Search Results (1,190)

Background/Objectives: Simulation has become an integral part of contemporary surgical training, allowing safe acquisition of technical skills with objective performance assessment. Microsurgery and robotic surgery share several technical features, including fine bimanual coordination, precise instrument control, and stereoscopic vision. This study aimed to evaluate whether a structured microsurgical course is associated with improved performance on a robotic surgical simulator and to explore its potential role within robotic training pathways. Methods: A prospective study was conducted between October 2022 and November 2025 at a single academic center, including 56 participants divided into three groups. Group A consisted of surgical residents attending a 3-day Basic Microsurgery Course; Group B included residents who did not undergo training during the same period; and Group C comprised experienced microsurgeons. Groups A and B performed two robotic simulation tasks at baseline (T0) and after three days (T1). Group C was assessed at T1 only as a reference benchmark. Performance was evaluated using simulator-derived metrics. Statistical analysis was performed using paired and unpaired t-tests. Results: Group A showed significant improvement across several performance parameters following training, whereas no comparable changes were observed in Group B. At T1, Group A demonstrated better performance than Group B in multiple metrics. Group C achieved the highest scores and was considered a reference group. Conclusions: Structured microsurgical training was associated with improved performance in a robotic simulation setting. These findings suggest that microsurgical skills may be transferable to robotic tasks and may contribute to the early phases of robotic skill acquisition. Further studies are required to assess their impact in clinical practice. Full article

Artificial intelligence (AI) is increasingly reshaping esthetic and reconstructive plastic surgery by improving measurement accuracy, treatment planning, and prediction of surgical outcomes. This article provides a scientific overview of current AI applications, including automated image analysis, machine-learning-based outcome forecasting, and generative models for preoperative simulation. AI-driven three-dimensional morphometrics allow precise, reproducible quantification of facial and body structures, supporting more objective assessments of symmetry, proportion, and contour. Predictive algorithms trained on large clinical datasets can estimate postoperative results and complication risks with higher consistency than traditional subjective evaluation. Intraoperative AI tools, such as real-time image guidance and robotic assistance, show potential to increase procedural precision and reduce variability. Despite these advances, important limitations persist. Algorithmic bias, restricted data diversity, opaque model architectures, and unresolved ethical concerns regarding data privacy and esthetic standardization challenge widespread clinical adoption. Overall, AI offers a powerful framework for enhancing precision and reproducibility in esthetic surgery, but its safe and responsible integration will require rigorous validation, transparent methodology, and continued human oversight. Full article

Introduction: Artificial intelligence (AI) and robot-assisted platforms are increasingly influencing cardiothoracic surgery. AI enhances risk prediction, imaging interpretation, and early complication detection, while robotics improves visualization, dexterity, and minimally invasive access. This systematic review evaluates the current evidence supporting these technologies and their implications for clinical practice. Methods: A systematic literature search was conducted across PubMed, Embase, Scopus, Web of Science, and Google Scholar (January 2000–May 2025) following PRISMA 2020 guidelines. After screening and eligibility assessment, 67 studies met predefined inclusion criteria and were incorporated into the qualitative synthesis. Additional high-impact reviews and consensus documents were consulted for contextual interpretation. Results: Machine learning models demonstrated modest but consistent improvements in predictive performance compared with EuroSCORE II and STS scores, particularly in high-risk cohorts. Robot-assisted mitral and coronary procedures showed reduced postoperative pain, blood loss, ICU stay, and recovery time in experienced centers, though early learning phases were associated with longer operative, cross-clamp, and bypass times. AI-enabled intraoperative tools, such as video analysis, workflow recognition, and real-time anatomical segmentation, emerged as promising adjuncts for surgical precision. Structured robotic training programs, especially simulation-based and dual-console pathways, accelerated proficiency acquisition. Conclusions: AI and robotic systems act as augmentative technologies that enhance rather than replace the surgeon’s role. Their safe and effective adoption requires standardized training, transparent AI decision pathways, and clear ethical and medico-legal governance. Full article

In recent years, applications with robots collaborating actively with humans have been increasing. The transition from Industry 4.0 to 5.0 rearranges the focus of fully automated processes to a human-centered system that allows more customization and flexibility. In human-centered systems, the robot is expected to safely assist or provide support to the human operator, avoiding any unintentional harm, while the latter is focused on tasks that require human reasoning, since current decision-making systems still have some limitations. This survey reviews all the main functionalities required to make a robot (collaborative or not) act as an assistant for human operators, analyzing and comparing solutions proposed by the authors (based on previous works) and/or the ones available in the literature. In this way, it is possible to combine those functionalities and build a complete framework enabling safe mobile manipulation while interacting with humans. In particular, a mobile manipulator is used to receive requests from a user, navigate in a human-shared environment, identify the requested object, and grasp and safely deliver such an object to the user. The framework, which is completed by a user interface designed using Android Studio, is developed in ROS1, tested, and validated on a real mobile manipulator in real-world conditions. Full article

