Remote-controlled robot-assisted gynecological surgery is an innovative medical model that combines advanced communication technologies with robotic surgical systems, and it holds significant value in promoting the distribution of high-quality medical resources and responding to public emergencies. This article was jointly organized by the Obstetrics and Gynecology Physicians Branch of the Chinese Medical Doctor Association and the Gynecological Intelligent Medicine Professional Committee of the Chinese Maternal and Child Health Association, with the aim of standardizing its clinical application and enhancing the quality and safety of surgeries. The article reviews the development history of remote surgery, introduces the construction and technical requirements of remote-controlled robot-assisted gynecological surgery systems supported by 5G and other communication technologies, emphasizes the importance of quality management, including equipment access, personnel qualifications, team collaboration, network communication and security, and health economics indicators, and proposes suggestions for remote surgery access and training assessment. At the same time, it elaborates on the operational norms of remote-controlled robot-assisted gynecological surgery, covering preoperative preparations, surgical procedures, postoperative management, and the prevention and treatment of complications and fault responses. Finally, it discusses the challenges faced by the development of this technology, such as the iterative upgrading of robotic surgical systems, network security guarantees, the realization of full-process remote medical services, and the implementation of remote surgeries in special environments, with the aim of providing references for the promotion of remote-controlled robot-assisted gynecological surgery in China.

Multifocal hepatocellular carcinoma (MHCC) complicates the treatment strategy due to its high tumor heterogeneity. Global guidelines exhibit regional variations in defining surgical indications: Western guidelines prioritize liver transplantation for patients with MHCC meeting Milan criteria, while Asia-Pacific regions demonstrate greater preference for liver resection (LR), adopting more positive strategy even in intermediate-advanced stage patients (including those with higher tumor burden, compromised hepatic function, and inferior performance status). Recent studies have demonstrated that LR can significantly prolong survival in selected intermediate-advanced stage patients with MHCC. Advancements in minimally invasive techniques, conversion therapy, and comprehensive perioperative management have further expanded surgical indications for MHCC, with survival benefits undergoing qualitative improvements. In the future, the integration of multidisciplinary strategies combining surgical, locoregional, and systemic therapies will be essential for formulating personalized, precision-based, and standardized treatment protocols. Concurrently, progress in evidence-based medicine and technological innovation remains indispensable for optimizing long-term prognosis in patients with MHCC.

After years of development, single-port laparoscopic surgery has become a routine approach in gynecological procedures. Its advantages-minimal invasiveness, rapid recovery, and excellent cosmetic outcomes-have made it highly favored by patients. The unique access approach demonstrates absolute superiority in procedures such as large ovarian tumor enucleation and massive uterine myomectomy, earning strong preference from surgeons. With the widespread clinical application of single-port laparoscopic techniques, novel surgical concepts and approaches continue to emerge. To further advance the concept of minimally invasive and scarless surgery for patients with preexisting abdominal scars, this article proposes a transabdominal scar approach for single-port laparoscopic gynecological surgery. Additionally, it provides an overview of the access establishment and reconstruction, limitations, and clinical applications of this technique.

Intrauterine device(IUD) removal, a gynecological procedure, is widely performed. Globally, approximately 18% of females use IUDs for contraception. In the past, many women had IUDs inserted to comply with national family planning policies. However, some women, due to fear of pain and lack of awareness, have not had their IUDs replaced for over 20 years and only seek medical attention when experiencing symptoms such as abdominal pain, back pain, vaginal bleeding, or discharge after menopause. Postmenopausal changes like cervical atrophy and IUD embedment pose challenges for safe and less traumatic removal. In 2022 and 2025, the publication of the Chinese Expert Consensus on Vaginoscopy provided standardized guidance for clinical application of vaginoscopy and Clinical recommendations from Chinese experts on no energy hysteroscopic techniques, offering an effective solution for postmenopausal IUD removal combine with no energy. Using the scope with an outer diameter of less than 5 mm reduces cervical dilation and pain, enabling removal without anesthesia. The use of 5 Fr scissors to separate embedded IUDs and a lateral removal approach decrease the risk of instrument damage, enhance removal efficiency, and reduce hospitalization. This method is recommended for broader clinical application.

Feasibility and safety of proximal rectal pre-disconnection technique (PDT) combined with 3D laparoscopic camera inversion technique in intersphincteric resection for low rectal cancer.

A retrospective analysis was performed on the clinical data of 52 patients with low rectal cancer and a narrow pelvis treated between Mar. 2022 and Mar. 2025. Surgical outcomes (operation time, blood loss, protective stoma rate), postoperative complications (anastomotic leakage, anastomotic bleeding), postoperative recovery (time to first flatus, length of hospital stay), follow-up data, and pathological findings (circumferential resection margin, cytology of peritoneal lavage) were recorded and analyzed.

