Residual biliary stones can potentially lead to biliary obstruction, recurrent infections, hepatic dysfunction, and an increased long-term risk of cholangiocarcinoma. To standardize diagnostic and management strategies, the Minimally Invasive Surgery Committee of the Chinese Research Hospital Association convened a multidisciplinary panel of experts. This consensus was developed using the GRADE evidence grading system in conjunction with the modified Delphi method. The document begins by defining residual biliary stones and systematically examines their epidemiology, clinical manifestations, and imaging diagnostic strategies. Based on this foundation, stratified treatment algorithms are proposed for three main categories: residual stones in the gallbladder/cystic duct remnant, the extrahepatic bile duct, and the intrahepatic bile ducts.Standardized management principles for associated conditions, such as cholangitis and biliary strictures, are systematically incorporated into the framework. The consensus delineates the indications and optimal timing for various techniques, including hepatectomy, endoscopic stone extraction, and percutaneous transhepatic cholangioscopy, while emphasizing the importance of correcting biliary strictures and ensuring adequate drainage as critical determinants of favorable long-term outcomes. Furthermore, adjunctive pharmacotherapy is acknowledged for its role in modulating bile metabolism and alleviating symptoms, thereby serving as an essential component of comprehensive management. The consensus also provides systematic recommendations for postoperative surveillance, patient education, and lifestyle interventions, thereby establishing a closed-loop management strategy that encompasses the entire diagnostic and therapeutic continuum. This consensus offers evidence-based guidance aimed at harmonizing and rationalizing clinical decision-making, ultimately enhancing therapeutic precision and improving long-term prognoses for patients with residual biliary stones in China.

To conduct a preliminary exploration of the feasibility, safety, and short-term functional outcomes of a biopsy-free diagnostic strategy guided by multiparametric magnetic resonance imaging (mpMRI) combined with prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT), together with robot-assisted radical prostate enucleation (RARPE) for localized prostate cancer (PCa).

This single-center retrospective study included 10 consecutive patients evaluated between Oct. 2024 and Apr. 2025 at the Department of Urology, The First Affiliated Hospital of Chongqing Medical University, who underwent screening by mpMRI and PSMA PET/CT and proceeded directly to RARPE without prior biopsy. Baseline characteristics, imaging findings, perioperative data, postoperative pathology, and functional outcomes were collected and analyzed.

Median operative time was 175 minutes, and median intraoperative blood loss was 80 mL. Bilateral neurovascular bundle (NVB) preservation was achieved in all patients. Mean duration of drainage tube placement was 2.6 days, mean postoperative hospital stay was 3.2 days, and mean total diagnostic-to-treatment time was 12.1 days. Postoperative pathology confirmed prostate adenocarcinoma in all cases, with pathologic stage pT2. Gleason Grade Group distribution was: Grade Group 2 (n=4), 3 (n=3), 4 (n=2), and 5 (n=1). Serum total PSA (tPSA) decreased markedly 4 weeks after surgery, with no biochemical recurrence observed during the 6-month follow-up. The positive surgical margin rate was 10%. No postoperative complications exceeding Clavien-Dindo grade I occurred, and all patients survived during the follow-up period. Functional outcomes were favorable: early urinary continence recovery was excellent, with a 100% continence rate achieved at the 1-month follow-up. Most patients maintained preoperative erectile function levels.

Under stringent imaging criteria, the biopsy-free diagnostic pathway combining mpMRI and PSMA PET/CT with robot-assisted radical prostate enucleation demonstrates encouraging preliminary results in diagnostic reliability, perioperative safety, and functional preservation. However, as this is an exploratory, single-center, retrospective single-arm study with a small sample size, this strategy cannot yet be recommended for routine clinical practice. Its efficacy requires further validation through prospective studies with larger cohorts and longer follow-up.

To explore the safety and feasibility of day surgery for robotic liver tumor resection.

The demographic characteristics, perioperative data, and short-term outcomes of patients who underwent robotic day surgery for liver tumor resection at Faculty of Hepato-Biliary-Pancreatic Surgery, The First Medical Center of Chinese People′s Liberation Army General Hospital from Jun.2024 to Jan.2025, were analyzed retrospectively.

A total of 31 patients were enrolled, including 23 males and 8 females, with a mean age of 54 years. Among them, 8 patients underwent left lateral hepatectomy, 18 underwent wedge hepatectomy, and 5 underwent segmentectomy. All day surgeries for robotic liver tumor resection were successfully completed without conversion to open surgery. The median operative time was 100 (85.5, 115.5) minutes, and the median estimated blood loss was 25 (20, 50) ml. No patient required blood transfusion, and no patient developed major postoperative complications, post-hepatectomy liver failure or post-hepatectomy hemorrhage. No patient needed reoperation or readmission, and no 30-day mortality was observed.

Day surgery for robotic liver tumor resection is safe and feasible. However, further accumulation of experience and comparative studies are required to verify its clinical value and clarify the surgical indications.

To investigate the clinical efficacy of liver tumor resection in same-day surgery.

