To systematically analyze the core challenges in the current research and development of domestic laparoscopic surgical robots and propose corresponding solutions to promote technological breakthroughs and strategic transformation for domestic systems.

Focusing on the three key problems prevalent in the research and development of domestic laparoscopic surgical robots-the challenge of multi-modal operational data fusion, the challenge of multi-arm collaborative obstacle avoidance in confined spaces, and the risk posed by the lack of force feedback-along with their solution strategies.

Significant progress has been made in the technological substitution process of domestic systems while seeking solutions around the aforementioned three major challenges.

The future development of domestic laparoscopic surgical robots should focus on specialized instrument innovation, the realization of remote surgery functionality, and AI-powered decision support to overcome core technical bottlenecks. This will expand access from top-tier Class A tertiary hospitals to grassroots healthcare systems, ultimately achieving a strategic transformation from technological substitution to original innovation leadership.

This study aims to explore the feasibility, safety, and clinical utility of robotic partial resection of pancreatic tumors combined with pancreatic duct repair for the treatment of benign and low-grade malignant pancreatic tumors.

A retrospective review was performed on the clinical records of 103 patients who underwent robotic partial resection of pancreatic tumors at the Pancreatic Surgery Department of Shanghai Changhai Hospital, under the care of a single attending surgeon team, between Aug. 2021 and Nov. 2024.

In 103 patients, 81 underwent pure enucleation with a mean operative time of 36.68±27.63 min and blood loss of 28.86±46.98 ml. There were 2 cases of Grade B postoperative pancreatic fistula (POPF) and 1 case of Grade C POPF. Postoperative abdominal infections occurred in 2 cases, one of which developed pancreatic fistula bleeding on the 20th day after surgery, underwent angiography, and was transferred to the ICU. The patient improved and was discharged after symptomatic and supportive treatment. Eight patients had tumor enucleation with pancreatic duct stent repair, averaging 53.13±33.03 min operation time and 42.50±20.89 ml blood loss. One case had Grade B POPF, and abdominal infection and transient bleeding occurred 13 days after surgery, which improved after continuous irrigation through the drainage tube and symptomatic supportive treatment such as anti-infection. Fourteen patients underwent segmental resection with end-to-end anastomosis, taking 60.86±23.95 min and losing 74.29±37.03 ml blood, without complications. Follow-up (1 month to 3 years) revealed no recurrence, metastasis, or pancreatic dysfunction.

Robotic partial resection of pancreatic tumors for benign and low-grade malignant tumors is a safe, feasible, and effective treatment.

To explore the safety and clinical outcomes of laparoscopic enucleation (LapEN) for middle pancreatic tumors adjacent to the main pancreatic duct.

Clinical data of 8 patients who underwent LapEN for benign or borderline tumors closely adjacent to the main pancreatic duct from Jan. 2023 to Dec. 2024 were retrospectively analyzed. Surgical time, intraoperative blood loss, postoperative pancreatic fistula (POPF), and other complications were recorded, and long-term preservation of pancreatic function was evaluated.

All 8 cases were successfully completed laparoscopically. The mean operative time was 125.0±52.98 min, and intraoperative blood loss was 58.7±29.00 ml. All patients developed POPF postoperatively, including 3 cases (37.5%) of grade B fistula, which were successfully managed conservatively or with minimal intervention. No severe POPF or major complications occurred. During the follow-up period (median follow-up of 13.5 months), no tumor recurrence or new-onset diabetes was observed.

With precise surgical techniques, LapEN is safe and effective for benign or borderline tumors adjacent to the main pancreatic duct in the middle pancreas. Despite a relatively high incidence of POPF, clinical management was feasible, and good long-term pancreatic function was preserved.

To explore the application value of prior esophageal trisection with mesenteric boundary-oriented radical gastrectomy in laparoscopic total gastrectomy for gastric cancer, and to improve the quality of radical resection and operational efficiency through optimizing the surgical procedure.

The clinical data of 28 gastric cancer patients admitted to Henan Cancer Hospital from Feb. 2024 to Dec. 2024 were retrospectively analyzed. All patients underwent the surgical procedure of "trisecting the esophagus first and then performing total gastric mesenteric boundary resection" , which involved freeing and trisecting the esophagus after laparoscopic exploration, and then accurately defining the anatomical boundaries of the left/gastric posterior mesentery, right gastric mesentery, right gastroepiploic mesentery, and left gastroepiploic/short gastric mesentery to complete total mesenteric resection. The indicators observed included intraoperative time under laparoscopy, intraoperative blood loss, esophageal margin status, number of lymph nodes dissected, and incidence of postoperative complications.

