Vinci System Research Articles

Clash of the Titans: the first multi-center retrospective comparative study between da Vinci and Hugo™ RAS surgical systems for the treatment of deep endometriosis

Background The proliferation of several robotic platforms presents an opportunity to pinpoint the most suitable system for specific procedures and patient profiles. This study aims to explore differences in complications and functional outcomes among patients undergoing deep endometriosis excision with the da Vinci surgical system compared to the Hugo™ RAS system. Method This is a retrospective, multicenter cohort study. Patients were categorized based on the surgical system used: the Da Vinci system and the Hugo™ RAS system. Perioperative complications, functional outcomes (via validated questionnaire: BFLUTS, KESS, GIQLI), and pain symptoms both before and after surgery were compared between the two groups. Results A total of six postoperative complications were reported: four in the Da Vinci system group (20%) and two in the Hugo™ RAS system group (12.5%). No difference in the mean operative time (p = 0.647), median estimated blood loss (p = 0.179), and hospital stay (p < 0.0001) was found between the two groups. A significant difference was reported in questionnaire score changes and dyspareunia severity in the da Vinci system arm. Conclusions Both robotic systems offer comparable performances in terms of intraoperative complications, although there was a higher incidence of postoperative complications in patients who underwent surgery with the Da Vinci system. Moreover, there was an improvement in dyspareunia, urinary, and gastrointestinal function in the same group.

Total Mesorectal Excision with New Robotic Platforms: A Scoping Review.

Colorectal surgery is one of the specialties that have significantly benefited from the adoption of robotic technology. Over 20 years since the first robotic rectal resection, the Intuitive Surgical Da Vinci system remains the predominant platform. The introduction of new robotic systems into the market has enabled the first documented total mesorectal excision (TME) using alternative platforms. This scoping review aimed to assess the role and adoption of these emerging robotic systems in performing TME for rectal cancer surgery. Methods: A comprehensive search of the Medline, Embase, and Cochrane databases was conducted up to August 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Results: Thirty-six studies were included in the review. The majority of rectal surgical procedures were performed using eight different robotic platforms. Intraoperative, short-term, and functional outcomes were generally favorable. However, pathological results were frequently incomplete. Several studies identified the lack of advanced robotic instruments as a significant limitation. Conclusions: The quality of the resected specimen is critical in rectal cancer surgery. Although TME performed with new robotic platforms appears to be feasible and safe, the current body of literature is limited, particularly in the assessment of pathological and long-term survival outcomes.

Perioperative, functional, and oncological outcomes of Da Vinci vs. Hugo RAS for robot‑assisted radical prostatectomy: evidence based on controlled studies.

A comparison was conducted between robot-assisted radical prostatectomy (RARP) performed using the Hugo RAS System and the Da Vinci System. We conducted an extensive search of online databases through September 2024. The data from eligible studies were pooled and analyzed with Review Manager 5.4, employing a random effects model. Weighted mean difference (WMD) and odds ratios (OR) with 95% confidence intervals (CI) were used to analyze continuous and categorical variables. A total of eight original studies, involving 1155 patients (HUGO-RARP: 468 vs. da Vinci-RARP: 687), were included. Compared with da Vinci-RARP, HUGO-RARP had a longer docking time (WMD: 6.2min; 95% CI 4.25-8.14; p < 0.0001), while no significant differences were observed in total operative time, console time, bladder neck dissection time, seminal vesicle dissection time, vesicourethral anastomosis time, or pelvic lymph node dissection time between two systems. There were no significant differences in hospital stay, estimated blood loss, catheter duration, or complication rates. Likewise, oncological and functional outcomes were similar between the two systems. While these results suggest that the Hugo RAS system performs as well as the Da Vinci system in RARP, more randomized controlled studies are needed to further evaluate prognostic outcomes.

Cadaveric Feasibility of Robotic-Assisted Radial Artery-Internal Carotid Artery-Middle Cerebral Artery Anastomosis for Neurovascular Surgery.

