plasty for radical resection of proximal gastric cancer can minimize surgical incision, reduce abdominal exposure, accelerate postoperative recovery of patients, and effectively prevent reflux esophagitis and maintain good hemoglobin concentration and nutritional status. The advantages of robotic surgery is less intraoperative bleeding and faster post-surgical recovery, but it is relatively more expensive.

暂无摘要。

UNASSIGNED: Esophagectomy is the gold standard treatment for resectable esophageal cancer; however, there is insufficient evidence to indicate potential advantages over standard minimally invasive esophagectomy (MIE) in treating thoracic esophageal cancer. Robot-assisted minimally invasive esophagectomy (RAMIE) bridges the gap between open and minimally invasive surgery. In this single-center retrospective review, we compare the clinical outcomes of EC patients treated with MIE and RAMIE.
UNASSIGNED: We retrospectively reviewed the clinical data of patients with esophageal cancer who underwent surgery at Qilu Hospital between August 2020 and August 2022, including 159 patients who underwent MIE and 35 patients who received RAMIE. The intraoperative, postoperative, and preoperative patient characteristics in both groups were evaluated.
UNASSIGNED: Except for height, the MIE and RAMIE groups showed no significant differences in preoperative features (P>0.05). Further, there were no significant differences in intraoperative indices, including TNM stage of the resected tumor, tumor tissue type, or ASA score, between the two groups. However, statistically significant differences were found in some factors; the RAMIE group had a shorter operative time, less intraoperative bleeding, and more lymph nodes removed compared to the MIE group. Patients in the RAMIE group reported less discomfort and greater chest drainage on the first postoperative day than patients in the MIE group; however, there were no differences in other features between the two datasets.
UNASSIGNED: By comparing the clinical characteristics and outcomes of RAMIE with MIE, this study verified the feasibility and safety of RAMIE for esophageal cancer. Overall, RAMIE resulted in more complete lymph node clearance, shorter operating time, reduced surgical hemorrhage, reduced postoperative discomfort, and chest drainage alleviation in patients. To investigate the function of RAMIE in esophageal cancer, we propose undertaking a future clinical trial with long-term follow-up to analyze tumor clearance, recurrence, and survival after RAMIE.

暂无摘要。

OBJECTIVE: The study aimed to analyze the clinical efficacy and safety of hand-sewn anastomosis for the digestive tract with Da Vinci robot in rectal cancer surgery.
METHODS: A retrospective study was conducted to collect the clinical data from 27 patients who underwent Da Vinci robotic rectal cancer radical surgery in the department of gastrointestinal surgery at the Second Affiliated Hospital of Dalian Medical University from August 2019 to February 2022. All patients received a manual suture for digestive tract reconstruction. After the posterior wall was sutured, the anterior wall was sutured continuously. Finally, a prilling thread was used to sew the junction of the front and rear walls. Perioperative indexes and complications were recorded.
RESULTS: All 27 patients successfully underwent the operation. Neither conversion to laparotomy nor perioperative death occurred. The operation time and intraoperative blood loss were 183.6 ± 44.8 min and 54.8 ± 34.4 ml, respectively. A total of 15.3 ± 7.8 lymph nodes were harvested. The pain score 24 h after operation was 1.3 ± 1.3. The time out of bed, the time to exhaust, and the time to eat were 15.6 ± 2.9 h, 2.2 ± 0.8 days, and 2.1 ± 0.6 days, respectively. A total of 4 patients (14.8%) developed complications after the operation. Grade B anastomotic leakage gradually resolved after drainage and antibiotic therapy in 1 case. A patient with grade C anastomotic leakage received a second operation for ileostomy. One patient with postoperative pneumonia recovered after anti-infective treatment. Another patient with intraperitoneal hemorrhage improved after symptomatic treatment with blood transfusion and hemostasis. The postoperative hospitalization time and total hospitalization costs were 8.9 ± 4.4 days and 89,236.1 ± 13,527.9 yuan, respectively.
CONCLUSIONS: Manual suture with Da Vinci robotic surgery system is safe and feasible for reconstructing the digestive tract in rectal cancer surgery.