Clinical data were retrospectively collected from 4 patients who underwent hepatectomy for liver tumors from Jan. 2026 to Feb. 2026. The cohort comprised 2 males and 2 females, aged 42-56 years, including 2 cases of hepatic hemangioma and 2 cases of hepatocellular carcinoma. Postoperative follow-up was conducted for 14 days. Parameters analyzed included operative time, intraoperative blood loss, surgical technique, postoperative complications, pain level at discharge, and patient satisfaction, aiming to comprehensively evaluate its clinical applicability.

All 4 same-day surgery hepatectomies for liver tumors were successfully completed. Operative time ranged from 60 to 84 minutes. Intraoperative blood loss was uniformly 20 ml, with no patient requiring a blood transfusion. No severe complications occurred. Portal triad clamping was not performed in any case. No abdominal drainage tubes were placed. All patients were discharged on the day of surgery, reporting a pain score of 1 on the Visual Analog Scale at discharge. Within the 14-day postoperative period, no complications such as hemorrhage, bile leakage, or liver failure were observed. There were no deaths or hospital readmissions within this period.

Hepatectomy for liver tumors performed within same-day surgery is safe and feasible, supporting its broader application in well-established hepatopancreatobiliary day surgery centers.

To evaluate the impact of tension gastrophasty approach (TGA) technique on postoperative complications and functional recovery in patients undergoing McKeown esophagectomy for esophageal cancer.

Clinical data from 75 patients treated in 2024 (personalized group) were compared with 126 historical controls (conventional group) from 2022 to 2023. The primary endpoint was anastomotic leakage rate, with secondary endpoints including reflux symptoms and nutritional status.

The personalized group demonstrated significantly lower rates of anastomotic leakage (5.3% vs. 15.9%, P=0.026) and moderate-to-severe reflux (21.3% vs. 35.7%, P=0.032). At 6 months postoperatively, this group also showed superior weight recovery (-5.8%±2.9% vs. -13.1%±6.2%, P<0.001) compared to the conventional group.

The personalized gastric conduit technique is safe and feasible for McKeown esophagectomy, reducing anastomotic leakage and reflux while improving postoperative nutritional recovery. These findings support its clinical adoption.

To evaluate the clinical efficacy and safety of the domestic SR-ENS-600 single-port laparoendoscopic surgical robot system combined with the enhanced recovery after surgery (ERAS) protocol in the treatment of benign gynecological diseases such as ovarian cysts, uterine fibroids, and cervical intraepithelial neoplasia.

A single-arm study was conducted, enrolling 44 patients with benign gynecological diseases who underwent surgery at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital from Jan. 2023 to Oct. 2025. All patients underwent single-port laparoscopic surgery (including single-port robotic ovarian cystectomy/adnexectomy, myomectomy, and total hysterectomy) using the SR-ENS-600 system, with standardized perioperative ERAS management. The surgical success rate, multiple perioperative parameters (operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay), numerical rating scale (NRS) pain scores, and adverse events were recorded and compared with literature data of the da Vinci SP single-port surgical robot system.

The surgical success rate was100% with no conversion to laparotomy or multi-port laparoscopic surgery. The operative time and intraoperative blood loss in the single-port robotic ovarian cystectomy/adnexectomy (SRC) group, single-port robotic myomectomy (SRM) group, and the overall cohort were lower than those reported for the corresponding procedures with the da Vinci SP system. For the single-port robotic total hysterectomy (SRH) group, the operative time and blood loss were slightly higher than those of the da Vinci SP system, but the difference was not statistically significant. For all patients, the mean time to first flatus was 20.97±6.23 h, and the mean postoperative hospital stay was 2.86±1.66 d, both significantly shorter than those of the da Vinci SP system (34.1±15.5 h and 4.6±0.7 d, respectively). Pain control was excellent: the median NRS pain score was 3.00 (2.00, 3.75) at 6 h postoperatively and decreased to 1.00 (0.00, 1.00) at 24 h postoperatively, with no need for additional analgesic drugs. During the study period, there were no serious adverse events or complications.

The domestic SR-ENS-600 single-port laparoendoscopic surgical robot system combined with the ERAS protocol is safe and effective in the treatment of benign gynecological diseases, comparable to that of imported similar robotic systems, and it is more competitive in terms of recovery efficiency and cost-effectiveness, showing promising potential for clinical application and promotion.

To explore the safety and feasibility of non-barbed suture method in transumbilical laparoendoscopic single-site surgery(TU-LESS) in cervical myomectomy, and to provide new ideas for the diagnosis and treatment of cervical myoma.

A total of 62 patients who underwent laparoscopic cervical myomectomy at Maternal and Child Health Hospital of Hubei Province from May 2017 to Mar. 2025 were collected. All patients′ tumor cavities were sutured with non-barbed sutures. There were 34 cases in the transumbilical laparoendoscopic single-site surgery group(TU-LESS group) and 28 cases in multiport laparoscopy group(ML group). There were 9 patients with giant cervical myoma in the TU-LESS group and 2 patients with giant cervical myoma in the ML group. The intraoperative and postoperative safety and quality indicators, postoperative recovery of the two groups of patients were analyzed and compared.