To the best of our knowledge, this is the first reported cadaveric feasibility study of leader-follower type robotic-assisted middle cerebral artery (MCA)-radial artery-internal carotid artery anastomosis in the neurovascular surgery field using the da Vinci Xi system (da Vinci Surgical System; Intuitive Surgical, Inc.). Vascular suturing is a necessary skill in neurosurgery; however, the learning curve for deep and high-flow bypasses is severely low. Thus, robot-assisted surgery has been introduced. Here, we describe the surgical workflow adaptations of vascular anastomosis using the da Vinci system to assess the feasibility of robot-assisted anastomoses of the radial and middle cerebral arteries. Two fresh cadaver heads were studied using the da Vinci Xi Surgical System with 0° and 30° stereoscopic endoscopes to visualize the neuroanatomy. The da Vinci Xi Surgical System was used throughout the anastomosis of the MCA and intracarotid artery. The optic nerve, optic chiasm, carotid artery, and oculomotor nerve were visualized using standard microdissection techniques. The Sylvian fissure was exposed from the proximal Sylvian membrane to the distal MCA. Using black diamond microforceps and Potts scissors, suturing was achieved on the radial artery-middle cerebral artery using 8-0 Prolene and on the radial artery-internal carotid artery using 7-0 Prolene. A bypass of the MCA-radial artery-internal carotid artery can be achieved using the da Vinci Xi Surgical System in cadaver models. This system provides experts and less experienced neurosurgeons with stable bypass techniques for both superficial and deep-seated arteries. However, further studies are needed to evaluate the safety and benefits of the da Vinci Xi Surgical System for bypass procedures.

Initial Experience of Robot Assisted Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction Using the Hinotori Surgical Robot System.

This study aimed to investigate the perioperative outcomes of robot-assisted laparoscopic pyeloplasty (RLP) using the recently launched hinotori surgical robot system. This retrospective study compared the perioperative outcomes of 11 consecutive patients who underwent RLP with the hinotori surgical robot system from October 2022 to March 2024 (hinotori group) and 30 consecutive patients who underwent RLP with the da Vinci system from March 2019 to September 2022 (da Vinci group). The patient characteristics of the groups were similar. The median operative times in the hinotori and da Vinci groups were 236.0 and 231.5min, respectively (p=0.480). The success rates were 100.0% and 96.7%, respectively (p=1.000). Clavien-Dindo grade ≥3 complications occurred in one patient (9.1%) in the hinotori group and one patient (3.3%) in the da Vinci group (p=0.470). The perioperative outcomes in the hinotori group were not inferior to those in the da Vinci group.

Hybrid robotic systems

Standard laparoscopic instruments have limited dexterity because of their few degrees of freedom, making some surgical tasks extremely challenging. Robotic surgery was developed to overcome these issues, but the da Vinci system is associated with high costs. During recent years, many companies developed new robotic systems to improve dexterity and ergonomics with less impact on cost-effectiveness. This work describes the main commercially available modular robotic platforms, focusing on the technology, architecture and features, and advantages and disadvantages of each system. One of the main advantages of modular systems is the possibility of performing the whole procedure robotically or performing part of the procedure laparoscopically and part robotically as a hybrid approach. Next-generation robotic systems mainly include a modular design, open or semiopen consoles, smaller instruments, decreased cost, and augmented reality. To date, there are still few data in the literature comparing the systems, as many of them are awaiting regulatory approval. Thus, future studies are necessary to answer these questions. Many other robotic platforms are currently under development and will be available on the market, with a potential to alter surgical practice.

Robotic-assisted sacrocolpopexy with hinotori, a brand-new surgical robot system produced in Japan; report of initial clinical case series.

