Abstract Purpose of Review To evaluate whether current evidence supports the use of robotic-assisted techniques over laparoscopic approaches in bariatric surgery. Background Robotic platforms have gained popularity in minimally invasive surgery, including bariatric procedures, due to their ergonomic and technical advantages. However, concerns persist regarding the cost-effectiveness and clinical benefits relative to laparoscopy. Brief Summary This review critically analyzes the existing literature comparing robotic and laparoscopic bariatric surgery, focusing on cost, operative outcomes, complication rates, and applicability in complex cases. The findings demonstrate that while robotic surgery is safe and feasible, it incurs significantly higher costs without providing superior weight loss, complication reduction, or metabolic outcomes. Even in high-risk subgroups such as revisional or super-obese patients, the clinical advantages remain marginal and inconsistent. Current data, primarily from retrospective studies, do not justify the routine adoption of robotics in bariatric surgery.

Abstract Purpose Decades of research has consistently demonstrated the advantage of a step-up approach for the treatment of pancreatic necrosis. However, the key to improved outcomes relies more on patience than the specific approach with a recent shift towards the importance of delayed intervention and medical optimization. This review breaks down ways to medically optimize patients with sterile and infected pancreatic necrosis, and guide timing of invasive approaches should nonoperative management fail. Recent Findings New data suggests that timing, rather than approach, has the biggest impact on mortality in the management of pancreatic necrosis. While the step-up minimally invasive approach improves morbidity outcomes, delaying procedures by at least four weeks improves morbidity and mortality outcomes. Multidisciplinary supportive care is the primary management for patients with pancreatic necrosis. For patients with clinical deterioration or persistent lifestyle-limiting symptoms despite supportive care, a stepwise approach is best summarized by the mantra delay , drain , debride , with emphasis on “delay”. If intervention is ultimately required, a step-up approach should be followed: drainage (percutaneous and/or endoscopic), endoscopic necrosectomy, video-assisted necrosectomy, and then open necrosectomy in select cases. For each step, clinical improvement or deterioration dictates whether a patient needs to advance to the next tier. Regardless, earlier intervention does not improve outcomes. Summary Supportive care followed by a stepwise mantra of delay , drain , debride provides the best outcomes for patients with pancreatic necrosis, whether infected or sterile. Intervention shoulder be pursued in a step-up fashion, and no advantage to intervention earlier than 4 weeks has been identified.

Abstract Purpose of Review Understanding the pathophysiology and risk factors for developing abdominal compartment syndrome is paramount to early diagnosis and management. Recent Findings Continuous pressure monitoring and drainage with percutaneous catheter decompression (PCD) can potentially avoid open surgery and improve survival in patients with intraabdominal hypertension (IAH). Future research will elucidate these findings. Summary Abdominal compartment syndrome (ACS) occurs when there is end organ dysfunction because of increased intra-abdominal pressure (IAP). Although this increase in pressure can be caused by an increase in extraluminal contents of the abdomen it is most frequently the result of systemic illnesses that necessitate massive fluid resuscitation. This leads to increased bowel edema and abdominal contents while also decreasing abdominal wall compliance. No matter what the etiology of ACS, it can lead to organ failure and death. Early recognition of ACS is necessary because early treatment is the best predictor of decreased morbidity and mortality. Clinical Trial Number Not applicable.

Abstract Purpose of Review This narrative review aims to explore the role of robotic surgery in liver procedures, with a particular focus on its evolution, clinical applications, and advantages compared to laparoscopic and open techniques. We examine how robotic systems are expanding the indications of minimally invasive liver surgery, current limitations, and provide insights into emerging technologies such as artificial intelligence and augmented reality. Recent Findings Recent literature highlights the growing adoption of robotic liver resections (RLR) for both minor and major hepatectomies, including challenging anatomical segments. Studies demonstrate improved precision, a potentially faster learning curve, and favorable short-term outcomes. Robotic techniques have also gained traction in living donor hepatectomy and, more recently, in full robotic liver transplantation. Technological advances such as near-infrared imaging, and AI integration are further enhancing the capabilities of the robotic platform. Summary Robotic liver surgery is a safe and effective minimally invasive alternative to conventional approaches, particularly in complex resections. Current evidence supports an emerging role even in both donor and recipient living donor liver transplants operations Our experience at the University of Illinois at Chicago reinforces these findings, suggesting the practical benefits of robotic systems and its growing role in clinical practice.