2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Ta15,Robot-assisted minimally invasive oesophagectomy is used increasingly worldwide. However, no large-scale, multicentre, randomised controlled trial has compared long-term survival as the primary endpoint between robot-assisted oesophagectomy and conventional thoracoscopic oesophagectomy. We aimed to confirm the non-inferiority in overall survival of robot-assisted oesophagectomy over thoracoscopic oesophagectomy in patients with resectable oesophageal squamous cell carcinoma. This multicentre, open-label, randomised, controlled, phase 3, non-inferiority trial (RAMIE) was conducted at six hospitals in China. Patients aged 18-75 years, with biopsy-proven squamous cell carcinoma, Eastern Cooperative Oncology Group scores of 0-2, and with tumour and nodal classifications of cT1-4a, N0-2, M0, or M1 (supraclavicular lymph nodes metastasis) were eligible. Patients were randomly assigned (1:1) using a computer-generated randomisation list and stratified by neoadjuvant therapy to robot-assisted oesophagectomy or thoracoscopic oesophagectomy, both with at least two-field lymphadenectomy. The primary endpoint was overall survival, analysed in the intention-to-treat population. The non-inferiority margin was 9% for 5-year overall survival (the upper limit of 95% CI of the hazard ratio [HR] was 1·33). Harms were assessed in the per-protocol population, defined as all eligible participants undergoing resection. This trial was registered with ClinicalTrials.gov, number NCT03094351 and is completed. Between Aug 2, 2017, and Dec 23, 2019, 362 patients were randomly assigned (183 to robot-assisted oesophagectomy and 179 to thoracoscopic oesophagectomy. 309 (85%) of 362 patients were men and 53 (15%) were women. Two patients in each group did not undergo resection and were excluded from the per-protocol population. Median follow-up of the planned final analysis was 71·5 months (IQR 63·9-81·8). At 5 years, overall survival was 69·4% (95% CI 62·1-75·6) with robot-assisted oesophagectomy versus 56·2% (48·5-63·2) with thoracoscopic oesophagectomy (HR 0·71, 95% CI 0·51-0·97), confirming non-inferiority (one-sided p In patients with resectable oesophageal squamous cell carcinoma, robot-assisted oesophagectomy was non-inferior, and seemed superior, to thoracoscopic oesophagectomy in terms of 5-year overall survival. National Clinical Key Specialty Construction Project, Shanghai Hospital Development Center, and the Program of Shanghai Academic/Technology Research Leader. For the Chinese translation of the abstract see Supplementary Materials section.31:T6a4,The femoral pin tracker in robotic-assisted total knee arthroplasty (TKA) can be placed intraincisionally or extraincisionally. The purpose of our study was to determine the impact of these placement methods on soft-tissue tension in the knee joint. A total of 132 patients undergoing robotic-assisted TKA were prospectively enrolled; of those, 80 were randomized to receive an intraincisional or extraincisional femoral pin tracker during surgery. Soft-tissue tension in the medial and lateral compartments of the knee joint was measured using a sensor before and after the removal of the pin tracker. Measurements were performed at 10°, 45°, 90°, and 120° of knee flexion. Changes in knee joint soft-tissue tension from before to after the removal of the pin tracker were compared between the 2 groups. Our trial included 80 patients (mean age, 66.98 ± 38.48 years; 24% male; 100% Han Chinese). The intraincisional group demonstrated significantly greater changes in soft-tissue tension in the medial compartment of the knee at 10° (p < 0.001), 45° (p = 0.028), and 90° (p = 0.046) of knee flexion compared with the extraincisional group. No significant between-group differences were found in the changes in tension in the medial compartment at 120° of knee flexion (p > 0.05) or in the lateral compartment at any angle (p > 0.05). Intraincisional placement of the femoral pin tracker may influence soft-tissue tension in the medial compartment of the knee. Surgeons should be aware of these differences when performing soft-tissue balancing before the removal of the femoral pin tracker. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.32:Ta14, Background: The femoral pin tracker in robotic-assisted total knee arthroplasty (TKA) can be placed intraincisionally or extraincisionally. The purpose of our study was to determine the impact of these placement methods on soft-tissue tension in the knee joint. Methods: A total of 132 patients undergoing robotic-assisted TKA were prospectively enrolled; of those, 80 were randomized to receive an intraincisional or extraincisional femoral pin tracker during surgery. Soft-tissue tension in the medial and lateral compartments of the knee joint was measured using a sensor before and after the removal of the pin tracker. Measurements were performed at 10°, 45°, 90°, and 120° of knee flexion. Changes in knee joint soft-tissue tension from before to after the removal of the pin tracker were compared between the 2 groups. Results: Our trial included 80 patients (mean age, 66.98 ± 38.48 years; 24% male; 100% Han Chinese). The intraincisional group demonstrated significantly greater changes in soft-tissue tension in the medial compartment of the knee at 10° (p < 0.001), 45° (p = 0.028), and 90° (p = 0.046) of knee flexion compared with the extraincisional group. No significant between-group differences were found in the changes in tension in the medial compartment at 120° of knee flexion (p > 0.05) or in the lateral compartment at any angle (p > 0.05). Conclusions: Intraincisional placement of the femoral pin tracker may influence soft-tissue tension in the medial compartment of the knee. Surgeons should be aware of these differences when performing soft-tissue balancing before the removal of the femoral pin tracker. Level of Evidence: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Robotic Surgery: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Robotic Surgery (modality). Clinician-written summaries and actionable practice insights. 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Larger, oncologically-powered RCTs are needed before adopting RS RARP as a standard oncological approach."}},{"doi":"10.1001/jamasurg.2026.3212","pmid":"42584916","title":"National Trends and Predictors of Waiting Times for Cancer Surgery in the US","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-08-12T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13470436/","source_score":151,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:05.962Z","updated_at":"2026-08-17T13:33:05.962Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"condition","value":"Colon Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"condition","value":"Esophageal Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"condition","value":"Gastric Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"condition","value":"Lung Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"condition","value":"Pancreatic Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"modality","value":"Neoadjuvant Therapy","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"modality","value":"Surgical Oncology","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"sample_size","value":"n=2731059","value_numeric":2731059},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"warning","value":"Full text is under PMC embargo until August 12, 2027; summary is based solely on the abstract and results section provided.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"warning","value":"The impact flag 'practice_changing' is applied cautiously — the findings are large-scale and policy-relevant, but causal claims are limited by the retrospective registry design.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3212","tag_type":"warning","value":"The study population is 85% female, heavily driven by breast cancer cases, which may disproportionately influence aggregate trend estimates.