There was no significant difference in age, myoma diameter (cm), operation time (min), and intraoperative blood loss (ml) between the TU-LESS group and the ML group (P>0.05). The postoperative hospitalization time and postoperative exhaust time of the TU-LESS group were shorter than those of the ML group (P<0.05). Complications occurred in 3 patients (8.8%) in the TU-LESS group and 3 (10.7%) in the ML group, and the difference was not statistically significant (P>0.05). No complications such as ureteral injury, intestinal injury, or postoperative incision infection occurred in any patient.

The use of non-barbed sutures during transumbilical laparoendoscopic single-site surgery cervical myomectomy is a safe and effective method.

Hysterectomy is one of the most common surgical procedures in obstetrics and gynecology, which can be performed via abdominal, laparoscopic and vaginal approaches. In recent years, driven by the growing aesthetic demands of female patients, transumbilical single-port laparoscopic surgery (US-LESS), which integrates the advantages of minimal invasiveness and cosmetic results, has emerged as a novel surgical modality. This surgical approach takes advantage of the natural anatomical features of the umbilicus, leading to a concealed and scarless incision after healing, and thus has achieved high clinical acceptance. However, previous US-LESS hysterectomies were mostly indicated for patients with a uterine size smaller than that of a 12-week gestation. For the hysterectomy of large uteri (uterine size ≥12 weeks of gestation), the surgical difficulty rises drastically due to problems such as limited operative space and narrow visual field. Up to now, there are no clinical guidelines or consensus statements to guide the performance of US-LESS for large uterus hysterectomy. Based on clinical practice, this article systematically summarizes the technical essentials and operative experience of transumbilical single-port laparoscopic hysterectomy for large uteri from the aspects of case selection, preoperative preparation, surgical procedures, intra-operative difficulties and corresponding solutions, postoperative management, as well as prevention and treatment of complications. The purpose is to provide practical references for the standardized clinical application and popularization of US-LESS in large uterus hysterectomy, thereby promoting this surgical modality that combines minimal invasiveness, enhanced recovery and excellent cosmetic effects to better serve patients.

Presents a case of primary gastric undifferentiated sarcoma, where the patient, an elderly male with a history of type 2 diabetes and recurrent melena, was admitted with severe anemia. Gastroscopy revealed a 4 cm×4 cm irregular mass in the gastric antrum, and biopsy indicated ulceration, necrosis, and mild atypical hyperplasia. CT scans showed a 7 cm×3 cm×2.6 cm tumor involving the full thickness of the gastric wall. The patient underwent partial gastrectomy, and postoperative pathology confirmed high-grade undifferentiated sarcoma without lymph node metastasis. Recovery was smooth, and follow-up is ongoing. This case underscores the importance of thorough diagnostics and highlights surgery as the primary treatment, with close postoperative monitoring to prevent recurrence.

Pancreaticoduodenectomy (PD) is the standard surgical procedure for malignant tumors of the pancreatic head/neck and peripapillary region with well-established consensus on its core techniques. However, severe complications such as pancreatic fistula frequently develop postoperatively. Consequently, current research focuses on optimizing surgical techniques to mitigate the risk of complications. Against this background, the growing application of minimally invasive techniques has extended the debate to whether minimally invasive PD demonstrates superior perioperative safety and improved long-term oncologic outcomes compared with open surgery. This article reviews advancements in key PD techniques, discusses these controversies, and provides references for clinical surgical decision-making to improve surgical safety and long-term patient prognosis.

The clinical application of pure laparoscopic liver transplantation is currently hindered by the technical complexity of vascular reconstruction and a steep learning curve. The hybrid procedure, integrating laparoscopic mobilization of the diseased liver with vascular reconstruction via a mini-laparotomy, effectively bridges the gap between minimally invasive benefits and operative safety. This article reviews current clinical practices, elaborating on anatomical foundations and key technical strategies, including early pre-dissection and indocyanine green (ICG) fluorescence navigation. Furthermore, it addresses controversies regarding the learning curve, indication expansion (e.g., robotic assistance), and health economics. Current evidence confirms that the hybrid approach significantly shortens warm ischemia time and reduces surgical trauma while ensuring oncological safety, representing a crucial transitional and supplementary modality in the era of minimally invasive liver transplantation.

In recent years, the deep integration of artificial intelligence (AI) and surgery has been driving the surgical field towards a new stage of precision and intelligence. By analyzing clinical, imaging, and pathological omics data and combining them with deep learning, AI optimizes the entire process of diagnosis, surgery, and prognosis, significantly enhancing surgical efficiency and safety. Minimally Invasive Surgery (MIS) has emerged as a crucial development trend in the surgical field. The numerous challenges faced by traditional MIS have given rise to the demand for intelligent technologies. In the field of gynecological MIS, AI will achieve wide application in precise diagnosis, clinical risk prediction, intraoperative diagnosis, surgical navigation, intraoperative decision, and postoperative recovery, effectively improving the treatment outcomes for patients and providing more precise medical services.