Female reproductive organs are adjacent to the urinary tracts. During gynecological surgery, it is difficult to avoid urinary tract injuries. Although urinary tract injuries are rare, injuries can cause mental and physical trauma to patients. As a clinician, it is necessary to identify urinary tract injuries as early as possible, accurately evaluate the condition and actively treat it to avoid serious complications. Ureter injury and bladder injury are the most common injuries in urinary tracts. The treatment principles are different according to different conditions. As a mature surgical technique, laparoscopic surgery has the advantages of less trauma, clear vision, wide operating range and short learning curve. Laparoscopic surgery can improve the prognosis of appropriate patients with urinary tract injuries.

Minimally invasive surgery has been widely adopted in the treatment of cervical cancer. However, robot-assisted laparoscopic radical hysterectomy, a representative minimally invasive procedure, is frequently associated with specific complications, including urinary tract injury, nerve injury, vascular injury, and lymphatic injury. This article reviews the types, etiologies, and management strategies of these complications in robotic surgery for cervical cancer, and summarizes preventive measures from the perspectives of preoperative evaluation, intraoperative technique, and postoperative management.

Para-aortic lymphadenectomy is an important component of surgical staging and regional lymph node assessment in gynecologic malignancies. The extent and quality of lymph node dissection directly affect staging accuracy and subsequent treatment decisions. Conventional laparotomy is associated with greater surgical trauma, whereas the transperitoneal multiport laparoscopic approach may be limited by bowel interference, omental obstruction, obesity, and other factors during dissection of the upper para-aortic region, resulting in suboptimal surgical exposure.The retroperitoneal approach facilitates exposure and dissection of high-level para-aortic lymph nodes. Meanwhile, transumbilical laparoendoscopic single-site surgery offers the advantages of minimal invasiveness and superior cosmetic outcomes. The combination of these two approaches has led to the development of transumbilical laparoendoscopic single-site retroperitoneal para-aortic lymphadenectomy, which reduces abdominal wall trauma while preserving the anatomical advantages of retroperitoneal access, thereby providing a novel minimally invasive option for surgical staging in gynecologic malignancies. Based on current evidence and clinical experience, this review summarizes the developmental background, technical characteristics, indications, standardized surgical procedures and key operative techniques, clinical value, and future perspectives of this procedure, with the aim of providing a reference for its standardized implementation and wider clinical application.

To investigate the learning curve characteristics, influencing factors, and optimization strategies of domestic single-port robotic assisted gynecological surgery, and to analyze proficiency inflection points under different surgical procedures and surgeon backgrounds.

A prospective, multicenter, single-arm clinical trial was conducted at six hospitals across China between Jan. 2023 and Oct. 2025. A total of 97 patients undergoing robotic assisted gynecological surgery using the Shurui SR-ENS-600 system were enrolled, including 32 cases of ovarian cystectomy, 11 cases of myomectomy, 45 cases of hysterectomy, and 9 cases of endometrial cancer staging. Docking time was recorded and compared with literature data. The cumulative sum (CUSUM) method was used to analyze the trend of console time and to identify proficiency inflection points.

In this study, the median age of patients undergoing endometrial cancer staging was lower than that reported in the literature (45 years vs. 61 years), while the age of myomectomy group was higher (42.27 years vs. 36.98 years). The learning curve for docking time was short, with median docking times ranging from 3.00 to 6.00 minutes across hospitals, and 80.4% of cases completed docking within 5 minutes. Significant inter-hospital differences in the learning curves of console time were observed: hospital 1 exhibited a "decline-rebound-decline" pattern, entering the proficiency phase after approximately 25 cases; hospital 5 achieved proficiency from the first case but showed limited subsequent improvement; hospital 6 demonstrated the most typical learning curve, reaching a stable plateau at 5-6 cases. Significant heterogeneity in learning curve inflection points was also found across different surgical procedures: routine procedures (Type 1) achieved proficiency quickly, while difficult procedures (Type 3) required 22 cases to reach a stable plateau (median console time of 105 minutes).