Six-dimensional force sensors are widely used in compliant robotic control and safe human–machine interactions due to their mature sensing mechanisms and high accuracy. However, conventional six-dimensional force sensors often suffer from complex structures, bulky size, and high manufacturing costs. To address these limitations, this paper proposes a compact and low-cost six-axis force sensor based on capacitive sensing. By employing a tailored arrangement of flexible sensing units, partial structural decoupling of force and torque in specific directions is achieved. A Physically Informed Neural Network (PINN) is further introduced to decouple the residual coupled signals. Experimental results demonstrate that the proposed method significantly improves decoupling accuracy, achieving force decoupling errors of 1.75%, 1.20%, and 1.31% for F_x, F_y, and F_z, respectively, and torque decoupling errors of 0.95%, 0.93%, and 0.97% for M_x, M_y, and M_z. The proposed sensor offers low-cost fabrication, compact integration, and high sensitivity, making it well suited for lightweight and high-precision sensing applications. Full article

HRC is increasingly adopted in industrial and logistics environments, while workforce preparation often remains constrained by instructional approaches that provide limited embodied understanding of safety and ergonomics. This study examines the architectural design and system integration of a modular, human-centred XR platform intended to support safe and ergonomics-aware collaboration within smart logistics contexts. The proposed system integrates XR training scenarios deployed on consumer-grade hardware and follows a structured pedagogical progression from conceptual familiarisation through experiential task execution to reflective ergonomic evaluation. Multimodal feedback mechanisms based on posture-oriented guidance, attention-aware interaction design, and context-sensitive safety cues are incorporated without reliance on intrusive sensing technologies. A structured evaluation framework is defined to examine usability, task performance, and ergonomics-aligned posture indicators using standardised instruments and system-generated telemetry. The architectural design indicates that the framework supports scalable deployment, consistent interaction fidelity, and privacy-conscious data handling across educational and vocational settings. The proposed framework suggests that human-centred XR architectures can strengthen safety-oriented and ergonomically informed HRC within Industry 4.0 logistics environments. Full article

Most camera view planning algorithms are employed in exploration tasks that maximise information gain, but few address the specific challenge of observing targeted surface areas with optimal image quality. This paper presents a novel camera view planning algorithm designed for dermoscopic mole mapping, which is crucial for early melanoma detection. Traditional full-body scanners, though beneficial, suffer from fixed camera positions that can compromise image quality due to varying body contours and patient sizes. Our algorithm addresses this limitation by dynamically optimizing the camera position on a set of collaborative robot (cobot) arms to enhance image resolution, safety, and viewing angles during skin examinations. The proposed method formulates the problem as a non-linear least-squares optimisation that ensures no camera occlusion and a safe distance from the end effector encapsulating the camera to the patient while adjusting the pose of the camera based on the topography of the body. This approach not only maintains optimal imaging conditions by considering resolution and angle of incidence but also prioritises patient safety by preventing physical contact between the camera and the patient. Extensive testing demonstrates that our algorithm adapts effectively to different body shapes and sizes, ensuring high-resolution images across various patient demographics. Moreover, the integration of our camera view planning algorithm into an intelligent dermoscopy system has shown promising results in improving the efficiency and geometric quality of dermoscopic image acquisition, which could lead to more reliable and faster diagnoses. This technology holds significant potential to transform melanoma screening and diagnosis, providing a scalable, safer, and more precise approach to dermatological imaging. Full article

Background: The role of minimally invasive surgery (MIS) for hepatocellular carcinoma (HCC) remains controversial because of concerns regarding oncologic adequacy, particularly margin status. While robotic-assisted hepatectomy has gained adoption, its true perioperative advantages over conventional laparoscopy and open surgery remain unclear. SIMMILR-5 was designed to evaluate the short-term outcomes of open, laparoscopic, and tele-robotic laparoscopic hepatectomy for HCC using rigorous adjustment for confounding. Methods: A retrospective international multicenter study was conducted including patients undergoing liver resection for HCC between June 2004 and November 2024 at five high-volume hepatobiliary centers. Surgical approaches included open (O), conventional laparoscopy (L), and tele-robotic laparoscopy (TRL). Propensity score matching was performed using demographic, clinical, and tumor-related variables. The primary endpoint was short-term mortality (30 and 90 days). Secondary outcomes included estimated blood loss (EBL), operative time, length of stay (LOS), R0 resection status, and major complications. Results: A total of 904 patients were identified (302 O, 568 L, 34 TRL). After matching, conventional laparoscopy was associated with significantly lower EBL, shorter operative time, and shorter LOS compared with open surgery (all p < 0.00001). Compared with open surgery, TRL was associated with lower EBL but no improvement in operative time or LOS. Compared with laparoscopy, TRL was associated with longer operative time and longer LOS. Short-term oncologic surrogates were comparable across approaches. Conclusions: Minimally invasive hepatectomy offers perioperative advantages over open surgery for selected patients with HCC, driven primarily by conventional laparoscopy. Tele-robotic hepatectomy is feasible and safe in experienced centers but does not demonstrate superiority over advanced laparoscopic techniques. Full article