All patients successfully underwent laparoscopic ISR with anal sphincter preservation, with no intraoperative death or conversion to open surgery. The mean operation time was 169.0 ± 43.5 minutes, and mean intraoperative blood loss was 75.0 ± 37.7 mL. Two patients required a protective stoma. The overall postoperative complication rate was 1.9%, including one case of anastomotic leakage that required reoperation. The mean time to first flatus was 2.8 ± 0.9 days, and the mean length of hospital stay was 11.2 ± 4.3 days. After a median follow-up of 12 months, the 1-year overall survival rate and disease-free survival rate were both 100%, with a 100% sphincter preservation rate. Pathological examination confirmed negative proximal, distal, and pre-disconnection margins. The mean proximal margin was 11.0 ± 1.2 cm, and the distal margin was 1.5 ± 0.3 cm. Cytological and bacteriological examinations of peritoneal lavage fluid were negative.

Based on the analysis of 52 cases, the application of PDT combined with 3D laparoscopic camera inversion technique in ISR for low rectal cancer proves to be a safe and feasible approach. This technique demonstrates advantages of providing clear intraoperative visualization and facilitating surgical manipulation. While ensuring oncological radicality, it achieves satisfactory sphincter preservation with favorable short-term oncological outcomes. This technique represents a valuable and recommendable option for ISR procedures.

To develop a novel thoracoscopic magnetic navigation-guided puncture-free global localization (TMPGL) technique based on magnetic navigation, 3D reconstruction, and bony landmarks.

Preoperative CT scanning was performed in the supine or lateral position, followed by 3D reconstruction to develop the strategy and plan the approach. The first rib-sternocostal joint, the fourth rib-vertebra joint, and the seventh rib-vertebra joint were selected as bony landmarks. CT-guided puncture localization was also performed. Intraoperatively, spatial coordinates were calibrated by touching the bony landmarks with a magnetic navigation probe, which then guided the probe to a virtual localization point on the chest wall where methylene blue dye was applied. After lung inflation, the dye was passively transferred to the visceral pleura, thereby achieving accurate localization of the lung nodule.

Both CT-guided puncture localization and TMPGL were successfully performed. TMPGL demonstrated significant advantages over puncture localization in terms of time, deviation from the target point, and distance from the nodule (P<0.001, P=0.025, P=0.039, respectively). During puncture localization, 9 patients (69.23%) developed complications of varying degrees, including bleeding (53.80%), pneumothorax (30.77%), and chest wall hematoma (23.08%). The median postoperative pain visual analogue scale (VAS) score was 3, with 3 patients (23.08%) experiencing pain lasting more than 30 minutes. No significant differences were observed in terms of time, deviation, distance from the nodule, or dye spread distance between the two body position groups in TMPGL (all P>0.05).

The TMPGL technique significantly outperforms conventional puncture localization in terms of time, accuracy, and distance from the nodule. It enables precise targeting of peripheral, mediastinal, and diaphragmatic lung nodules-regions that are challenging for traditional puncture-based approaches-providing a safe, efficient strategy for accurate localization in early-stage lung cancer.

This study evaluates the feasibility and safety of modular Carina surgical robot system for thyroidectomy.

In this prospective single-arm trial, 8 patients with papillary thyroid carcinoma were enrolled at Yantai Yuhuangding Hospital following pig and cadaver feasibility studies. Carina™ was used to perform robotic thyroidectomy, with outcomes assessing system feasibility and safety.

Between May 2025 and Jul. 2025, all 8 subjects successfully underwent robot-assisted endoscopic thyroid cancer surgery using Carina™: 7 via gasless axillary approach and 1 via bilateral axillo-breast approach (BABA), with no conversions to laparoscopy or open surgery. The average system preparation time was 11.75±5.26 minutes, the average remote operation time was 111.88±25.45 minutes, and the average total operation time was 194.38±27.83 minutes. The system preparation time, remote operation time, and total operation time all showed a stable downward trend. The average physiological load score of the lead surgeon was 1.75±2.92 points, and the average psychological load score was 21.13±10.45 points. Both the physiological load and psychological load scores showed a significant downward trend as the number of surgeries increased. An average of 6.38 ± 2.77 lymph nodes were obtained, and an average of 0.88±1.73 metastatic lymph nodes were present. Postoperative follow-up was conducted for at least 2 month, and no serious complications was observed.

This study demonstrates for the first time that modular robotic thyroidectomy using Carina™ is feasible, safe, and effective.

To explore the feasibility of non-intubated uniportal video-assisted thoracic surgery (NI UVATS) for the resection of mediastinal tumors via a subxiphoid approach, and to summarize the surgical techniques and clinical outcomes.