Robot-assisted sacrocolpopexy (RASC) is increasingly common due to the increased uptake of surgical robot systems. The aim of this retrospective study was to assess the perioperative outcomes of the first patient cohort to undergo RASC using a brand-new surgical robot system, the hinotori surgical system (robot-assisted sacrocolpopexy with hinotori surgical system [h-RASC]). This study also aimed to compare the outcomes of this group with those of the group of patients who had undergone RASC with the da Vinci surgical system (d-RASC). This study included 15 patients per group. Operative times, blood loss, complications, overactive bladder symptom score (OABSS; subjective measure), and urodynamic outcomes (objective measure) were compared between the groups. All cases were completed without serious problems during RASC procedure. Perioperative outcomes were similar between the groups except for longer operation time (min) (h-RASC 266 vs. d-RASC 229; p < .01) and console time (min) (178 vs. 159; p = .02) in the h-RASC group than in the d-RASC. De novo stress urinary incontinence (SUI) and pelvic organ prolapse (POP) recurrence were comparable. LUTS improved in the postoperative OABSS total score (preoperative 6 vs. postoperative 3; p < .01) in the h-RASC group. However, OABSS assessment (h-RASC -3 vs. d-RASC -4; p = .38) was similar between the two groups. Urodynamic studies showed similar outcomes in the median Qmax (maximum flow rate) values in both groups. This is the first report focusing on RASC using the hinotori surgical system. RASC using the hinotori surgical system could provide favorable perioperative outcomes as comparable with those of the existing da Vinci system.

Transoral Robotic Approach to Parapharyngeal Space Tumors: Changes in Paradigm of Surgery.

PPS space tumors are extremely rare, accounting for 0.5% of head and neck neoplasms. Trans-oral, Trans-cervical, Trans-parotid, Trans-cervical-trans-mandibular, and infratemporal are various surgical approaches that have been described for PPS tumors. Of late, with the advent of robotic surgery, Trans Oral Robotic Surgery (TORS) for PPS tumors is being increasingly advocated with promising results. To establish both efficacy and safety of Trans Oral Robotic Surgery, Five cases of pleomorphic adenoma of parapharyngeal space with sizes varying between 2.5 cm to 7.5 cm were evaluated and removed using Trans oral robotic approach using the Da Vinci system. Three were removed in toto and two in piecemeal fashion. There was capsule breach in 2 cases, no major complication was reported in any of the cases. Transoral Robotic Approach for PPS tumors can provide the much-required bridge between Transcervical and Trans mandibular Oral Approach. It provides a better direct approach. Carefully selected patients with well encapsulated tumors are more amenable to this approach.

Da Vinci vs. Hugo RAS for robot-assisted radical prostatectomy: a prospective comparative single-center study.

To evaluate Hugo RAS against the Da Vinci system for Robot-Assisted Radical Prostatectomy (RARP) in prostate cancer treatment. We compared outcomes of 150 patients with prostate cancer undergoing RARP with either Hugo or Da Vinci systems. Our analysis included operative, postoperative, pathological, and functional outcomes. Both groups had 75 patients. Baseline characteristics and tumor features were similar. Intraoperatively, Da Vinci had a shorter docking time (10.45 vs. 18.62min, p = 0.02), but total operative times were comparable (145.34 vs 138.95, p = 0.85). Hugo outperformed in neck dissection and lymphadenectomy times (22 vs 13.67min, p = 0.027 and 37.82 vs 45.77min, p = 0.025). Postoperative metrics like stay duration, catheter time, and complications showed no significant difference. Functional results, using IPSS and IIEF5, were similar between systems. Six Da Vinci patients (8%) and nine Hugo patients (12%) experienced social incontinence (p = 0.072). Pathological outcomes like T stage, Gleason Score, and nodes removed were alike. However, Hugo had more positive surgical margins (20% vs. 10.67%, p = 0.034). RARP outcomes using Hugo RAS were similar to the Da Vinci system in our study. More research and extended follow-up are required to ascertain long-term oncological and functional results.

Da Vinci and Hugo RAS Platforms for robot-assisted partial nephrectomy: a preliminary prospective comparative analysis of the outcomes.