The learning curve for domestic single-port robotic gynecological surgery exhibits significant procedure-dependency and inter-individual heterogeneity. Difficult procedures require more than 20 cases to achieve proficiency, while routine procedures can reach a stable level within 5 cases. Surgeons′ prior experience in single-port laparoscopy and multi-port robotic surgery can significantly shorten the learning cycle for single-port robotic surgery. The domestic Shurui SR-ENS-600 system demonstrates comparable docking time and operative time to the da Vinci SP system, indicating good clinical accessibility and potential for widespread adoption. Dual-console teaching and augmented reality-assisted feedback techniques can help optimize the learning curve.

To compare the safety and efficacy of the KangDuo surgical robotic system (KD-SR-01/KD-SR-02) and the da Vinci surgical robotic system (Si/Xi) in single-position robot-assisted laparoscopic radical nephroureterectomy.

A retrospective review was conducted of 117 patients with upper tract urothelial carcinoma (UTUC) who underwent single-position robot-assisted laparoscopic radical nephroureterectomy at the Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, between Dec. 2021 and Dec. 2024. Among them, 52 patients underwent surgery with the KangDuo robotic system (K-RRNU group), and 65 patients underwent surgery with the da Vinci robotic system (D-RRNU group). Demographic characteristics, clinical data, perioperative outcomes, and follow-up results were collected and compared between the two groups.

There were no significant differences in baseline demographic characteristics or preoperative clinical data between the two groups (P>0.05). Both groups had a 100% surgical success rate, with no conversions to open or conventional laparoscopic surgery. In terms of perioperative outcomes, the K-RRNU group had significantly longer operative time and console time than the D-RRNU group (P<0.05). However, no significant differences were observed between the two groups in complication rates, postoperative length of hospital stay, or oncological outcomes, including recurrence-free survival (RFS) and cancer-specific survival (CSS) (P>0.05). The K-RRNU group had significantly lower hospitalization costs than the D-RRNU group (P<0.05).

Compared with the da Vinci robotic system, the KangDuo robotic system demonstrated comparable safety and efficacy in single-position robot-assisted laparoscopic radical nephroureterectomy.

To compare the clinical outcomes of da Vinci Xi-vNOTES and domestic Shurui SP-vNOTES in hysterectomy.

A retrospective analysis was conducted on 141 patients who underwent hysterectomy at the Second Affiliated Hospital of Nanjing Medical University from Oct. 2024 to Feb. 2026. Among them, 87 patients were in the da Vinci group and 54 patients were in the Shurui group. Baseline data, surgical indicators, perioperative complications, and postoperative recovery were compared between the two groups.

The setup time in the Shurui group was significantly shorter than that in the da Vinci group (3.2±0.8 min vs. 8.1±1.5 min, P<0.001). There were no statistically significant differences between the two groups in operative time, intraoperative bleeding volume, postoperative pain score, time to first ambulation, time to first urination, time to first flatus, and complication rate (P>0.05). In the da Vinci group, there was one case of bladder injury and one case of transumbilical single-port surgery; no such events occurred in the Shurui group.

The domestic Shurui SP-vNOTES demonstrates good safety and efficacy in hysterectomy, with superior setup efficiency compared to da Vinci Xi-vNOTES. Its clinical outcomes are comparable to those of the da Vinci group, making it a feasible alternative for minimally invasive gynecological surgery in China.

To compare the clinical efficacy of three-port reduced-port laparoscopic surgery with conventional five-port laparoscopic surgery for radical resection of colorectal cancer, and to evaluate the safety, effectiveness, and clinical value of the three-port approach.

A retrospective analysis was conducted on the clinicopathological data of 84 patients who underwent laparoscopic radical resection for colorectal cancer at our institution between Jan. 2024 and Mar. 2025. According to the port configuration used during surgery, patients were divided into a three-port group (reduced-port group, n=26) and a five-port group (conventional group, n=58). Baseline characteristics, intraoperative parameters, oncological outcomes, postoperative recovery, and complication rates were compared between the two groups.

No significant differences were observed in baseline characteristics, including sex, age, BMI, NRS 2002 score, history of prior abdominal surgery, preoperative hemoglobin levels, or tumor location (all P>0.05), indicating good baseline comparability. The total abdominal incision length was significantly shorter in the three-port group(5.2±1.2 cm) compared to the five-port group(7.8±0.8 cm) (P<0.001). The time to first postoperative flatus was significantly earlier in the three-port group compared with the five-port group (48.5 ± 8.2 h vs. 56.8±10.5 h; P<0.001). There were no statistically significant differences in operative time, intraoperative blood loss, tumor size, pathological T stage, or number of harvested lymph nodes (all P>0.05). The overall postoperative complication rate was comparable between the two groups (P>0.05).