BACKGROUND: Hydatid liver disease is a prevalent condition in endemic areas, particularly in the Middle East and North Africa. The use of laparoscopy as a treatment option has gained popularity. However, there is still ongoing debate regarding the optimal approach for surgical management. In this study, we present our experience with the surgical treatment of hydatid liver disease comparing conventional and minimally invasive approaches, including laparoscopic and robotic options.
METHODS: We conducted a retrospective review of patients who underwent surgery for hydatid liver disease at our institution. Data was collected on the patients\' clinical presentations, cyst characteristics, surgical procedures performed, intraoperative findings, and postoperative complications.
RESULTS: A total of 98 hydatid liver cysts were surgically managed in 57 patients. The mean age of the patients was 37.2 ± 10.2 years, with 38 (66.7%) being male. Among the patients, 14 (24.6%) underwent conventional surgery (6 partial pericystectomy, 4 total pericystectomy, and 4 liver resection), 37 (64.9%) underwent laparoscopic surgery (31 partial pericystectomy, 4 total pericystectomy, and 2 liver resection), and 6 (10.5%) underwent robotic surgery (6 partial pericystectomy). There were no significant differences between the conventional surgery and minimally invasive groups in terms of patient age, gender, cyst size, or number. However, laparotomy was associated with a higher number of total pericystectomy and liver resection procedures compared to the minimally invasive approach (P = 0.010). Nonetheless, the operation time and blood loss were comparable between both groups. Perioperative complications occurred in 19 (33.3%) patients, with 16 (84%) experiencing minor issues. Bile leak occurred in 8 (14%) patients, resolving spontaneously in 5 patients. There was no significant difference (P = 0.314) in the incidence of complications between the two groups. Conventional surgery, however, was associated with a significantly longer hospital stay (P = 0.034). During follow-up, there were no cases of mortality or cyst recurrence in our cohort.
CONCLUSIONS: Minimally invasive approaches for hydatid liver cysts offer advantages such as shorter hospitalization and potentially quicker recovery, making them valuable treatment options when accompanied by careful patient selection and adherence to proper surgical techniques.

Objective:To explore the safety and feasibility of bilateral axillo-breast approach （BABA） robot in the operation of thyroid cancer in obese women. Methods:The clinical data of 81 obese female patients who underwent da Vinci robotic thyroid cancer surgery（robotic group） at the Department of Thyroid and Breast Surgery, PLA 960 Hospital from May 2018 to December 2021 were retrospectively analyzed and compared with the clinical data of 106 obese female thyroid cancer patients who underwent open surgery（open group） during the same period. The age, body mass index（BMI）, mean time of surgery, mean postoperative drainage, tumor diameter, postoperative tumor stage, number of lymph node dissection in the central and lateral cervical regions, number of positive lymph nodes in the central and lateral cervical regions, postoperative cosmetic outcome satisfaction score, mean postoperative hospital stay and postoperative complications of all patients were counted. The results were analyzed using SPSS 26.0 statistical software, and the count data were compared using the χ² test, and the measurement data were compared using the t test. Results:All patients completed the operation successfully, and there was no conversion in the robot group, postoperative pathological results were all composed of papillary thyroid carcinoma. The operation time in the robot group was（144.62±36.38） min, which was longer than that in the open group（117.06±18.72） min（P<0.05）. The average age of the robot group was（40.25±9.27） years, which was lower than that of the open group（49.59±8.70） years（P<0.05）. The satisfactory score of cosmetic effect in the robot group（9.44±0.65） was higher than that in the open group（5.23±1.07）（P<0.05）. There was no significant difference in tumor diameter, BMI, average postoperative drainage, temporary hypoparathyroidism and recurrent laryngeal nerve injury, number of central and lateral cervical lymph node dissection, number of positive lymph nodes in the central and lateral cervical regions, and average postoperative hospital stay between the two groups. There was no permanent hypoparathyroidism and recurrent laryngeal nerve injury in both groups. Conclusion:The application of BABA pathway robot in thyroid cancer surgery in obese women is safe and feasible, and the cosmetic effect is better after operation.
目的：探讨双侧乳晕腋窝径路（bilateral axillo-breast approach，BABA）机器人在肥胖女性甲状腺癌手术应用中的安全性及可行性。 方法：回顾性分析2018年5月—2021年12月在解放军第九六〇医院甲状腺乳腺外科行达芬奇机器人甲状腺癌手术的81例肥胖女性患者（机器人组）的临床资料，与同期行开放手术的106例肥胖女性甲状腺癌患者（开放组）的临床资料进行比较。统计所有患者的年龄、体重指数（BMI）、手术平均时间、术后平均引流量、肿瘤直径、中央区及颈侧区淋巴结清扫数目、术后肿瘤分期、中央区及颈侧区阳性淋巴结数目、术后美容效果满意评分、术后平均住院时间及术后并发症的情况。采用SPSS 26.0统计软件对结果进行分析，计数资料采用χ²检验进行比较，计量资料采用t检验进行比较。 结果：所有患者顺利完成手术，机器人组手术无中转开放，术后病理结果均为甲状腺乳头状癌。机器人组手术时间（144.62±36.38） min，长于开放组[（117.06±18.72） min]（P<0.05）。机器人组的平均年龄（40.25±9.27）岁，低于开放组[（49.59±8.70）岁]（P<0.05）。机器人组术后美容效果满意评分（9.44±0.65）分，高于开放组[（5.23±1.07）分]（P<0.05）。两组患者的肿瘤直径、BMI、术后平均引流量、暂时性的甲状旁腺功能减退及喉返神经损伤、中央区及颈侧区淋巴结清扫数目、术后平均住院时间、中央区及颈侧区阳性淋巴结数目等差异均无统计学意义（P>0.05）。两组患者术后均未发生永久性的甲状旁腺功能减退及喉返神经损伤。 结论：BABA径路机器人在肥胖女性甲状腺癌手术中应用安全可行，术后美容效果更好。.