To create a risk stratification model for biochemical recurrence by examining the relationship between the positive surgical margin status and biochemical recurrence in patients with prostate cancer after radical prostatectomy. This retrospective study included 3,010 patients who received radical prostatectomy. We analyzed the effect of postoperative pathological results using the Kaplan-Meier method and Cox model regression analysis in patients with no positive lymph node. A risk stratification model incorporating the total positive surgical margin length was constructed based on factors predicting biochemical recurrence. Among the total 1,865 patients, 346 (19%) experienced biochemical recurrence after radical prostatectomy and 377 (20%) had a positive surgical margin. The median positive surgical margin count was 1, and the median total positive surgical margin length measured 1.0 mm. The multivariable regression analysis revealed significant associations between biochemical recurrence and the following factors: preoperative prostate-specific antigen level > 20 ng/mL (p < 0.001), pathological Gleason grade (p < 0.001), extraprostatic extension (p < 0.001), seminal vesicle invasion (p < 0.001), lymphovascular invasion (p = 0.010), and total positive surgical margin length of ≥ 1 mm (p < 0.001). Patients were classified into good-, intermediate-, and poor-risk groups corresponding to the presence of 0, 1, or ≥ 2 factors, respectively. The 5-year survival rates without biochemical recurrence were 93%, 81%, and 47%, respectively. Our risk stratification model for biochemical recurrence after radical prostatectomy incorporates preoperative prostate-specific antigen level and pathological results, thereby aiding in patient counseling and the selection of appropriate adjunctive therapy after radical prostatectomy.

Minimally invasive liver surgery requires a precise understanding of complex liver anatomy. Extended reality (XR) technologies, including virtual reality and mixed reality, offer promising solutions for enhancing preoperative planning and intraoperative guidance. This study aimed to investigate the effectiveness of XR technology in minimally invasive hepatectomy and compare the outcomes of laparoscopic and robotic approaches. We retrospectively reviewed the clinical records of 102 patients who underwent minimally invasive hepatectomy. Patients were categorized into XR-assisted (n = 47) and without XR (n = 55) groups. The XR group had significantly higher IWATE difficulty scores (median 6 vs. 4, P < 0.001) and a greater proportion of anatomical resections (57.4% vs. 27.3%, P = 0.003). Nevertheless, the estimated blood loss (median 150 mL vs. 100 mL, P = 0.054) and incidence of severe complications (6.4% vs. 0%, P = 0.094) did not differ significantly between the XR and non-XR groups. Subgroup analyses of the robotic and laparoscopic procedures showed similar trends in safety outcomes. The potential of XR technology to enhance anatomical understanding suggests its valuable role in improving surgical quality and safety.

The EDGE single-port endoscopic surgical robot (SP1000), specifically designed for urological, gynecological, thoracic and general surgical procedures, has recently been applied in various operations. However, there is currently a lack of evidence comparing its performance with the Da Vinci Xi robot system. This study aims to compare the technique and perioperative outcomes of radical prostatectomy (RP) performed with EDGE SP1000 versus the Da Vinci Xi robot system. Data were collected from radical prostatectomy cases performed at Anhui Medical University from March 2025 to December 2025. 101 patients underwent radical prostatectomy using EDGE SP1000 and 102 patients using Da Vinci Xi were operated on using the Da Vinci Xi system. A 1:1 propensity score matching method was applied to compare the two groups both before and after matching based on age, body mass index, prostate size, prostate specific antigen (PSA) level, and Gleason score. We primarily evaluated the surgical efficacy of the two robotic systems by comparing perioperative clinical data. In the matched surgery groups (EDGE SP1000 vs. Da Vinci Xi), there were no significant differences in age (68.6 years vs. 69.3 years; p = 0.59), PSA (10.3 ng/ml vs. 10.1 ng/ml; p = 0.93), Gleason score (7 vs. 7; p = 0.41) and prostate volume (38.0 cm3 vs. 37.4 cm3; p = 0.81). All procedures were completed successfully without any conversion to open surgery. There was no significant difference in the total operative time between the two groups (136.6 vs. 129.0min; p = 0.14). No major intra or postoperative complications were observed in either group. Positive surgical margin rates were no significant (36% vs. 41%; p = 0.41). Despite the design variations between the two robotic systems, there were no significant differences in the final surgical outcomes. The EDGE SP1000 system serves as a viable option for radical prostatectomy.