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used the National Cancer Database (2012–2023) to evaluate trends and predictors of waiting time from diagnosis to first-course therapy (up-front surgery or neoadjuvant therapy) in ~2.73 million patients with nonmetastatic stage I–III breast, colon, lung, pancreatic, gastric, or esophageal cancer who underwent definitive surgical resection.","key_result":"Median wait times increased significantly across all six cancer types from 2012–2015 to 2022–2023 (e.g., breast: 34→45 days; colon: 20→31 days; lung: 41→53 days; pancreas: 23→32 days; gastric: 35→49 days; esophageal: 38→48 days; all P<.001). Key predictors of longer delays included Medicaid insurance (5/6 cancers), lowest-quartile income (6/6), Black race (5/6), greater travel distance (4/6), care in the West (6/6), treatment at academic institutions (6/6), and use of robotic surgery (5/5 nonbreast cancers).","limitations":"- Retrospective design using administrative/registry data (National Cancer Database) limits causal inference and may not capture unmeasured confounders.\n- Full text is under embargo; detailed methodology and multivariable model specifications could not be reviewed.\n- The 85% female composition reflects heavy representation of breast cancer patients, which may skew overall pooled estimates.","practice_takeaway":"Surgical wait times for major cancers have risen steadily over a decade and are longest at academic centers and for referred, lower-income, or Black patients — clinicians and health systems should proactively track and address these gaps. Robotic surgery adoption is also independently linked to longer delays and warrants operational scrutiny."}},{"doi":"10.1016/j.amjsurg.2026.117173","pmid":"42574772","title":"Robot-assisted right adrenalectomy (with video)","journal_title":"The American Journal of Surgery","journal_issn":"0002-9610","published_at":"2026-08-06T00:00:00.000Z","url":"https://doi.org/10.1016/j.amjsurg.2026.117173","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:19.119Z","updated_at":"2026-08-12T13:26:19.119Z","tags":[{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"condition","value":"Adrenal Gland Neoplasm","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"study_design","value":"Surgical Technique Description","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"warning","value":"No sample size, patient demographics, or quantitative results could be extracted from the available information.","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117173","tag_type":"warning","value":"The paper contains very limited extractable data — it is a technique/video article with no patient cohort, outcomes, or comparative data reported in the provided metadata. Summary fields reflect this significant limitation.","value_numeric":null}],"summaries":{"what_studied":"This paper describes the technique for robot-assisted right adrenalectomy, accompanied by a video demonstration of the surgical procedure.","limitations":"The paper appears to be a surgical technique description/video article rather than a comparative or outcomes study, limiting the ability to draw conclusions about efficacy or safety relative to other approaches.","practice_takeaway":"Robot-assisted right adrenalectomy is presented as a defined surgical technique; surgeons seeking a step-by-step procedural reference may find the accompanying video a useful educational resource."}},{"doi":"10.1016/j.ajog.2026.07.035","pmid":"42551580","title":"Ultrasound-guided robotic myomectomy using a drop-in probe","journal_title":"American Journal of Obstetrics and Gynecology","journal_issn":"0002-9378","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajog.2026.07.035","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:18.079Z","updated_at":"2026-08-12T13:26:18.079Z","tags":[{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"condition","value":"Uterine Fibroids","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"condition","value":"Uterine Leiomyoma","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"modality","value":"Intraoperative Ultrasound","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"study_design","value":"Surgical Technique Description","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"warning","value":"No brand name for the specific drop-in ultrasound probe is mentioned in the abstract; modality tags reflect the device class only.","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"warning","value":"No patient data, sample size, or comparative outcomes are reported — this is a pure technique description/video article. Level of evidence is assigned as 7 (expert opinion/technique report).","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.07.035","tag_type":"warning","value":"Study design label 'Surgical Technique Description' is non-standard; closest canonical label applied.","value_numeric":null}],"summaries":{"what_studied":"A technique for ultrasound-guided robot-assisted myomectomy using a robotic drop-in intraoperative ultrasound probe, applied directly to the uterine surface after visual fibroid enucleation to detect occult intramural fibroids in real time.","key_result":"The technique enabled real-time correlation of ultrasound imaging with surgical anatomy on the robotic console, facilitating identification and enucleation of occult intramural fibroids not detectable by visual assessment alone; no quantitative outcomes were reported.","limitations":"This is a technique description with no comparative data, sample size, or outcomes reported. Generalizability and clinical benefit over standard robot-assisted myomectomy are unestablished.","practice_takeaway":"Consider adding a drop-in ultrasound probe to robot-assisted myomectomy when completeness of fibroid removal is critical, especially in fertility-preserving cases or patients with multiple myomas. This technique may reduce the risk of missing occult intramural fibroids without requiring open surgery."}},{"doi":"10.1016/j.amjsurg.2026.117160","pmid":"42541836","title":"Robotic appendicectomy: Sufficient evidence to serve as the standard of care?","journal_title":"The American Journal of Surgery","journal_issn":"0002-9610","published_at":"2026-07-29T00:00:00.000Z","url":"https://doi.org/10.1016/j.amjsurg.2026.117160","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:17:47.778Z","updated_at":"2026-08-04T18:17:47.778Z","tags":[{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"condition","value":"Appendicitis","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"study_design","value":"Review","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"warning","value":"Only the paper title, DOI, journal, and publication date were provided — no abstract, methods, results, or conclusions were available. All structured fields reflect what can be reasonably inferred from the title alone. Key result, limitations, and practice takeaway cannot be populated without access to the full text.","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"warning","value":"Sample size is unknown and has been omitted.","value_numeric":null},{"paper_doi":"10.1016/j.amjsurg.2026.117160","tag_type":"warning","value":"Study design is uncertain; 'Review' is inferred from the title's framing ('Sufficient evidence to serve as...') but could be an editorial, systematic review, or meta-analysis.","value_numeric":null}],"summaries":{"what_studied":"This paper evaluates whether the current evidence is sufficient to establish robotic appendicectomy as the standard of care, likely comparing robotic versus laparoscopic or open approaches for appendicitis."}},{"doi":"10.1001/jamasurg.2026.3048","pmid":"42525398","title":"Laparoscopic Deskilling—The Hidden Risk of Robotic Dominance","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-07-29T00:00:00.000Z","url":"https://doi.org/10.1001/jamasurg.2026.3048","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:17:41.532Z","updated_at":"2026-08-04T18:17:41.532Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"condition","value":"Surgical Skill Decay","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"study_design","value":"Viewpoint / Opinion","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"warning","value":"Level of evidence set to 7 (expert opinion) given the Viewpoint format.