Robot-assisted partial nephrectomy (RAPN) has emerged as the preferred approach for T1 renal-cell-carcinoma. As new robotic platforms like Hugo RAS emerge, we seek to understand their potential in achieving similar RAPN outcomes as the established Da Vinci system. A prospective single-center comparative study was conducted, and 50 patients selected for RAPN were enrolled (25 Da Vinci Xi; 25 Hugo RAS). The choice of robotic system was based solely on hospital logistics criteria. Surgeries were performed by expert surgeons. Demographic data, tumor characteristics, operative details and postoperative outcomes were collected. SPSS version 22.0 was used for statistical analyses. The average age of patients was 62.52±9.47 years, with no significant differences in median age, sex, and nephrometry scores between groups. Da Vinci group showed a significantly shorter docking time (12.56 vs. 20.08 min; P<0.01), while other intraoperative measures like console time and warm ischemia time were similar. The Hugo RAS group had a shorter renorraphy time (14.33 vs. 18.84 min; P=0.024). Postoperative outcomes and surgical margin positivity showed no significant differences. Each group had one patient (4%) who developed major surgical complications (Clavien IIIa). Trifecta rates were comparable between both groups (Da Vinci 88% vs. Hugo RAS 84%; P=0.93). Initial findings suggest similar perioperative outcomes for RAPN when using Hugo RAS compared to the Da Vinci system. Further research with long-term follow-up is necessary to evaluate oncological and functional outcomes.

Three-arm robotic cholecystectomy: a novel, cost-effective method of delivering and learning robotic surgery in upper GI surgery.

Cholecystectomy is one of the commonest performed surgeries worldwide. With the introduction of robotic surgery, the numbers of robot-assisted cholecystectomies has risen over the past decade. Despite the proven use of this procedure as a training operation for those surgeons adopting robotics, the consumable cost of routine robotic cholecystectomy can be difficult to justify in the absence of evidence favouring or disputing this approach.Here, we describe a novel method for performing a robot-assisted cholecystectomyusing a "three-arm" techniqueon the newer, 4th generation, da Vinci system. Whilst maintaining the ability to perform precision dissection, this method reduces the consumable cost by 46%. The initial series of 109 procedures proves this procedure to be safe, feasible, trainable and time efficient.

Robot-Assisted Radical Prostatectomy by the Hugo Robotic-Assisted Surgery (RAS) System and the da Vinci System: A Comparison between the Two Platforms.

In a previous study, we proved that an experienced urologist is more likely to adapt to the Hugo RAS system. Based on this, we further examine various parameters in this study. Parameters included in this study consisted of console time, functional outcomes, and oncological outcomes. A total of 60 patients who underwent robot-assisted radical prostatectomy (RARP) performed by a single surgeon using the da Vinci (DV) system (n = 30) or the Hugo RAS system (n = 30) between March 2023 and August 2023 were included in the analysis. The intraoperative operative time was categorized into vesicourethral anastomosis time and overall console time. Functional and oncological outcomes were documented at the 1st and 3rd postoperative months. Parametric and non-parametric methods were adopted after checking skewness and kurtosis, and an α value of 5% was used to determine the significance. The vesicourethral anastomosis time was significantly lengthened (Hedge's g: 0.87; 95% confidence interval (CI): 0.34-1.39; J factor = 0.987). However, the overall console time was not affected. The functional (postoperative 3rd month: p = 0.130) and oncological outcomes (postoperative 3rd month: p = 0.103) were not significantly different. We also found that the adverse effect on surgical specimens and positive surgical margins was not affected (p = 0.552). During the process of adaptation, although intricate motions (such as the vesicourethral anastomosis time) would be lengthened, the overall console time would not change remarkably. In this process, the functional and oncological outcomes would not be compromised. This encourages urologists to adopt the Hugo RAS system in RARP if they have previous experiences of using the DV system, since their trifecta advantage would not be compromised.

Robot-assisted surgery in urology

Background: In the field of urological surgery, robotic surgery continues to develop and increase. This paper is an overview of the present and future of robotic urological surgery.Current Concepts: Robot-assisted surgery has revolutionized minimally invasive surgery and advanced the technical limitations of laparoscopy. Urologists have always been eager to adopt new technological advances to benefit their patients, and they have also been pioneers in the field of robotic surgery.Discussion and Conclusion: Following the first approval by the Food and Drug Administration in 2000, the da Vinci System (Intuitive Surgical, USA) remained the leading robotic surgical system for over 20 years. In 2000, the first robot-assisted laparoscopic radical prostatectomy was performed in urology. Subsequently, applications of the da Vinci System in urology have grown exponentially, including the kidney, urinary bladder, and reconstructive and functional urological surgeries. To date, urology is driving robotic innovation. The first specialist-engineered system for single-site surgery, the da Vinci SP, was initially approved for use in urological surgery. Due to the advantages of robotic surgery, such as excellent visibility and operability, the demand for robotic surgery in the urology department is continuously increasing. Recently, in addition to the da Vinci System, other robot platforms are being developed and commercialized in many countries. In South Korea, robots such as Revo-I (Meere Company Inc., Korea) and Zamenix (Roen Surgical, Korea) are being released and commercialized. Urologists continue to lead the development of domestic robots and robotic surgery.

