Robot-assisted laparoendoscopic single-site upper urinary tract surgery with da Vinci Xi surgical system: Initial experience

Comparison of effectiveness and safety of Da Vinci robot's "3 + 1" and "4 + 1" modes of treatment for colorectal cancer

To compare the effectiveness of the Da Vinci Surgical Robot System (DSRS) "3 + 1" and "4 + 1" models for colorectal cancer (CRC). A total of 107 patients with CRC admitted to our hospital from February 2021 to May 2022 were selected for the retrospective analysis. Of these, 57 patients underwent the DSRS "4 + 1" model (control group), while the rest 50 underwent the DSRS "3 + 1" model (research group). The operation time, intraoperative bleeding, number of lymph nodes detected, time of first postoperative urinary catheter removal, time of first feeding, time of first venting and hospitalization were compared between the two groups. The changes of white blood cell (WBC) and C-reactive protein (CRP) levels before and after surgery were detected, and patients' adverse effects and treatment costs between surgery and hospital discharge were counted. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to assess the psychological state of the patients. There was no difference in operative time, intraoperative bleeding, and number of lymph nodes detected between both groups (P > 0.05), while time to first postoperative urinary catheter removal, time to first feeding, time to first venting, length of stay (LOS), postoperative inflammatory factor levels, incidence of adverse events, and treatment costs were all lower in the research group than in the control group (P < 0.05). SAS and SDS scores decreased after treatment in both groups, but the decrease was more obvious in the research group (P < 0.05). Both DSRS "4 + 1" and "3 + 1" modes have better treatment effects for CRC. However, the "3 + 1" mode has higher safety and lower treatment cost, which can significantly improve the postoperative recovery process of patients and is more worthy to be promoted in clinical practice.

Robot-assisted radical prostatectomy: Advancements in surgical technique and perioperative care

We reviewed the evolving strategies, practice patterns, and recent advancements aimed at improving the perioperative and surgical outcomes in patients undergoing robot-assisted radical prostatectomy for the management of localized prostate cancer.

Clinical implications for da Vinci SP partial nephrectomy in high complexity tumors; Propensity score matching analysis

PURPOSE

To compare surgical outcomes between robot-assisted laparoendoscopic single-site surgery using the da Vinci Si or Xi system and the da Vinci SP system for partial nephrectomy.

MATERIAL AND METHODS

From 2008 to 2020, 66 partial nephrectomies were performed using a single-site robotic approach: 44 used the da Vinci Xi or Si system (R-LESS group) and 22 used the da Vinci SP system (SP group). After 1:1 propensity score-matching, surgical outcomes were compared between groups Results: Median patient age was 51.5 years. Median tumor size was 2.1 cm and was not significantly different between groups. Median operation time was longer in the R-LESS group (R-LESS vs SP: 180 min vs 155 min, p=0.034), but median warm ischemic time was comparable between groups. Estimated blood loss was higher in the R-LESS group (R-LESS vs SP: 215 mL vs 20 mL, p<0.001). Median operation time was significantly shorter in the SP group in patients with moderate to high complexity tumors (R-LESS vs SP: 200 min vs 172 min, p=0.035). Rates of trifecta achievement were similar between groups (63.6% in both groups, p=1.00).

CONCLUSIONS

R-LESS and da Vinci SP methods are both feasible approaches for single-site incision robotic partial nephrectomy. The da Vinci SP platform allows "true" single-site surgery without additional ports and provides a wider working space. It was associated with better performance than R-LESS partial nephrectomy. In moderate to high complex tumors, operation time was shorter with SP partial nephrectomy than with R-LESS partial nephrectomy, suggesting that the SP method is especially advantageous for managing complex renal tumors.

Design of a New Catheter Operating System for the Surgical Robot

In interventional surgery, the manual operation of the catheter is not accurate. It is necessary to operate the catheter skillfully and effectively to protect the surgeon from radiation injury. The purpose of this paper is to design a new robot catheter operating system, which can help surgeons to complete the operation with high mechanical precision. On the basis of the original mechanical structure-real catheter, the operation information of the main end operator is collected. After the information is collected, the control algorithm of the system is improved, and the BP neural network is combined with the traditional PID controller to adjust the PID control parameters more effectively and intelligently so that the motor can reflect the output of the controller better and faster. The feasibility and superiority of the BP neural network PID controller are verified by simulation experiments.