All 28 patients successfully completed the surgery without conversion to open surgery. The intraoperative time under laparoscopy was 75.21±5.03 minutes, intraoperative blood loss was 85.14±28.92 ml, the number of lymph nodes dissected was 32.14±11.56, and the incidence of postoperative complications was 3.6%(1/28). The median follow-up period was 8.3 months, with no tumor recurrence or metastasis, and intraoperative frozen section of the esophageal margin confirmed negative in all patients.

Prior esophageal trisection with mesenteric boundary-oriented radical gastrectomy can achieve standardized surgical operation by early clarification of the esophageal margin and optimization of the mesenteric exposure path, improve surgical efficiency while ensuring radical resection, and is safe and feasible.

To explore the feasibility, safety, and surgical efficacy of complete laparoscopic radical surgery for the treatment of congenital choledochal cysts in children.

From Apr. 2022 to Dec. 2023, retrospective analysis was conducted for the relevant clinical data of 36 children undergoing complete laparoscopic radical surgery and traditional laparoscopic radical surgery for the congenital choledochal cyst. There were 11 boys and 25 girls with an average age of 2.5 (1.6-10.5) years. They were randomized into two groups of control (n=19) and observation (n=17). Observation group underwent complete laparoscopic radical surgery, while control group underwent traditional laparoscopic radical surgery. The size of cysts, operation time, surgical blood loss, postoperative bowel emptying time, initial feeding time, postoperative hospitalization stay and postoperative complication rate in two groups were compared, and analyze the advantages and disadvantages of the two surgical methods.

All patients successfully completed surgery, with no cases converted to open surgery. There was no statistical difference in cyst diameter [(2.3 ± 1.1) vs. (2.2 ± 1.4) cm ] and operation duration [(277±38) vs. (280 ± 36) min ] between the observation group and the control group (P>0.05). As compared with control group, observation group was lower with records of intraoperative blood loss [(20 ± 4.5) vs. (46 ± 4.9) ml], postoperative intestinal function recovery [(21 ± 3.7) vs. (38 ± 6) h], postoperative initial feeding time [(3.2 ± 0.4) vs. (4.3 ± 0.5) d] and postoperative hospitalization stay [(6.6 ± 0.8) vs. (7.6 ± 0.8) d]. During a follow-up period of 12 months, no significant difference existed in the incidence of complications(1/19 vs. 1/17) (P>0.05).

Complete laparoscopic radical surgery for the treatment of congenital choledochal cyst is a safe and reliable technique with satisfactory therapeutic effects, and can be used as a new option for minimally invasive treatment.

To explore the feasibility, safety, efficacy, and preliminary experience of robotic pancreatoduodenectomy (RPD) in the treatment of pediatric malignant pancreaticobiliary tumors.

A retrospective analysis was performed on the clinical data of 3 children with malignant pancreaticobiliary tumors who underwent RPD at Guangzhou Medical University Affiliated Women and Children's Medical Center from Apr. 2023 to Feb. 2024. The patients were 1 male and 2 female. The surgical procedure was robotic pylorus-preserving pancreatoduodenectomy (RPPPD) using the da Vinci robotic system Xi. Postoperative follow-up was conducted for 12 to 18 months.

The 3 patients were aged 29 months, 12 years, and 23 months, respectively. Case 1 had a tumor located in the ampulla of vater, invading the pancreatic head and common bile duct, with a size of 31 mm×27 mm×25 mm. Case 2 and 3 had tumors located in the pancreatic head, with sizes of 110 mm×98 mm×90 mm and 69 mm×58 mm×45 mm, respectively. All three patients underwent RPPPD. Postoperative pathological examination results revealed ampullary rhabdomyosarcoma in patient 1, solid pseudopapillary neoplasm in patient 2, and pancreatoblastoma in patient 3. All patients were discharged from the hospital with complete recovery. Patient 1 experienced gastric emptying disorder during the perioperative period, which resolved after 1 week of conservative treatment. During the follow-up period, all patients recovered well without any intraoperative or postoperative complications such as major bleeding, pancreatic fistula, biliary fistula, gastrointestinal anastomotic leakage, anastomotic stricture, intestinal obstruction, acute pancreatitis, or tumor recurrence. The three children are growing and developing well.

Robotic pancreatoduodenectomy is safe and feasible for malignant pancreaticobiliary tumors in children, with good short-term and medium-term outcomes.

To explore the feasibility and potential value of single-port robotic breast-conserving surgery for early breast cancer.

The clinicopathological characteristics of 5 patients with early breast cancer who underwent single-port robotic breast-conserving surgery in the Department of Breast Surgery, Beijing Chaoyang Hospital, Capital Medical University from Feb. 2025 to Mar. 2025 were retrospectively included. The completion of the surgery, perioperative conditions, and postoperative Breast-Q scores were evaluated.