Minimally Invasive Mitral Valve Repair: From Total Endoscopic To Closed-Chest Robotic.

Minimally invasive cardiac surgery has evolved over the past few decades, thanks to advancements in technology and surgical techniques. These advancements have allowed surgeons to perform cardiac interventions through small incisions, reducing surgical trauma and improving patient outcomes1. However, despite these advancements, thoracoscopic mitral repair has not been widely adopted by the cardiac surgery community, possibly due to the lack of familiarity with video-assisted procedures1. Over the years, various minimally invasive mitral valve surgery (MIMVS) techniques have been developed to achieve comparable or better results while minimizing surgical trauma. These techniques have evolved from direct-vision procedures performed through a right thoracotomy with a rib retractor to video-directed approaches using long-shafted instruments1. Robotic surgery, introduced in the late 90s, has also played a significant role in mitral valve repair. The da Vinci system, the only robotic platform currently used for cardiac surgery, provides surgeons with enhanced dexterity and high-definition 3D visualization, allowing for precise and accurate procedure2, and is now the preferred approach for mitral repair in many programs3. The first mitral repair using the da Vinci system was performed in Europe by Carpentier and Mohr in 1998, followed by the first mitral replacement by Chitwood in the USA in 20002-4. The advantages of robotic technology allow surgeons to perform complex repair techniques such as papillary muscle repositioning and sliding leaflet plasty4. Studies have shown that robotic mitral surgery results in shorter ICU and hospital stays, better quality of life postoperatively, and improved cosmesis compared to conventional surgery5,6. In our experience, we have also observed significant benefits with robotic surgery, including reduced blood loss and the need for transfusions. This can be attributed to the closed-chest technique, which eliminates the need for a thoracotomy and rib retractor, reducing the risk of bleeding associated with these approaches7. In this article, we will compare the surgical steps of endoscopic and robotic mitral valve repair, providing detailed information on patient selection, operative techniques, and the requirements for building a successful program. By understanding the advantages and challenges of both approaches, surgeons can make informed decisions and provide the best possible care for their patients. Combined ablation and multivalvular procedures are mostly performed in few centers by minimally invasive techniques.

Initial experience with robotic technology for thoracic surgery using the da Vinci Xi system in Tibet, China.

Although the robotic surgical system has accumulated rich experience in the development of thoracic surgery, its application in Tibet area is relatively late. We report our experience concerning da Vinci Xi system in thoracic surgery and observe its practicability and surgical effect. We retrospectively analyzed 26 patients who underwent robotic thoracic surgery including: twelve lung resection, two esophagectomies, ten mediastinal surgeries and two rib mass resection. The data of patient characteristics, operative time, perioperative complications were collected. Of the 26 patients, 22 cases were completed with da Vinci system successfully, including 7 segmentectomies, 4 lobectomies, 1 subsegmentectomy, 2 esophagectomies, 10 mediastinal surgeries (6 thymic resections, 3 posterior mediastinal tumor resection, 1 mediastinal cyst resection) and 2 rib mass resection. In which, 3 cases of lung resection begun with robotic technique were converted to thoracoscopic surgery (due to calcification of hilar lymph node), 1 case of bilobectomy was converted to thoracotomy due to thoracic adhesion. All the operations went well and no patients need blood transfusion. All patients had satisfactory postoperative recovery. It is safe, reliable and effective to carry out robotic thoracic surgery on the plateau. On the premise of carefully and seriously discussing the indications of surgery, we should actively carry out the application of da Vinci robotic surgery system in Tibet Plateau.