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"warning","value":"The specific 'strategies to preserve laparoscopic proficiency' mentioned in the abstract are not detailed in the provided text; summary reflects only what is stated in the abstract.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.3048","tag_type":"warning","value":"This is an expert Viewpoint with no primary data or patient outcomes — conclusions are opinion-based and cannot be quantitatively evaluated.","value_numeric":null}],"summaries":{"what_studied":"This Viewpoint examines the risk of laparoscopic skill decay ('deskilling') among surgeons as robotic surgery platforms are rapidly adopted, reducing laparoscopic case volumes.","key_result":"The authors argue that falling laparoscopic case volumes driven by robotic dominance pose a hidden but material risk to surgical proficiency, and propose strategies to preserve laparoscopic skills.","limitations":"As a Viewpoint, this piece offers expert opinion without primary data, quantitative outcomes, or a systematic review of evidence on deskilling rates.","practice_takeaway":"Surgical programs and training directors should actively monitor laparoscopic case volumes and implement deliberate practice strategies to prevent skill decay as robotic platforms expand. Maintaining laparoscopic proficiency is critical for situations where robotic systems are unavailable or must be abandoned mid-procedure."}},{"doi":"10.1016/j.ajt.2026.07.022","pmid":"42476316","title":"Fully Robotic Dual-Graft Living Donor Liver Transplantation: A Case Report","journal_title":"American Journal of Transplantation","journal_issn":"1600-6135","published_at":"2026-07-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajt.2026.07.022","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-23T13:33:18.124Z","updated_at":"2026-07-23T13:33:18.124Z","tags":[{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"condition","value":"End-Stage Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"condition","value":"Hepatic Schistosomiasis","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"modality","value":"Liver Transplantation","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"warning","value":"GRWR of 0.74% is at the lower threshold for adequacy; applicability to other patients depends heavily on recipient body habitus and portal flow dynamics.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"warning","value":"Single case report — no control group, no follow-up duration specified beyond hospital discharge; long-term graft and patient survival are unknown.","value_numeric":null},{"paper_doi":"10.1016/j.ajt.2026.07.022","tag_type":"warning","value":"Today's date is July 23, 2026, and this paper was published July 20, 2026 — this is a very recent publication with no external replication or peer commentary yet available.","value_numeric":null}],"summaries":{"practice_takeaway":"Fully robotic dual-graft LDLT appears feasible in carefully selected patients when no single donor graft provides adequate volume, but this remains a highly complex procedure limited to expert robotic transplant centers.","what_studied":"Feasibility of fully robotic dual-graft living donor liver transplantation (LDLT) in a 62-year-old woman with end-stage liver disease (MELD 23) due to hepatic schistosomiasis, using two robotic left-lobe donor hepatectomies when a single graft was insufficient.","key_result":"The recipient underwent successful fully robotic dual-graft LDLT (12-hour operation; warm ischemia times of 46 and 36 minutes; combined graft weight 524 g; GRWR 0.74%) with no early allograft dysfunction or surgical complications and was discharged with excellent graft function.","limitations":"Single case report with no comparator group; findings may not generalize beyond highly specialized centers; long-term outcomes not reported."}},{"doi":"10.1001/jamasurg.2026.2650","pmid":"42455567","title":"Outcomes and Costs After Robotic vs Laparoscopic Complex Elective Cholecystectomy","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-07-15T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13373735/","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:35:45.894Z","updated_at":"2026-07-20T13:35:45.894Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"condition","value":"Cholelithiasis","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"condition","value":"Complex Gallbladder Disease","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"sample_size","value":"n=863","value_numeric":863},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"warning","value":"DOI and publication date (2026-07-15) are ahead of today's widely indexed literature; article availability and peer-review status could not be independently verified from the provided text.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"warning","value":"The full text was not accessible; summary is based solely on the abstract and results excerpt. Some subgroup sample sizes (e.g., CEC vs non-CEC breakdown) are not reported, limiting appraisal of statistical power.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2650","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously — this is a single-center retrospective study, and findings should ideally be confirmed in a prospective or multi-center design before broad adoption.","value_numeric":null}],"summaries":{"what_studied":"This cohort study compared robotic-assisted vs laparoscopic cholecystectomy in 863 patients at an academic hepatobiliary referral center (August 2018–August 2024), focusing on complex elective cholecystectomy (CEC) defined by prior aborted/partial cholecystectomy, cholecystostomy tube, or history of gallbladder perforation/fistula.","key_result":"In CEC patients, laparoscopic approach was independently associated with 4× higher odds of unplanned endoscopic or percutaneous intervention vs robotic (OR 4.24; 95% CI 1.24–14.52; P=.02). Despite higher OR costs for robotic surgery, total cost of care was equivalent for CEC ($14,309 laparoscopic vs $14,476 robotic), but robotic non-CEC carried significantly higher total costs ($11,416 vs $9,925 laparoscopic).","limitations":"Single academic hepatobiliary referral center limits generalizability. Retrospective cohort design carries inherent selection bias—robotic cases may have been selectively assigned to more experienced surgeons. The absolute number of CEC cases is not broken out, limiting power assessment.","practice_takeaway":"For complex gallbladder disease (prior failed cholecystectomy, cholecystostomy tube, or fistula), consider robotic cholecystectomy to reduce downstream interventions without increasing total cost. Reserve robotic approach for high-complexity cases; in routine (non-CEC) cholecystectomy, laparoscopic surgery remains more cost-effective overall."}},{"doi":"10.1001/jamasurg.2026.2645","pmid":"42455564","title":"Chasing Value in an Evolving Era of Robotic Cholecystectomy","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-07-15T00:00:00.000Z","url":"https://doi.org/10.1001/jamasurg.2026.2645","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-20T13:35:45.641Z","updated_at":"2026-07-20T13:35:45.641Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"condition","value":"Cholelithiasis","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"study_design","value":"Invited Commentary","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"warning","value":"No sample size, sex, or specific outcomes data are present in the available text.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"warning","value":"Study design tagged as 'Invited Commentary'; level of evidence set to 7 (expert opinion) accordingly.