All 5 patients successfully completed the surgery without conversion to open surgery, and no patients received a second operation due to positive surgical margins. The average operation time was 211.25±35.60 minutes, and the average incision length was 3.5±0.32 cm. There were no complications such as wound infection and bleeding during the perioperative period. According to the evaluation of the Breast-Q scale, the postoperative breast satisfaction score was 70.25±17.25, the satisfaction score of the chest wall condition was 57.75±31.78, the psychosocial status score was 86.00±13.51, and the sexual health degree score was 77.75±13.90.

Single-port robotic breast-conserving surgery is a feasible method for the surgical treatment of early breast cancer, achieving reliable radical resection results and satisfying aesthetic outcomes. The utilization of single-port canal facilitates the adaptation of a multi-port robotic system for single-port procedures.

In the era of rapid development of science and technology, the relationship between artificial intelligence (AI) and medicine has become increasingly close, and the integration of the above two has greatly promoted the rapid development of disease diagnosis and treatment. At present, AI has been applied in the diagnosis and treatment of clinical diseases, and its application in hepatobiliary and pancreatic surgery is developing rapidly, providing vital technical support and guarantee for the diagnosis of hepatobiliary and pancreatic tumors, treatment plan decision-making, surgical safety and accuracy, tumor pathology, treatment prognosis, and simulation training of surgeons. This article reviews the application and research progress of AI in the treatment of hepatobiliary and pancreatic tumors, in order to provide a new direction for the accurate and minimally invasive diagnosis and treatment of hepatobiliary and pancreatic tumors.

This paper comprehensively reviews the current application status of artificial intelligence (AI) in the entire process of "preoperative diagnosis - treatment decision-making - intraoperative navigation" for the minimally invasive treatment of adenomyosis. It briefly introduces the application prospects of deep learning algorithms combined with elastography in the diagnosis of adenomyosis, as well as the cutting-edge applications of AI in special scenarios such as the obliteration of the Douglas pouch. At the same time, it also points out the challenges faced and puts forward prospects for the further development of interdisciplinary research, the establishment of ethical consensus, and the standardized clinical application.

Laparoscopic surgery, despite its minimally invasive benefits, faces challenges like limited visualization and complexity. Artificial intelligence (AI), particularly machine learning and deep learning, offers revolutionary tools to enhance surgical quality. This review surveys AI applications across the laparoscopic surgical workflow, focusing on its power to improve precision, safety, efficiency/standardization, training, and personalization. AI enhances precision by optimizing surgical planning and guiding intraoperative navigation through real-time anatomical recognition. It bolsters safety via preoperative risk assessment, intraoperative hazard warnings (e.g., hemorrhage), vital structure protection, and postoperative complication prediction. AI promotes efficiency and standardization by automating planning, recognizing surgical phases for workflow optimization, and enabling objective quality assessment. For training, AI provides objective skill evaluation using video, kinematic, and physiological data, potentially accelerating learning curves with personalized feedback. Furthermore, AI facilitates personalization through risk stratification, outcome prediction, and risk-driven follow-up, advancing precision surgery.Despite the remarkable potential demonstrated by AI in laparoscopic surgery, challenges remain, including data privacy, cross-center generalization, model interpretability, and clinical integration. Future research should focus on enhancing multimodal data sharing and federated learning, the design of explainable models, and deep integration with robotic systems, to propel laparoscopic surgery towards greater intelligence, safety, and efficiency, thereby laying the technological foundation for precision surgery.

To review the progress of robotic-assisted prostate aspiration biopsy to guide clinical trials and promote the optimization of diagnostic and therapeutic techniques.

The common types of prostate biopsy, including nuclear magnetic resonance guidance, ultrasound-guided transrectal puncture, and transperineal puncture, are summarized, their advantages and disadvantages are analyzed, and the theoretical basis and development history of robotic-assisted prostate biopsy, as well as the current status and advantages of the different technological routes, are presented in detail.

The current status of robot-assisted prostate aspiration biopsy is summarized, the problems of intelligent aspiration biopsy due to technical factors are pointed out, and the future development direction of intelligent aspiration is prospected.

Robotic prostate aspiration technology provides more efficient and precise technical support for the early diagnosis of prostate cancer and better treatment outcomes for patients.

Radical prostatectomy (RP), as the current standard surgical treatment for prostate cancer, has achieved satisfactory tumor control. However, postoperative urinary incontinence still significantly impacts patients′ quality of life. In recent years, numerous studies have explored the risk factors influencing post-RP UI, including physiological alterations, anatomical injuries, and surgical techniques. This article aims to systematically analyze the pathophysiological mechanisms, examining its physiological, anatomical, and surgical-related factors, and to propose effective prevention and management strategies for improving postoperative urinary continence.