ROBOTIC SURGERY – PAST, PRESENT AND FUTURE

In the quest for progress, humanity has always aimed for ‘faster, higher, stronger’. The modern surgical journey owes much to pioneers like William Halsted and Howard Kelly from Johns Hopkins University. Despite their invasive procedures, they saved countless lives. The next leap in surgery came thanks to German gynecologist Kurt Semm. In September 1980, he performed the first laparoscopic appendectomy. Initially viewed as a charlatan by his colleagues, Semm’s groundbreaking work revolutionized surgical techniques. In the third surgery revolution, a remarkable transformation occurred as minimally invasive endo- scopic procedures became commonplace. A significant breakthrough occurred in 1985 with the introduction of the PUMA 560, the first surgical robot used for brain biopsies. This marked a turning point in the history of surgery, opening up new possibilities and saving countless lives. Before this, surgical robots had been in development for about a decade, thanks to pioneering efforts by NASA and the United States Defense Research Advanced Project Agency (DARPA). These agencies recognized the need for remote-controlled surgery, especially for astronauts and wounded soldiers in combat zones. By the late 1990s, three distinct surgical systems emerged, combining laparoscopic technology with robotic assistance: da Vinci Surgical System, AESOM, and ZEUS Surgical System. The first-ever robotic surgery was a tubal reanastomosis procedure performed in 1996. These advancements marked a paradigm shift, allowing for greater precision, reduced tissue trauma, and improved patient outcomes. Between 2000 and 2003, the author of this presentation had hands-on experience with three different surgical robots. Among them, the da Vinci robot, developed by Intuitive Surgical, stood out. Initially designed for coronary artery bypass procedures, the da Vinci system faced technological challenges in synchronizing the beating heart with visual feedback and surgeon hand movements. However, it found an unexpected niche: prostatectomies. Early Intuitive executives humorously quipped,“We aimed for the heart, but we hit the prostate.”Robotic surgeries are most common in gynecology, where they enhance comfort during longer and more complex procedures. Interestingly, despite its cardiac origins, the da Vinci robot now performs approximately 75% of all prostatectomies worldwide. The global market for surgical robots grew from $800 million in 2015 to a staggering $3.5 billion a decade later. In the United States, a remarkable 78% of surgeons across various specialties express interest in using robotic assistance. Robotic surgery provides several advantages over straight-stick laparoscopy. Surgeons benefit from 7 degrees of freedom and 520° of rotation, along with three-dimensional vision through a high-definition camera. While theoretical improvements in precision exist, studies have not yet fully demonstrated this. Additionally, robotic surgery enables less experienced laparoscopic surgeons to perform complex procedures due to enhanced range of motion and three-dimensional vision. Tremor reduction further allows for precise dissection and suturing. Undoubtedly, the robotic platform significantly enhances surgeon comfort, especially during lengthy and intricate procedures. As artificial intelligence rapidly evolves, so does robotic surgery. While fully autonomous surgery remains a distant goal, certain advancements are imminent. For instance, augmented reality systems – already in use on some platforms – overlay patient images with radiological scans, enhancing safety and precision. Additionally, these systems can be combined with fluorescent imaging. By injecting dyes into the patient, surgeons gain visualization of specific structures such as vessels, ureters, malignant lesions, and sometimes endometriosis. The development of flexible, snake-like robotic arms surpasses the capabilities of current 7-degree-of-freedom instruments. These arms provide enhanced dexterity, allowing precise maneuvers during surgery. The next frontier involves robots performing semi-automated tasks like coagulation or suturing. These capabilities enhance surgical precision and reduce human error. A significant advancement we eagerly anticipate is miniaturization and micro-robotics. Ideally, surgical robots could operate from within the abdominal cavity, eliminating the need for external devices. However, challenges related to signal latency persist. The initial goal of robotic surgery – to enable ground-based surgeons to operate remotely – may remain limited by the time it takes for signals to travel between the surgeon and the robot. Despite the remarkable technological advancements in robotic surgery, the surgeon remains at the helm, overseeing the entire procedure. Surgical robots serve as valuable tools, enhancing precision and capabilities, but the human touch and expertise remain irreplaceable.