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2645","tag_type":"warning","value":"This is a publisher landing/preview page only — full text was not accessible. Summary is based solely on the abstract-level content and commentary excerpt provided. No original data, patient population, outcomes, or statistics are reported in the available text.","value_numeric":null}],"summaries":{"what_studied":"An invited commentary examining the ongoing debate around the clinical value of robotic platforms for cholecystectomy, weighing arguments from skeptics (cost, learning curve, bile duct injury risk, lack of evidence for fewer open conversions) against proponents (precision, complex case capability, ergonomics, lower conversion rates).","limitations":"This is an invited commentary with no original data, patient cohort, or quantitative analysis — conclusions are opinion-based and not drawn from a primary study.","practice_takeaway":"The value of robotic cholecystectomy remains unresolved; clinicians should critically weigh institutional, ergonomic, and patient-centered factors rather than adopt the platform based on marketing or branding alone."}},{"doi":"10.1001/jamasurg.2026.2248","pmid":"42340709","title":"Inferior Mesenteric Artery Ligation Level and Anastomotic Leakage in Low Anterior Resection","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.1001/jamasurg.2026.2248","source_score":16,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:32.719Z","updated_at":"2026-06-27T13:27:32.719Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"condition","value":"Anastomotic Leakage","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"condition","value":"Rectal Cancer","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"modality","value":"Minimally Invasive Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"sample_size","value":"n=293","value_numeric":293},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"warning","value":"21 patients were excluded post-randomization (314 randomized, 293 analyzed); reasons for exclusion are not detailed in the abstract, which introduces potential bias.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"warning","value":"The study was powered primarily around anastomotic leakage rates; the observed event rates (~5–6%) are low, raising the possibility of insufficient power to detect a clinically meaningful difference.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.2248","tag_type":"warning","value":"The trial was registered with a South Korean registry (KCT0003523), suggesting a single-country origin that may limit generalizability.","value_numeric":null}],"summaries":{"what_studied":"This multicenter RCT compared high IMA ligation (at the root) vs low IMA ligation (distal to the left colic artery origin) in 293 patients with clinical stage I–III rectal cancer undergoing minimally invasive (laparoscopic or robotic) anterior resection, enrolled July 2019–August 2024, with functional outcomes assessed at 12 months.","key_result":"Symptomatic anastomotic leakage was 4.9% (7/143) with low ligation vs 6.0% (9/150) with high ligation — not significantly different (RR 0.82; 95% CI 0.31–2.13; P = .68). 30-day morbidity (14.0% vs 22.0%; P = .08) and 12-month LARS scores (15.8 vs 17.3; P = .32) were also similar.","limitations":"- Trial may have been underpowered to detect a small but clinically meaningful difference in anastomotic leakage rates.\n- 21 of 314 randomized patients were excluded from the modified ITT analysis, risking selection bias.\n- Single-country trial (South Korea registry) limits generalizability to other practice settings.","practice_takeaway":"Surgeons can choose either high or low IMA ligation in minimally invasive rectal cancer resection without meaningfully changing anastomotic leak risk or long-term bowel function. Low ligation does not need to be routinely favored over high ligation on the basis of leak prevention alone."}},{"doi":"10.1093/bjs/znag054","pmid":"42317016","title":"Development of a robotic training curriculum for visceral and gastrointestinal surgical trainees: an international Delphi study","journal_title":"British Journal of Surgery","journal_issn":"0007-1323","published_at":"2026-06-19T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13280418/","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-25T13:25:24.878Z","updated_at":"2026-06-25T13:25:24.878Z","tags":[{"paper_doi":"10.1093/bjs/znag054","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"condition","value":"Gastrointestinal Surgery","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"condition","value":"Visceral Surgery","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"modality","value":"Surgical Education and Training","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"sample_size","value":"n=83","value_numeric":83},{"paper_doi":"10.1093/bjs/znag054","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"study_design","value":"Delphi Consensus Study","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"warning","value":"Consensus threshold was set at 70%, which is on the lower end; some items with borderline agreement may not reflect strong expert alignment.","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"warning","value":"The Delphi panel included industry representatives (5 companies), which may introduce commercial bias despite efforts to maintain a platform-agnostic approach.","value_numeric":null},{"paper_doi":"10.1093/bjs/znag054","tag_type":"warning","value":"The final 57-statement curriculum is described qualitatively; specific competency benchmarks and case-volume thresholds were not finalised in this publication and require future validation in real-world settings.","value_numeric":null}],"summaries":{"what_studied":"A two-round international Delphi study with 83 invited panelists (GI surgeons, trainees, theatre staff, human factors experts, and industry representatives from 15 countries) sought consensus on a platform-agnostic robotic surgery training curriculum for visceral and GI surgical trainees, covering knowledge requirements, training components, performance assessment, and certification.","key_result":"71 of 83 panelists (86%) completed round 1; 82 of 106 items (77%) reached consensus (≥70% agreement). 70 panelists (99%) completed round 2; 36 of 56 items (64%) reached consensus. A subsequent hybrid consensus meeting finalised 57 statements across four domains: knowledge requirements, training components, performance assessment, and certification/supervision.","limitations":"- Over half of panelists were from the UK (35%), Italy (23%), and Spain (11%), limiting generalisability to Eastern/Northern Europe and low- and middle-income countries.\n- Panel skewed toward early adopters with >50 independent robotic cases, potentially biasing toward intensive training requirements.\n- Broad GI scope without subspecialty stratification may obscure procedure-specific training needs.","practice_takeaway":"Programs training GI surgeons in robotic surgery should adopt a structured, phased curriculum covering e-learning, simulation (virtual, dry, and wet lab), bedside assisting, and supervised console operating—assessed with validated tools like GEARS and procedure-specific CATs before sign-off. Certification should be competency-based, led by a qualified proctor, tracking case numbers and clinical outcomes over time."