The three-port reduced-port laparoscopic approach for radical resection of colorectal cancer achieves comparable oncological outcomes and safety to the conventional five-port method. It offers distinct advantages in terms of shorter incision length and faster recovery of gastrointestinal function, without increasing operative time, blood loss, or complication risk. This technique is safe, effective, and minimally invasive, and represents a promising surgical option worthy of broader clinical adoption in high-volume centers with established laparoscopic expertise.

To investigate the clinical efficacy of arthroscopic resection of the too-long anterior process (TLAP) of the calcaneus combined with sinus tarsi debridement in the treatment of sinus tarsi syndrome (STS) with a too-long anterior process of the calcaneus.

A retrospective analysis was conducted on the clinical data of 7 patients with refractory STS with TLAP admitted from Sep. 2023 to Sep. 2025. All patients underwent arthroscopic resection of TLAP combined with sinus tarsi debridement. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, foot and ankle outcome score(FAOS) , and visual analogue scale (VAS) pain score were recorded preoperatively and at 1, 3, and 6 months postoperatively. The incidence of complications including infection, skin necrosis, tendon injury, or deep vein thrombosis of the lower extremity, the recurrence rate of sinus tarsi pain, and the time to return to activity were documented to evaluate the clinical outcomes.

All 7 patients successfully underwent surgery and completed the entire follow-up period. At 6 months after treatment, the patients′ FAOS score increased from 42.86±6.84 to 90.86±4.6, the VAS pain score decreased from 7.14±1.34 to 1.71±0.76, and the AOFAS score improved from 40.14±4.71 to 85.29±3.23. No postoperative complications occurred in any patient. At the final follow-up, no recurrence was observed in any patient.

For STS with TLAP, arthroscopic resection of TLAP combined with tarsal sinus debridement can significantly improve foot and ankle function and relieve pain, with low complication and recurrence rates, yielding satisfactory short-term clinical outcomes.

By reviewing the whole process of multi-disciplinary treatment (MDT) for elderly patients with gastric cancer complicated with gastrointestinal obstruction and bleeding in our center, the principles of surgical diagnosis and treatment for elderly patients with gastric cancer were summarized and discussed.

Based on a patient admitted to the Department of Oncological Laparoscopic Surgery, the First Affiliated Hospital of Harbin Medical University in Apr. 2025, who was clinically diagnosed as gastric cancer with gastrointestinal bleeding and pyloric obstruction in the recent examination due to melena and severe vomiting after eating. By starting MDT diagnosis and treatment mode, the patient′s preoperative general status and systemic organ reserve function were evaluated, and the minimally invasive surgical treatment strategy was formulated after digestive endoscopy and tumor staging evaluation.

The patient successfully underwent laparoscopic radical gastrectomy D2 (distal gastrectomy+ Billroth Ⅱ anastomosis+ intestinal anastomosis). The operation time was about 3 hours, and the amount of bleeding was about 50ml. There was no postoperative infection, bleeding, anastomotic leakage, gastrointestinal dysfunction, thrombosis and other complications. Postoperative pathological examination showed gastric ulcer moderately to poorly differentiated adenocarcinoma (T3N0MX).

Elderly patients with gastric cancer should start the MDT diagnosis and treatment mode immediately after admission, carry out rigorous and comprehensive preoperative evaluation of their systemic organ reserve function, formulate precise perioperative preparation plan, and treat the tumor and its complications through minimally invasive surgery, so that patients can finally achieve maximum benefits.