Introduction: Simultaneous resection of primary colorectal malignancies and liver metastases resulted in outcomes comparable to those achieved through a two-stage procedure, while offering the advantage of a single surgical intervention. The role of the robotic approach remains underexplored because of the lack of comprehensive evidence. The objective of our study was to examine the safety of the robotic surgical platform, assess its short-term outcomes, and compare them with those of open procedures. Methods and Material: We retrospectively analyzed data from an initial small series of eight consecutive patients treated at the UMC Ljubljana between March 2023 and December 2025. These patients underwent robot-assisted simultaneous resection of colorectal malignancies and liver metastases. Their outcomes were compared with those of an open cohort of eight patients. Results: The median operative time was 334 min (range, 193–415 min). No conversions or transfusions were required. Three patients experienced severe complications, accounting for 37.5% of the cohort. The median duration of hospitalization was 9.5 days. The median number of lymph nodes retrieved was 22. Complete (R0) resection of the primary tumor was achieved in all cases (100%), whereas resection of the liver was achieved in 87.5% of the cases. Importantly, there were no instances of re-hospitalization within 30 days or mortality within 90 days. Conclusions: Although the rate of severe complications is relatively high, the robotic surgical platform allows for the safe simultaneous resection of colorectal malignancies and liver metastases, achieving short-term outcomes comparable to those of open surgery. Full article

Background/Objectives: Fully robotic pancreatic resections using the Hugo™ RAS platform have not yet been described in the literature. Methods: A 72-year-old male with a cystic lesion in the pancreatic tail underwent a fully robotic distal pancreatectomy and splenectomy using the Hugo RAS platform and the newly introduced robotic vessel sealer LigaSure RAS. The proposed configurational setup and technical details are described. Results: The procedure was completed safely without complications: blood loss was <50 mL, total duration of surgery was 305 min, and console time was 195 min. The postoperative period was uneventful, and the patient was discharged on postoperative day 7. Conclusions: Distal pancreatectomy with the Hugo RAS platform may be feasible and safe in selected cases. Full article

Carbon-Fiber-Reinforced Polyetheretherketone (CFR-PEEK) instrumentation is increasingly preferred in spinal oncology for its physical properties, minimizing imaging artifacts and facilitating precise postoperative radiotherapy planning and tumor surveillance. However, a significant technical limitation exists: the current unavailability of dedicated CFR-PEEK pedicle screws for the cervical spine. The smallest available implants are designed for thoracic use (minimum diameter 4.5 mm, minimum length 25 mm), posing substantial risks of neurovascular injury when applied to smaller cervical pedicles. We present a technical note/feasibility report illustrated by a single case of robot-assisted placement of thoracic CFR-PEEK screws in the cervical spine for the treatment of a C7 Giant Cell Tumor. Following neoadjuvant therapy with Denosumab, a single-stage, two-step circumferential resection and reconstruction was performed. The anterior step was complicated by an iatrogenic injury to the highly adherent left vertebral artery (VA), which was successfully repaired. Consequently, the posterior step required maximal precision to preserve the sole remaining intact VA on the right side. Given the anatomical mismatch between the 4.5 mm thoracic screws and the narrow cervical pedicles (measuring as narrow as 3.2 mm on the critical right side), robotic navigation (ExcelsiusGPS^®) was utilized to plan and execute safe trajectories. Specifically, on the side of the intact VA, a small, controlled medial cortical violation was planned to avoid lateral vascular compromise. The procedure resulted in rigid, artifact-free stabilization with no immediate neurological sequelae. This single-case experience suggests that robotic guidance may facilitate adaptation of thoracic CFR-PEEK instrumentation to the cervical spine in selected oncologic scenarios; reproducibility, costs, and long-term outcomes remain uncertain. Full article