Tasks of an Operating Nurse in Patient Care during Robotic Procedures

Operating nursing is a unique field because it requires specific physical and mental characteristics from nursing staff. The specificity and difference of work between operational nursing staff and nursing staff employed in hospital wards differs significantly. Care for the operated on involved performing standard procedures but also providing individual care for the patient’s needs before and after surgery. The range of requirements is also expanded to include assisting and providing professional care for a patient operated on with the assistance of the da Vinci surgical robot. The aim of the study is to present the specifics of the work of an operating nurse during operations performed using surgical robots. To fully use robotic techniques, full cooperation between the operator and the instrumental team is necessary. The tasks are divided into preoperative, intraoperative and postoperative. Indication of the advantages of the modern da Vinci system and presentation of the operating theatre with modern organizational and epidemiological infrastructure were discussed on the example of robotic surgeries performed on patients with bladder cancer. (JNNN 2023;12(4):183–187)

Advancements in Minimally Invasive Urological Surgery: The Da Vinci Robotic System's Impact on Surgical Precision and Patient Outcomes in Mexico

In recent years, the field of urological surgery has witnessed a transformative paradigm shift with the integration of robotic-assisted technology, particularly the Da Vinci Surgical System, into its clinical armamentarium. This article explores the profound impact of the Da Vinci robot on urological surgical procedures conducted in the Mexican healthcare landscape. The utilization of robotic platforms in urology has enabled surgeons to achieve unparalleled precision, dexterity, and visualization, thereby revolutionizing the management of complex urological conditions. Through meticulous examination of both historical and contemporary data, this study sheds light on the remarkable evolution of urological surgery in Mexico. Key areas of focus include the burgeoning adoption of robotic techniques for prostatectomy, nephrectomy, cystectomy, and other intricate urological interventions. The incorporation of robotic assistance has translated into reduced operative times, decreased blood loss, shorter hospital stays, and improved postoperative patient outcomes, a fact underscored through comprehensive statistical analysis. Moreover, this article underscores the critical role played by Mexican medical institutions in embracing this cutting-edge technology. It discusses the challenges and opportunities associated with training, credentialing, and establishing best practices to ensure the safe and effective implementation of the Da Vinci system. In conclusion, the article underscores the Da Vinci robot's pivotal role in enhancing urological surgery across Mexico. Its growing significance in improving surgical precision and patient well-being cements its status as a groundbreaking tool for the modern urologist. As robotic technology continues to evolve and adapt, urological surgery in Mexico stands on the precipice of further innovation, ultimately leading to improved healthcare outcomes for patients suffering from urological disorders.

Application of tactile sensing in human-computer interaction in robot-assisted surgery and medical fields

Robot-assisted Minimally Invasive Surgery (RMIS) is a revolutionary breakthrough in the field of surgery in 21st-century clinical medicine, and in recent years it has become the standard of care in Western medicine. It makes highly accurate medical operations possible based on the advantages of traditional minimally invasive surgery, such as reducing patient trauma and accelerating post-operative healing. However, the most advanced robotic-assisted surgical systems available on the market, as exemplified by the da Vinci system, are still not equipped with tactile receptors. In recent years, scientists and engineers have come up with different techniques and ideas, including various forms of tactile sensors, to improve the quality of the process. In this paper, the sensor devices that can be used for RMIS are classified into six different types based on their structural characteristics, and typical examples of them are listed. For some of the sensing structures that are only in the theoretical stage, inferences and explanations are given based on references. And the application directions are summarized as tactile diagnosis and operator sensing. Research in the last decade in both areas of sensing technology is summarized and outlined respectively.

Robot-assisted radical prostatectomy using hugo RAS system: The pioneer experience in Taiwan and Northeast Asia.

Among the novel robotic platforms, the Hugo RAS system is the second most studied platform, next to the da Vinci system, and we aim to address our experiences in radical prostatectomy (RP) with the Hugo RAS system. We recorded our first 12 cases of prostate cancer undergoing RP with the Hugo RAS system. The median console time was 145min and median hospital stay was 7days. Hedge' g was applied to search for the cut-off case in four parameters in surgeries. Pre-console preparation was significantly improved after the first seven cases, and the console time was remarkably shortened after the first two cases. The intraoperative pause for trouble shooting was remarkably shortened after the first three cases. We found that RP with the Hugo RAS system was feasible, and the learning curve was short as surgeons may benefit from the previous experience with the da Vinci system.