}},{"doi":"10.1002/ueg2.70224","pmid":"42317030","title":"Development of a Robotic Training Curriculum for Visceral and Gastrointestinal Surgical Trainees: An International Delphi Study","journal_title":"United European Gastroenterology Journal","journal_issn":"2050-6406","published_at":"2026-06-19T00:00:00.000Z","url":"https://doi.org/10.1002/ueg2.70224","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-23T13:25:11.667Z","updated_at":"2026-06-23T13:25:11.667Z","tags":[{"paper_doi":"10.1002/ueg2.70224","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"condition","value":"Gastrointestinal Surgery","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"condition","value":"Visceral Surgery","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"sample_size","value":"n=83","value_numeric":83},{"paper_doi":"10.1002/ueg2.70224","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"study_design","value":"Delphi Consensus Study","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"warning","value":"'Platform-agnostic' framing was aspirational—some elements (e.g., dual-console training) remain platform-specific in practice.","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"warning","value":"Sample size of 83 reflects invitees; only 71 completed round 1 and 70 completed round 2, so effective voting N is smaller than headline figure.","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"warning","value":"The 70% consensus threshold is a common but arbitrary cutoff; no formal validity testing of the final curriculum against patient outcomes was performed.","value_numeric":null},{"paper_doi":"10.1002/ueg2.70224","tag_type":"warning","value":"The Delphi panel included robotic industry representatives (5 companies), which may introduce commercial bias despite mitigation efforts.","value_numeric":null}],"summaries":{"what_studied":"A two-round international Delphi process (n=83 invited, 71 completing round 1) plus a hybrid consensus meeting was used to build agreement on a platform-agnostic robotic surgery training curriculum for gastrointestinal (GI) and visceral surgical trainees, covering knowledge requirements, training components, performance assessment, and certification.","key_result":"Round 1: 82/106 items (77%) reached consensus (≥70% scoring 7–9); round 2: 36/56 items (64%) reached consensus. A final 57-statement curriculum was agreed upon across four domains: knowledge requirements for bedside assistant and console surgeon, training components (e-learning → simulation → bedside assisting → supervised console), performance assessment (case logs, GEARS, procedure-specific CATs, video assessment), and certification/supervision (proctor sign-off with stepwise progression in increasing case complexity).","limitations":"- Panel skewed toward UK (35%), Italy (23%), and Spain (11%), limiting generalisability to Eastern/Northern Europe and low- and middle-income countries.\n- Panel largely comprised early adopters with >50 independent robotic cases, risking bias toward resource-intensive training assumptions.\n- Consensus reflects primarily European context; wet-lab access, standardised assessment tools, and dedicated proctoring may not be universally available.","practice_takeaway":"GI surgery programs should structure robotic training as a stepwise progression—e-learning, simulation (virtual/dry/wet lab), bedside assisting, then supervised console time—with trainee sign-off based on objective tools (GEARS, CATs, video assessment) and clinical outcome data rather than case numbers or hours alone. Fellowship completion was considered desirable but not mandatory, given limited availability."}},{"doi":"10.1002/pros.70199","pmid":"42189967","title":"Outcome Differences Between Subgroups of Favorable Intermediate Risk Prostate Cancer After Radical Prostatectomy","journal_title":"The Prostate","journal_issn":"0270-4137","published_at":"2026-05-26T00:00:00.000Z","url":"https://doi.org/10.1002/pros.70199","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-05T13:26:33.829Z","updated_at":"2026-06-05T13:26:33.829Z","tags":[{"paper_doi":"10.1002/pros.70199","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"category","value":"Endocrinology & Metabolism","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"condition","value":"Favorable Intermediate Risk Prostate Cancer","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"sample_size","value":"n=553","value_numeric":553},{"paper_doi":"10.1002/pros.70199","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"warning","value":"GG1-FIR subgroup (n=103) is small, and some outcome comparisons (e.g., nodal positivity) may be underpowered.","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"warning","value":"Study is retrospective and single-institution; selection bias in who underwent RARP vs. other treatments cannot be excluded.","value_numeric":null},{"paper_doi":"10.1002/pros.70199","tag_type":"warning","value":"The total RARP cohort was 2703, but tagged sample size reflects only the 553 FIR patients who met study inclusion criteria; sensitivity analyses also included 1242 low-risk patients.","value_numeric":null}],"summaries":{"what_studied":"Retrospective analysis comparing oncologic outcomes after robot-assisted radical prostatectomy (RARP) between two favorable intermediate-risk (FIR) prostate cancer subgroups: GG1 with PSA 10–20 ng/mL (GG1-FIR, n=103) vs. GG2 as the only IR feature (GG2-FIR, n=450), over a 20-year period (2003–2023).","key_result":"No significant difference in long-term outcomes between FIR subgroups: 10-year OS was 80.9% vs. 81.5% (HR=0.8, p=0.63) and 10-year BCRFS was 87.5% vs. 89.8% (HR=0.7, p=0.54). However, GG1-FIR had significantly worse BCRFS than low-risk patients (HR=2.56, 95% CI 1.22–5.38), suggesting high PSA drives clinically meaningful risk even in GG1 disease.","limitations":"- Retrospective single-institution design limits generalizability.\n- GG1-FIR subgroup was small (n=103), reducing statistical power to detect differences.\n- No comparison to non-surgical management (e.g., active surveillance or radiation).","practice_takeaway":"GG1 prostate cancer with PSA 10–20 ng/mL should not be equated with low-risk disease—its biochemical recurrence outcomes after RARP are worse than true low-risk patients. Clinicians should weigh this carefully when counseling GG1-FIR patients about active surveillance vs. definitive treatment."}},{"doi":"10.1002/jhbp.70135","pmid":"42186132","title":"Expert Survey on Chyle Leakage After Pancreaticoduodenectomy: The Precision Anatomy for Minimally Invasive Hepato‐Biliary‐Pancreatic Surgery (\n PAM\n ‐\n HBP\n Surgery) Project 2024","journal_title":"Journal of Hepato-Biliary-Pancreatic Sciences","journal_issn":"1868-6974","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1002/jhbp.70135","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-31T13:35:31.239Z","updated_at":"2026-05-31T13:35:31.239Z","tags":[{"paper_doi":"10.1002/jhbp.70135","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"condition","value":"Chyle Leakage","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"condition","value":"Pancreaticoduodenectomy Complications","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Minimally Invasive Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"sample_size","value":"n=57","value_numeric":57},{"paper_doi":"10.1002/jhbp.70135","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"study_design","value":"Expert Survey","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"Study design is an expert survey, which may overrepresent high-volume centers and may not reflect typical practice.","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"The 'level of evidence' is assigned as 5 (expert opinion) given the survey-based methodology.","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"The sample of 57 surgeons represents expert opinion only; no patient outcomes or incidence rates are quantified, limiting clinical applicability.","value_numeric":null}],"summaries":{"what_studied":"A structured expert survey of 57 surgeons from 10 countries examined the incidence, anatomical pitfalls, and surgical techniques related to chyle leakage (CL) after pancreaticoduodenectomy (PD), comparing open, laparoscopic, and robotic approaches.","key_result":"Experts reported CL incidence as open ≥ laparoscopic, open > robotic, and laparoscopic = robotic. Three key anatomical risk zones were identified: (i) transverse mesocolon at the ventral SMA/SMV, (ii) meso-jejunum at the dorsal SMA/SMV, and (iii) fusion fascia of Treitz at the ventral IVC. No consensus was reached on the optimal dissection plane at Treitz fascia (21% pancreatic surface, 31% within fascia, 38% IVC-exposing).","limitations":"Survey-based design captures expert opinion rather than objective outcome data; no patient-level data or incidence rates reported; potential selection bias toward high-volume, experienced surgeons.","practice_takeaway":"Focus lymphatic control at three key anatomical zones during PD—transverse mesocolon, meso-jejunum, and Treitz fascia—using energy devices as the preferred modality across all surgical approaches. Robotic PD may carry a lower CL risk than open surgery per expert consensus, though prospective data are lacking."