The learning curve for robotic colorectal surgery is increasingly characterised. However, the specific learning curve for intracorporeal anastomosis (IA) remains poorly defined. This review compares robotic and laparoscopic IA with respect to operative time, cases required for proficiency, complication rates, and conversion to extracorporeal anastomosis (EA). A systematic review was conducted in accordance with PRISMA guidelines. The protocol was registered on Open science framework ( https://doi.org/10.17605/OSF.IO/K4MYZ ). On March 18, 2025, OVID and PubMed were searched using the search terms; "laparoscopic," "robotic," "anastomosis," "learning," "education," and "training." Yielding a total of 273 results from PubMed (179) and OVID (94). After screening a total of thirteen studies were included. Thirteen studies met inclusion criteria, including eight comparative analyses and six directly comparing robotic and laparoscopic techniques. Four studies evaluated robotic learning curves without a comparator group, while one was a literature review incorporating institutional experience. Most studies were retrospective (n = 8), with two prospective clinical studies and two experimental simulation-based studies. Hybrid approaches (robotic mobilisation with laparoscopic EA) contributed to heterogeneity (Reitz et al. 2018, https://doi.org/10.1007/s00464-018-6074-7 ). Learning curve assessment was heterogeneous, with most studies using cumulative sum (CUSUM) or risk-adjusted CUSUM (RA-CUSUM) analyses based on operative time or technical performance metrics. Proficiency in robotic IA was reported after approximately 11-29 cases in some series and around 20 cases in others, although larger studies of robotic colorectal surgery demonstrated broader ranges of up to 100 cases. Robotic right hemicolectomy with IA demonstrated a shorter learning curve and reduced anastomosis time compared with laparoscopic IA. Complication rates, conversion rates, and oncological outcomes were comparable between approaches (Gachabayov et al. 2019, Surg Technol Int, 34:163-168). Robotic intracorporeal anastomosis, particularly in right hemicolectomy, appears to have a shorter and less technically demanding learning curve compared with laparoscopic techniques, without compromising safety or oncological outcomes. These findings support a potential role for robotic platforms in facilitating adoption of intracorporeal anastomosis. However, current evidence is limited by retrospective design, small cohorts, and inconsistent definitions of proficiency (Gachabayov et al. 2019, Surg Technol Int, 34:163-168; Van Eetvelde et al. 2022, https://doi.org/10.1007/s11701-022-01514-6 ).

Robotic surgery has evolved from a technological adjunct into a major platform for extending the reach of minimally invasive surgery (MIS). In contrast to conventional laparoscopy, robotic systems offer three-dimensional magnified visualization, wristed instrumentation, tremor filtration, improved ergonomics, and greater precision in narrow anatomical spaces. These features have supported wider adoption of technically demanding minimally invasive procedures that are difficult to reproduce consistently with straight-stick laparoscopy alone. This narrative review examines how robotic platforms have expanded MIS across urology, gynecology, colorectal surgery, thoracic surgery, and upper gastrointestinal surgery. Current evidence suggests that robotic surgery often reduces conversion to open surgery, blood loss, and length of hospital stay in complex procedures, although operative time is frequently longer and superiority over laparoscopy is not universal. The review also discusses the barriers that continue to limit broader expansion, including capital and maintenance costs, learning curves, absent or limited haptic feedback, unequal access, and heterogeneity in the evidence base. Finally, it considers emerging directions, including artificial intelligence, image guidance, robotic ultrasound integration, and haptic innovation. Robotic surgery should therefore be understood not as a wholesale replacement for laparoscopy, but as a selective enabler of advanced MIS when anatomical and technical constraints expose the limitations of conventional approaches.