Flexible and safe object handling in modern industrial environments increasingly relies on mobile robotic systems capable of both dexterous manipulation and adaptive motion. However, when wheeled mobile manipulators (WMMs) operate under heavy or dynamically varying loads, challenges arise in maintaining sufficient force exertion capability and achieving stable coordination, particularly during cooperative transportation. In this paper, we present a unified framework to address these challenges with three main contributions. A quadratic-programming-based redundancy resolution scheme incorporating a load-capacity maximization metric is developed to explicitly enhance the force exertion capability of the system under heavy loads. A variable-admittance cooperative control strategy for dual-WMM transport is proposed to ensure synchronized motion and adaptive force regulation during collaborative manipulation. In addition, a unified framework that integrates configuration optimization with compliant cooperative control is established, enabling strict constraint enforcement, improved load capacity, and robust coordination between the two WMMs. Extensive simulations demonstrate the effectiveness of the proposed methods in improving load-handling performance and ensuring coordinated, compliant cooperative manipulation. Full article

Intracorporeal anastomosis (IA) has gained increasing acceptance in minimally invasive colorectal surgery, primarily owing to its demonstrated association with improved perioperative outcomes compared with extracorporeal techniques. Nevertheless, the specific role of intracorporeal handsewn anastomosis remains insufficiently explored within the context of laparoscopic colorectal procedures. The present study describes a standardized technique for performing a side-to-side isoperistaltic handsewn intracorporeal ileocolic anastomosis following laparoscopic right colectomy and evaluates its safety and feasibility through a review of the relevant literature and institutional experience. The procedure is executed employing a medial-to-lateral dissection approach, and a single-layer isoperistaltic handsewn anastomosis is constructed entirely intracorporeally. Over a three-year period, 68 laparoscopic right colectomies were completed using this technique, predominantly for malignant disease, all performed by a single surgeon. Notably, no anastomotic leaks or anastomosis-related complications, including bleeding, stenosis, or hematoma formation, were observed. Available evidence supports the advantages of intracorporeal anastomosis, including reduced surgical trauma, lower incidence of wound-related complications, faster recovery of bowel function, and comparable oncological outcomes. Furthermore, emerging data from robotic-assisted colorectal surgery suggest potential benefits of handsewn techniques with respect to hemostasis and anastomotic quality. In conclusion, intracorporeal handsewn ileocolic anastomosis following laparoscopic right colectomy appears to represent a safe and reproducible technique when performed by experienced surgeons, thereby warranting further prospective, comparative and multicenter studies to delineate its broader applicability and long-term outcomes. Full article

Background: Novel robotic surgical techniques have substantially improved the safety and outcomes of Ivor Lewis esophagectomy, offering greater precision, reduced surgical trauma, and more radical lymphadenectomy compared to conventional approaches. While perioperative results are increasingly promising, the adoption of robotic technology appears to be accompanied by an emerging set of procedure-specific complications not previously encountered—or encountered with different frequency—in open surgery. Understanding this evolving complication profile is essential to fully realize the oncological potential of robotic esophagectomy. Methods: This retrospective single-center study compared 407 consecutive patients undergoing Ivor Lewis esophagectomy at a high-volume center (OPE n = 163; HRB n = 75; FRB n = 169; 2012–2023) regarding three pathophysiologically motivated primary endpoints within 12 months: paraconduit herniation, chylothorax, and neo-esophagus–airway fistula. Results: One-year survival was 71.8%, 74.7%, and 82.2% (p = 0.073). Chylothorax was significantly more frequent in FRB (12.4%) than in OPE (2.5%) or HRB (2.7%) (p < 0.001), with surgical approach as sole independent predictor. Lymphangiography in three FRB patients demonstrated thoracic duct integrity in all; leakage originated from the celiac lymphadenectomy field ascending transhiatally—suggesting a distinct mechanism potentially linked to surgical radicality. All cases resolved conservatively. Neo-esophagus–airway fistula occured significantly less frequently with robotic approaches (FRB 0.6% vs. OPE 4.9%; p = 0.031). Paraconduit herniation did not differ significantly within 12 months (p = 0.272). Conclusions: The complication profile of robotic Ivor Lewis esophagectomy reflects its oncological ambition: elevated chylothorax rates may correlate with radical lymphadenectomy and represent an acceptable trade-off within a multimodal treatment strategy. Fistula risk is meaningfully reduced. These findings support robotic esophagectomy as a safe and effective approach in experienced centers. Full article

This paper provides a comprehensive survey of Human–Robot Interaction (HRI) for indoor mobile robots operating in human-centered environments such as hospitals, laboratories, offices, and homes. We review interaction modalities—including speech, gesture, touch, visual, and multimodal interfaces—and examine key user experience factors such as usability, trust, and social acceptance. Implementation challenges are discussed, encompassing safety, privacy, and regulatory considerations. Representative case studies, including healthcare and domestic platforms, highlight design trade-offs and integration lessons. We identify critical technical challenges, including robust perception, reliable multimodal fusion, navigation in dynamic spaces, and constraints on computation and power. Finally, we outline future directions, including embodied AI, adaptive context-aware interactions, and standards for safety and data protection. This survey aims to guide the development of indoor mobile robots capable of collaborating with humans naturally, safely, and effectively. Full article