}},{"doi":"10.1093/bjs/znaf224","pmid":"42149732","title":"Surgical innovation and technology","journal_title":"British Journal of Surgery","journal_issn":"0007-1323","published_at":"2026-05-18T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13182719/","source_score":11,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:35:06.384Z","updated_at":"2026-05-26T13:35:06.384Z","tags":[{"paper_doi":"10.1093/bjs/znaf224","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"condition","value":"Malignant Surgical Disease","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"condition","value":"Surgical Disease","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"modality","value":"Artificial Intelligence","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"modality","value":"Genomic Profiling","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"modality","value":"Micro/Nanorobotics","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"modality","value":"Molecular Imaging","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"study_design","value":"Expert Commission / Narrative Review","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"warning","value":"No primary clinical data or patient outcomes are reported; findings are entirely expert opinion and narrative synthesis.","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"warning","value":"Sample size tag omitted as no study population was enrolled.","value_numeric":null},{"paper_doi":"10.1093/bjs/znaf224","tag_type":"warning","value":"Study design is an expert commission with undefined selection criteria for contributors — potential for selection and publication bias.","value_numeric":null}],"summaries":{"what_studied":"A broad expert commission reviewed current and future surgical innovations across multiple specialties, covering translational genomics (ctDNA), microbiomics, proteomics, micro/nanorobotics, AI, molecular image-guidance, and personalized surgical care pathways.","key_result":"The commission identified key emerging domains reshaping surgery: ctDNA-guided diagnosis and monitoring, micro/nanorobots for minimally invasive intervention, AI applications in training/simulation/robotics, and genomic profiling enabling bespoke treatment and surveillance pathways.","limitations":"No primary data or clinical outcomes are reported; all content is expert narrative and opinion. No systematic literature search methodology is described. Equity, cost, and environmental impact are acknowledged but not formally analyzed.","practice_takeaway":"Surgeons should actively engage with engineers, data scientists, and industry to shape how these technologies enter clinical practice. Clinicians should critically evaluate new tools for patient impact, not novelty alone."}},{"doi":"10.1186/s12894-026-02168-4","pmid":"42116100","title":"Risk factors for recurrence following robot-assisted laparoscopic partial nephrectomy (RAPN): a single-center retrospective study","journal_title":"BMC Urology","journal_issn":"1471-2490","published_at":"2026-05-11T00:00:00.000Z","url":"https://doi.org/10.1186/s12894-026-02168-4","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-22T13:22:28.691Z","updated_at":"2026-05-22T13:22:28.691Z","tags":[{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"condition","value":"Renal Cell Carcinoma","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"sample_size","value":"n=205","value_numeric":205},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"warning","value":"Fuhrman grading (used here) has largely been replaced by the WHO/ISUP grading system; comparability with contemporary series may be limited.","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"warning","value":"Only 11 recurrence events were observed, making hazard ratio estimates wide and potentially unstable — interpret confidence intervals with caution.","value_numeric":null},{"paper_doi":"10.1186/s12894-026-02168-4","tag_type":"warning","value":"The full text metadata indicates the document was authored in Japanese (Language=ja-JP), which may suggest an Asian patient population with specific demographic or pathologic characteristics not generalizable to all centers.","value_numeric":null}],"summaries":{"what_studied":"This single-center retrospective study examined recurrence rates and risk factors after robot-assisted laparoscopic partial nephrectomy (RAPN) in 205 patients with renal cell carcinoma (RCC) treated from 2016 to 2024, with a median follow-up of 63.5 months.","key_result":"Recurrence occurred in 11 of 205 patients (5.3%; 3 local, 8 non-local) at a median of 15 months. On Cox regression, pT stage ≥3a (HR 8.2, 95% CI 2.0–33.8) and Fuhrman grade ≥3 (HR 9.2, 95% CI 2.5–33.8) were independently associated with recurrence. A combined high-risk group (≥1 criterion; n=37, 18%) had markedly shorter recurrence-free survival vs. the low-risk group (HR 15.6, 95% CI 4.1–59.9). Positive surgical margins (n=7) were **not** significantly associated with recurrence.","limitations":"- Only 11 recurrence events limit the power of multivariate analysis and increase uncertainty around hazard ratio estimates.\n- Single-center, retrospective design with potential selection and ascertainment bias.\n- Fuhrman grading is an older classification system; WHO/ISUP grade was not reported.","practice_takeaway":"After RAPN for RCC, patients with pT stage ≥3a or Fuhrman grade ≥3 carry a markedly higher recurrence risk and warrant closer surveillance. A positive surgical margin alone should not automatically trigger escalation, but this finding needs confirmation in larger cohorts."}},{"doi":"10.1016/j.euo.2026.04.002","pmid":"42103552","title":"Single Port Robotic Radical Prostatectomy: A Propensity-matched Comparison of Transvesical Versus Extraperitoneal Approaches from the Single Port Advanced Research Consortium","journal_title":"European Urology Oncology","journal_issn":"2588-9311","published_at":"2026-05-08T00:00:00.000Z","url":"https://doi.org/10.1016/j.euo.2026.04.002","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-16T13:22:27.759Z","updated_at":"2026-05-16T13:22:27.759Z","tags":[{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"modality","value":"Radical Prostatectomy","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"sample_size","value":"n=2230","value_numeric":2230},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"study_design","value":"Propensity-Matched Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"warning","value":"No brand name for the robotic system (e.g., da Vinci SP) was explicitly stated in the abstract; brand/generic tags for the device were omitted.","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — while continence and recovery results favor TV, median follow-up is only 10 months, which is insufficient to draw firm oncological conclusions.","value_numeric":null},{"paper_doi":"10.1016/j.euo.2026.04.002","tag_type":"warning","value":"TV cohort had significantly more patients with prior abdominal surgery (49.5% vs 33%), which may have influenced surgical approach selection and recovery outcomes despite propensity matching.","value_numeric":null}],"summaries":{"what_studied":"This multi-institutional retrospective study compared Single Port (SP) robotic radical prostatectomy (RARP) via Transvesical (TV) versus Extraperitoneal (EP) approaches in 2,230 patients (2019–2025), using 1:1 propensity score matching (n=884) on age, prostate volume, PSA, and ISUP Grade Group.","key_result":"TV SP-RARP achieved higher same-day discharge rates (78.2% vs 60.6%, p<0.001), shorter Foley catheter duration (median 5 vs 7 days, p<0.001), and better early continence at 6 weeks (52.9% vs 44%), 3 months (79.1% vs 69.7%), and 6 months (87.2% vs 77.9%); positive surgical margin rates (pT2: 14.7% vs 13.3%) and biochemical recurrence at median 10 months (3.6% vs 3.1%) were similar between groups.","limitations":"- Retrospective design with inherent selection bias; TV approach patients had more prior abdominal surgery (49.5% vs 33%).