To report 1 case in China of a 5G-based remote robot-assisted laparoscopic surgery for endometrial cancer. A 49-year-old female patient presented with postmenopausal vaginal bleeding and discharge for over a month and was diagnosed preoperatively with endometrioid carcinoma (FIGO stage I) and uterine leiomyoma. After multidisciplinary evaluation, she underwent remote robot-assisted laparoscopic total hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, pelvic adhesiolysis, and high ligation of ovarian vessels. The surgery was performed at the People′s Hospital of Xinjiang Uygur Autonomous Region by surgeons from the First Affiliated Hospital of Nanchang University, using a domestic four-arm laparoscopic robotic system remotely operated via a 5G wireless network and client equipment. The connection between the surgeon′s console and the operative platform was established through a public 5G network. During the procedure, the average air interface latency was 125 ms with a packet loss rate of 0.00%, and both signal coverage and retention ratio reached 100%. The surgery lasted 3 hours with approximately 100 ml of blood loss, and no intraoperative network or robotic malfunctions occurred. The patient recovered well, resumed oral intake and passed flatus on postoperative day 1, had the urinary catheter removed on day 2, and was discharged on day 3. Final pathology confirmed endometrioid adenocarcinoma. Follow-up showed satisfactory incision healing with no discomfort. This case demonstrates the preliminary feasibility and safety of 5G-based remote robot-assisted surgery for gynecologic malignancies in remote regions.

We report a rare case of congenital, incarcerated HFW, discussing its diagnosis, management, and surgical strategies along with a literature review.

Case Description A young male with an unremarkable medical history presented with abdominal pain and hematochezia for 5 hours. Abdominal CT showed gastric dilatation, irregular duodenal contour with localized luminal expansion, and air-fluid levels, initially suspicious for a duodenal diverticulum or volvulus with possible obstruction. Treatment Due to progressive pain despite conservative therapy, emergency laparoscopy was performed, revealing an incarcerated ileal HFW with 200 ml ascites, a foramen diameter of 3cm, and herniated ileal segment of 50 cm. Laparoscopic bowel decompression, hernia reduction, and foramen closure with hemostatic gauzeplus medical gluer were successfully executed.

The patient recovered uneventfully with normal bowel function. Follow-up CT was clear, and no recurrence was observed at 6 months.

HFW mimics simple bowel obstruction but progresses rapidly to necrosis, perforation, or sepsis if misdiagnosed. High vigilance regarding specific CT findings and changing abdominal signs is crucial. Early laparoscopic exploration is both diagnostic and therapeutic to prevent necrosis, while individualized foramen closure is key to preventing recurrence.

Artificial intelligence is reshaping the landscape of gastric cancer surgery. Deep learning-based technologies, with their powerful capabilities in multidimensional data mining and pattern recognition, have demonstrated significant value across key clinical scenarios, including preoperative accurate staging, screening of occult peritoneal metastasis, prediction of neoadjuvant therapy response, intraoperative lymph node dissection and functional preservation, and postoperative individualized adjuvant therapy decision-making. The integration of radiomics and deep learning has increased the area under the curve (AUC) for predicting occult peritoneal metastasis to over 0.92. Intraoperative AI combined with indocyanine green fluorescence navigation and three-dimensional reconstruction offers a novel approach to preserve tumor-draining lymph nodes (TDLNs) without compromising oncological radicality. In the field of adjuvant therapy, AI can efficiently identify molecular features such as microsatellite instability-high (MSI-H), Epstein-Barr virus positivity, and HER2 expression from routine histopathological sections, facilitating precise selection of patients who are most likely to benefit from immunotherapy and targeted therapy. However, clinical translation of AI still faces challenges, including a lack of high-quality datasets, insufficient model interpretability, and weak prospective validation. In the future, surgeons should engage deeply in the development and iteration of AI models as definers of clinical problems and producers of high-quality data, and promote innovation through multimodal integration, federated learning, and explainable algorithms, thereby driving gastric cancer surgery from an experience-driven discipline toward a new paradigm of data-driven precision minimally invasive surgery.

As a product of the profound integration of medicine and engineering, robotic surgery has evolved over more than three decades into a cornerstone of minimally invasive procedures, now widely applied in urology, general surgery, gynecology, and neurosurgery. Robotic platforms exemplified by the da Vinci system have markedly enhanced operative precision, three-dimensional visualization, and procedural stability; however, limitations persist in haptic feedback, human–machine interaction, and system integration. Looking ahead, robotic surgery is poised to advance toward greater subspecialization, miniaturization, natural orifice approaches, and intelligent functionality. The integration of artificial intelligence will catalyze breakthroughs in autonomous navigation, optimized force feedback, data-driven decision-making, and postoperative surveillance, enabling a transition from master–slave assistance to higher levels of automation. This evolution promises not only enhanced safety and accuracy, but also a profound transformation of personalized medicine and contemporary models of diagnosis and treatment.