A retrospective analysis was conducted on the medical records of 20 patients who underwent NI UVATS for subxiphoid resection of mediastinal tumors by the same surgical team in the Department of Thoracic Surgery at Shanghai Pulmonary Hospital between Mar. 2019 and Jul. 2023. The pathological diagnoses included 11 cases of thymic cyst, 7 cases of thymoma, 1 case of thymic carcinoma, and 1 case of lymphoid hyperplasia.

All 20 procedures were successfully completed with radical resection, and no cases required conversion to open thoracotomy. The mean operative time was 66.00 ± 26.83 minutes. The mean drainage volume on the day of surgery was 265 (115, 435) ml, and the mean postoperative hospital stay was 2.85 ± 1.27 days. Among the 7 patients diagnosed with thymoma, one received postoperative radiotherapy and showed no metastasis or recurrence at the 3-year follow-up. The one patient diagnosed with thymic carcinoma received postoperative chemotherapy and radiotherapy, with no metastasis or recurrence observed at the 3-year follow-up. The mean postoperative follow-up duration was 28.5 ± 10.7 months, with a mortality rate of 0% during this period.

For carefully selected patients, NI UVATS for subxiphoid resection of mediastinal tumors is feasible when performed by an experienced uniportal VATS surgeon in close collaboration with an anesthesiologist.

To explore the clinical manifestations, imaging characteristics, minimally invasive surgical treatment, and prognosis of aggressive fibromatosis (AF), aiming to enhance the understanding of the disease and provide a reference for its clinical diagnosis and management.

A case initially diagnosed preoperatively as abdominal wall endometriosis following cesarean section was reported. The patient underwent single-port laparoscopic resection, and postoperative pathology confirmed a diagnosis of abdominal wall AF. A literature review was conducted to support the discussion.

The mass and surrounding tissue were excised via single-port laparoscopy, and a mesh was used to repair the resulting tissue defect. Postoperative pathology revealed a spindle cell lesion, and immunohistochemical analysis confirmed the diagnosis of AF. No adjuvant therapy was administered, and no recurrence was observed during a 3-month follow-up period.

Aggressive fibromatosis is a borderline tumor with an unclear pathogenesis, characterized by high recurrence rates and strong local invasiveness. Due to its low incidence, there are currently no standardized diagnostic or treatment protocols. While open surgical resection remains the primary treatment approach, this case demonstrated that single-port laparoscopic resection can also achieve satisfactory therapeutic outcomes.

To investigate the feasibility and clinical efficacy of the single-port laparoscopic transgastric approach for treating pancreatic pseudocyst(PPC) located between the pancreas and the stomach.

A 47-year-old male patient with a pancreatic pseudocyst underwent single-port laparoscopic transgastric internal drainage. A small incision was made on the anterior wall of the stomach via the abdominal wall, and a single-port device was inserted to facilitate anastomosis between the posterior gastric wall and the cyst wall.

The patient resumed oral intake three days postoperatively, and no recurrence or complications were observed during the six-month follow-up period.

This minimally invasive surgical technique demonstrates reduced trauma and fewer complications, offering a safe and effective treatment option for PPC located between the pancreas and the stomach. But more relevant research and data are needed to support it.

Minimally invasive techniques have emerged as a dominant trend in surgical management of pancreatic tumors. Radical antegrade modular pancreatosplenectomy (RAMPS), by standardizing dissection along the renal fascia/adrenal plane and employing an antegrade modular resection approach, significantly improves oncological outcomes in distal pancreatectomy (DP) for pancreatic cancer. However, it still has core challenges such as instrumental limitations and controversies regarding the optimal lymphadenectomy extent. Based on multicenter evidence and our institutional surgical experience, this article systematically addresses three key aspects: the current research status, critical technical controversies, and future technological innovations. To provide a theoretical basis and clinical decision-making framework for the standardized implementation of minimally invasive RAMPS, promote prospective studies validating the oncological benefits of robotic-assisted technology.

Artificial intelligence (AI) technology is increasingly integrated into minimally invasive surgery for colorectal cancer, playing a vital role in key areas such as medical image analysis, anatomical structure segmentation, automated surgical workflow annotation, quantitative assessment of surgical skills, and personalized decision support. These advancements are accelerating the intelligent transformation of surgery, enhancing intraoperative navigation accuracy, and promoting individualized treatment. Despite its promising potential, the application of AI still faces challenges including limited algorithm generalizability, delays in real-time data processing, and data privacy concerns. This review summarizes recent progress in the application of AI in colorectal cancer minimally invasive surgery, highlights cutting-edge research, and envisions the transition of AI from proof-of-concept to clinical practice, aiming to establish a safer, more precise, and intelligent surgical paradigm.