\n- Median follow-up of only 10 months limits oncological conclusions.\n- Novel techniques with limited long-term functional and oncological outcome data.","practice_takeaway":"For men undergoing SP robotic prostatectomy, the transvesical approach offers faster recovery milestones—same-day discharge, shorter catheter use, and better early continence—without compromising safety or short-term cancer control. Surgeons proficient in SP robotics may consider TV as the preferred approach, especially in patients with prior abdominal surgery."}},{"doi":"10.1016/s2468-1253(25)00402-9","pmid":"41932350","title":"Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-04-04T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(25)00402-9","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1016/s2468-1253(25)00402-9","days":"7","issn":"2468-1253","rank":"10","field":"Clinical Medicine","score":"5","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1016/S2468-1253(25)00402-9","title":"Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial.","journal":"The lancet. 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Adults aged 18–75 years (cT1–4a, N0–2, M0 or M1 with supraclavicular nodes) were randomised 1:1, stratified by neoadjuvant therapy; the primary endpoint was 5-year overall survival with a median follow-up of 71.5 months.","key_result":"At 5 years, overall survival was 69.4% (95% CI 62.1–75.6) with robot-assisted versus 56.2% (48.5–63.2) with thoracoscopic oesophagectomy; HR 0.71 (95% CI 0.51–0.97), meeting non-inferiority.","limitations":"Open-label design; all centres were in China, limiting generalisability; findings apply to squamous histology only.","practice_takeaway":"For resectable oesophageal squamous cell carcinoma, robot-assisted oesophagectomy provides at least non-inferior 5-year survival versus thoracoscopic surgery and may be superior."}},{"doi":"10.1001/jamasurg.2025.6865","pmid":"41739485","title":"Contemporary Outcomes of Cholecystectomy","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-02-25T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12936969/","source_score":40,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:21.345Z","updated_at":"2026-05-07T22:49:21.345Z","tags":[{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"condition","value":"Biliary Disease","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"condition","value":"Cholelithiasis","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"sample_size","value":"n=516,372","value_numeric":516372},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"warning","value":"Conversion-to-open cases are not described; it is unclear whether converted cases were excluded or included in the minimally invasive cohort.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"warning","value":"Study population is exclusively Medicare fee-for-service beneficiaries (mean age ~75), so results may not apply to younger or non-Medicare patients undergoing cholecystectomy.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6865","tag_type":"warning","value":"The paper does not separately report outcomes for laparoscopic vs. robotic subgroups, so modality-specific trends cannot be inferred.","value_numeric":null}],"summaries":{"what_studied":"This cohort study examined trends in postoperative outcomes following inpatient minimally invasive (laparoscopic or robotic) cholecystectomy among 516,372 Medicare fee-for-service beneficiaries (mean age 74.8 years; 52.4% female) from 2011 to 2021, using risk-adjusted multivariable regression.","key_result":"Despite rising patient complexity and unplanned admissions (78.8% → 90.1%), risk-adjusted overall complications fell from 21.5% to 16.5% and serious complications from 12.3% to 7.0%; bile duct injury dropped from 0.19% to 0.12% and transfusion from 5.47% to 1.87% — but percutaneous drainage rates nearly doubled (1.32% → 2.91%), all P < .001.","limitations":"- Findings are limited to Medicare fee-for-service beneficiaries (older adults), limiting generalizability to younger or privately insured populations.\n- Claims-based data cannot capture surgeon-level factors, hospital volume, or granular clinical details that may explain outcome trends.\n- The rising use of percutaneous drainage is noted but its clinical drivers (evolving practice vs. complication patterns) remain unclear from claims alone.","practice_takeaway":"Surgeons can be reassured that minimally invasive cholecystectomy outcomes have meaningfully improved over the past decade, even as patients arrive sicker and more urgently. The rise in post-op percutaneous drainage warrants monitoring to determine whether it reflects a deliberate practice shift or an emerging quality signal."}},{"doi":"10.2106/jbjs.25.00705","pmid":"41490306","title":"Impact of the Femoral Pin Tracker on Soft-Tissue Tension in Robotic-Assisted Total Knee Arthroplasty","journal_title":"Journal of Bone and Joint Surgery","journal_issn":"0021-9355","published_at":"2026-01-06T00:00:00.000Z","url":"https://doi.org/10.2106/jbjs.25.00705","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-06","doi":"10.2106/jbjs.25.00705","days":"7","issn":"0021-9355","rank":"4","field":"Clinical Medicine","score":"7","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.2106/JBJS.25.00705","title":"Impact of the Femoral Pin Tracker on Soft-Tissue Tension in Robotic-Assisted Total Knee Arthroplasty: A Prospective Randomized Controlled Trial.","journal":"The Journal of bone and joint surgery. American volume","methods":"","results":"Our trial included 80 patients (mean age, 66.98 ± 38.48 years; 24% male; 100% Han Chinese). The intraincisional group demonstrated significantly greater changes in soft-tissue tension in the medial compartment of the knee at 10° (p < 0.001), 45° (p = 0.028), and 90° (p = 0.046) of knee flexion compared with the extraincisional group. No significant between-group differences were found in the changes in tension in the medial compartment at 120° of knee flexion (p > 0.05) or in the lateral compartment at any angle (p > 0.05).","abstract":"$31","keywords":[],"pubmed_id":"41490306","conclusions":"","publication_date":"2026-01-06T00:00:00"},"crossref":{"DOI":"10.2106/jbjs.25.00705","URL":"https://doi.org/10.2106/jbjs.25.00705","ISSN":["0021-9355","1535-1386"],"link":[{"URL":"https://journals.lww.com/10.2106/JBJS.25.00705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Impact of the Femoral Pin Tracker on Soft-Tissue Tension in Robotic-Assisted Total Knee Arthroplasty"],"author":[{"given":"Hao-Ming","family":"An","sequence":"first","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin, People’s Republic of China"},{"name":"Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, People’s Republic of China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, People’s Republic of China"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, People’s Republic of China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, People’s Republic of China"}]},{"given":"Wang","family":"Gu","sequence":"additional","affiliation":[{"name":"Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, People’s Republic of China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, People’s Republic of China"}]},{"given":"Shao-Kui","family":"Nan","sequence":"additional","affiliation":[{"name":"Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, People’s Republic of China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, People’s Republic of China"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, People’s Republic of China"},{"name":"National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, People’s Republic of China"}]},{"given":"Wei","family":"Chai","sequence":"additional","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin, People’s Republic of China"},{"name":"Senior Department of Orthopedics, Fourth Medical Center of PLA General Hospital, Beijing, People’s Republic of China"}]}],"issued":{"date-parts":[[2026,1,5]]},"member":"276","prefix":"10.2106","source":"Crossref","volume":null,"created":{"date-time":"2026-01-05T19:05:40Z","timestamp":1767639940000,"date-parts":[[2026,1,5]]},"indexed":{"date-time":"2026-01-05T21:13:46Z","timestamp":1767647626593,"date-parts":[[2026,1,5]]},"subject":[],"abstract":"$32","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.2106/JBJS.25.00705"}},"subtitle":["A Prospective Randomized Controlled Trial"],"deposited":{"date-time":"2026-01-05T19:05:42Z","timestamp":1767639942000,"date-parts":[[2026,1,5]]},"issn-type":[{"type":"print","value":"0021-9355"},{"type":"electronic","value":"1535-1386"}],"published":{"date-parts":[[2026,1,5]]},"publisher":"Ovid Technologies (Wolters Kluwer Health)","reference":[{"DOI":"10.1016/j.arth.2013.12.010","key":"bib1-20260105","year":"2014","issue":"12","author":"Liow","volume":"29","first-page":"2373","unstructured":null,"article-title":"Robot-assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study","journal-title":"J Arthroplasty.","doi-asserted-by":"crossref"},{"DOI":"10.1055/s-0038-1641729","key":"bib2-20260105","year":"2019","issue":"3","author":"Hampp","volume":"32","first-page":"239","unstructured":null,"article-title":"Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques","journal-title":"J Knee Surg.","doi-asserted-by":"crossref"},{"DOI":"10.1007/s11999-012-2407-3","key":"bib3-20260105","year":"2013","issue":"1","author":"Song","volume":"471","first-page":"118","unstructured":null,"article-title":"Robotic-assisted TKA reduces postoperative alignment outliers and improves gap balance compared to conventional TKA","journal-title":"Clin Orthop Relat Res.","doi-asserted-by":"crossref"},{"DOI":"10.1302/0301-620X.96B10.34068","key":"bib5-20260105","year":"2014","issue":"10","author":"Gustke","volume":"96-B","first-page":"1333","unstructured":null,"article-title":"Increased satisfaction after total knee replacement using sensor-guided technology","journal-title":"Bone Joint J.","doi-asserted-by":"crossref"},{"DOI":"10.3928/01477447-20170503-01","key":"bib6-20260105","year":"2017","issue":"4","author":"Chow","volume":"40","first-page":"e648","unstructured":null,"article-title":"The Use of Intraoperative Sensors Significantly Increases the Patient-Reported Rate of Improvement in Primary Total Knee Arthroplasty","journal-title":"Orthopedics.","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.arth.2016.03.046","key":"bib7-20260105","year":"2016","issue":"10","author":"Meneghini","volume":"31","first-page":"2181","unstructured":null,"article-title":"Can Intraoperative Sensors Determine the “Target” Ligament Balance? Early Outcomes in Total Knee Arthroplasty","journal-title":"J Arthroplasty.","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.arth.2016.12.019","key":"bib8-20260105","year":"2017","issue":"5","author":"Geller","volume":"32","first-page":"1502","unstructured":null,"article-title":"The Use of Electronic Sensor Device to Augment Ligament Balancing Leads to a Lower Rate of Arthrofibrosis After Total Knee Arthroplasty","journal-title":"J Arthroplasty.","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.arth.2013.10.020","key":"bib9-20260105","year":"2014","issue":"5","author":"Gustke","volume":"29","first-page":"955","unstructured":null,"article-title":"A new method for defining balance: promising short-term clinical outcomes of sensor-guided TKA","journal-title":"J Arthroplasty.","doi-asserted-by":"crossref"},{"DOI":"10.1007/s11999-008-0150-6","key":"bib10-20260105","year":"2008","issue":"6","author":"Bonutti","volume":"466","first-page":"1499","unstructured":null,"article-title":"Case report: femoral shaft fracture resulting from femoral tracker placement in navigated TKA","journal-title":"Clin Orthop Relat Res.","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.otsr.2009.12.005","key":"bib11-20260105","year":"2010","issue":"3","author":"Beldame","volume":"96","first-page":"249","unstructured":null,"article-title":"Pin track induced fractures around computer-assisted TKA","journal-title":"Orthop Traumatol Surg Res.","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.arth.2010.01.006","key":"bib12-20260105","year":"2011","issue":"3","author":"Jung","volume":"26","first-page":"505.e9","unstructured":null,"article-title":"Delayed femoral fracture through a tracker pin site after navigated total knee arthroplasty","journal-title":"J Arthroplasty.","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.arth.2017.01.045","key":"bib13-20260105","year":"2017","issue":"7","author":"Brown","volume":"32","first-page":"2120","unstructured":null,"article-title":"Low Incidence of Postoperative Complications With Navigated Total Knee Arthroplasty","journal-title":"J Arthroplasty.","doi-asserted-by":"crossref"},{"DOI":"10.2106/JBJS.21.01496","key":"bib14-20260105","year":"2022","issue":"19","author":"Sun","volume":"104","first-page":"1738","unstructured":null,"article-title":"Biomechanical and Finite-Element Analysis of Femoral Pin-Site Fractures Following Navigation-Assisted Total Knee Arthroplasty","journal-title":"J Bone Joint Surg Am.","doi-asserted-by":"crossref"}],"short-title":[],"update-policy":"https://doi.org/10.1097/lww.0000000000001000","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Journal of Bone and Joint Surgery"],"reference-count":13,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,1,5]]},"references-count":13,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.2106/jbjs.25.00705","is_oa":false,"title":"Impact of the Femoral Pin Tracker on Soft-Tissue Tension in Robotic-Assisted Total Knee Arthroplasty","updated":"2026-01-06T03:47:31+00:00","published_date":"2026-01-05","best_oa_location":null}},"created_at":"2026-01-11T11:19:33.869Z","updated_at":"2026-01-11T11:19:33.869Z","tags":[{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"condition","value":"Total Knee Arthroplasty","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"sample_size","value":"n=80","value_numeric":80},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"warning","value":"Abstract reports p-values only; absolute tension changes and effect sizes are not provided.","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"warning","value":"Only 80 of 132 enrolled were randomized; reasons for exclusion/attrition are not detailed in the abstract.","value_numeric":null},{"paper_doi":"10.2106/jbjs.25.00705","tag_type":"warning","value":"Population was 100% Han Chinese with 24% male, which may limit generalizability.","value_numeric":null}],"summaries":{"what_studied":"A randomized trial in 80 patients undergoing robotic-assisted total knee arthroplasty compared intraincisional versus extraincisional femoral pin tracker placement. Medial and lateral knee compartment soft-tissue tension was sensor-measured before and after tracker removal at 10°, 45°, 90°, and 120° of flexion.","key_result":"Intraincisional placement led to larger changes in medial compartment tension at 10° (p<0.001), 45° (p=0.028), and 90° (p=0.046) versus extraincisional, with no difference at 120° (p>0.05). No significant between-group differences were seen in lateral compartment tension at any angle (p>0.05).","practice_takeaway":"During robotic TKA, anticipate greater medial tension changes with intraincisional femoral pin trackers before removal and factor this into soft‑tissue balancing."}}],"initialOffset":22,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Robotic Surgery"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Robotic Surgery"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Robotic Surgery"}}}]]

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