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Active compliance in robotic surgery--the use of force control as a dynamic constraint.

Robotic surgery can be carried out automatically by using a robot to move the cutting tool under position control. However, although the surgeon can observe the procedure on a visual display and has the ability to stop the operation in an emergency, he has little direct contact with the task. An alternative approach is to involve the surgeon more directly, by his moving a robot using active force control. The robot is then used to allow motion in preprogrammed regions, by the surgeon back-driving the robot motors, while preventing motion in prohibited areas. This active constraint robot (or ACROBOT) is described in this paper applied to knee surgery, in which the knee bones are accurately machined to allow the fitting of prosthetic knee implants. The ACROBOT is, however, ideally suited to a range of surgical procedure, because it allows the surgeon to feel the forces exerted during cutting and take appropriate action. This ability to be in direct control, while being constrained to cut within a permitted region, enhances safety and makes the system more acceptable to the medical community. The system of programmable constraint also allows the ACROBOT to provide the traditional benefits of robot surgery, namely the ability to machine complex geometrical surfaces very accurately and to make repetitive motions tirelessly. The system also has a potential for minimally invasive procedures. In knee surgery, for example, the robot could operate through a small incision in the skin and excise a volume into which a small, specially designed, unicompartmental prosthesis could fit.

Arthroplasty, Replacement, Knee↗

[Maintenance and improvement of quality of life among elderly patients using a pet-type robot].

There have been reports of cases in which quality of life and loneliness of elderly people have been affected by interaction with the pet-type robot AIBO. In the present comparison between first and 20th sessions of activity with the pet-type robot, statistically significant improvements were observed in speech, emotional words and satisfaction index. The AKO loneliness scale value was 3.33 at the first session, and was 1.00 at the 20th session (statistically significant decrease). In a comparison of health-related QOL before and after interaction with AIBO, using the SF-36 survey, role function (RP) was statistically higher at the 20th session than at the first session. Evaluation by CgA, a mental stress index, showed a statistically significant decrease as the number of AIBO sessions increased. Case 1: The patient was a 68-year-old woman with chronic rheumatoid arthritis. Her AKO loneliness scale value was 4 on the first session and 1 on the 20th session. She said, "I do not think about anything while playing with the pet-type robot. It heals my mind." Case 2: The patient was a 74-year-old woman with cervical osteochondrosis. Her AKO loneliness scale value was 5 on the first session and 2 on the 20th session. She said, "The first time, I didn't like playing with the robot because I was depressed. After I had played with the robot several times, I felt good." Case 3: The patient was an 84-year-old man with cerebral apoplexy sequelae. His AKO loneliness scale value was 6 on the first session and 1 on the 20th session. He sang with the robot occasionally. The amount of conversation between him and his children greatly increased. Unlike animals, a pet robot does not carry the risk of bacterial infection. The present results suggest the possibility of using robots as a substitute for animal-assisted therapy and other psychosocial therapy in aseptic rooms, ICUs, children's wards, and special care wards for patients with dementia.

Aged↗

The da Vinci robotic system for general surgical applications: a critical interim appraisal.

PRINCIPLES: The recently introduced robotic surgical systems were developed to overcome the limitations of conventional minimally invasive surgery. We analyse the impact of the da Vinci robotic system on general surgery. METHODS: The da Vinci operating robot is a telemanipulation system consisting of a surgical arm cart, a master console and a conventional monitor cart. Since its purchase in June 2001, 128 patients have undergone surgery using the da Vinci robot in our department. The mean age of the 78 female and 50 male patients was 52 (range 18-78) years. RESULTS: The procedures included 29 cholecystectomies, 16 partial fundoplications, 16 extended thymectomies, 14 colonic interventions, 10 splenectomies, 10 bariatric procedures, 7 hernioplasties, 6 oesophageal interventions, 5 adrenalectomies, 5 lower lobectomies, 4 neurinomectomies and 6 others. 122 of 128 procedures (95%) were completed successfully with the da Vinci robot. Open conversion proved necessary in 4 patients due to surgical problems, and two other procedures were completed by conventional laparoscopy due to robot system technical errors. 30-day mortality was 0%, one redo-operation was necessary and two lower complications not requiring surgical re-intervention occurred. The resection margins of all tumour specimens were histologically tumour free. CONCLUSIONS: Various general surgical procedures have proved feasible and safe when performed with the da Vinci robot. The advantage of the system is best seen in tiny areas difficult of access and when dissecting delicate, vulnerable anatomical structures. However, in view of longer operating times, higher costs and the lack of adequate instruments, robotic surgery does not at the moment represent a general alternative to conventional minimally invasive surgery.

Adolescent↗

Survey of resident training in robotic surgery.

Robotics has been recognized as a major driving force in the advancement of minimally invasive surgery. However, the extent to which General Surgery residents are being trained to use robotic technology has never been assessed. A survey was sent to program directors of accredited General Surgery training programs to determine the prevalence and application of robotics in surgical training programs. Responses were tabulated and analyzed. Thirty-three per cent indicated interest in minimally invasive surgery. Twelve per cent of responders have used robotics in their practice, and 65 per cent felt robotics will play an important role in the future of General Surgery. Currently residents from 14 per cent of the responding training programs have exposure to robotic technology, and residents from an additional 4 per cent of these programs have limited didactic exposure. Program directors from 23 per cent of responding programs identified plans to incorporate robotics into their program. Robotics have been shown to make standard endoscopic surgical procedures more efficient and cost-effective as well as allowing a variety of procedures that were only possible with conventional methods to be completed with minimally invasive techniques. This new technology promises to be a large part of the future of surgery and as such deserves more attention in the training of General Surgery residents.

Diffusion of Innovation↗

Robotic assisted kidney transplantation: an initial experience.

PURPOSE: The use of robotics is a recent innovation in surgery. In addition to dexterity enhancement and motion scaling, this new technology opens the horizon of remote surgery. This latter advancement has potential use during surgery involving a high risk of patient-to-professional or professional-to-patient virus transmission. We investigated the feasibility of robotic assisted kidney transplantation. MATERIALS AND METHODS: A right cadaveric kidney was transplanted into a 26-year-old male patient who has been on hemodialysis for 11 years. Surgery was done with the help of the da Vinci robot (Intuitive Surgical, Inc., Mountain View, California) by a remote surgeon, who completely performed vascular dissection and anastomosis as well as ureterovesical anastomosis. The role of the assistant by the side of the patient was limited to access creation, exposure, hemostasis and maintaining traction on the running sutures performed by the robot. RESULTS: Operative time was 178 minutes. Robotic assistance made anastomosis possible by its unique ability of stereoscopic magnification and ultra-precise suturing techniques due to the flexibility of the robotic wristed instruments. Renal perfusion was excellent with immediate diuresis. Postoperative acute tubular necrosis started to resolve after 1 week. CONCLUSIONS: This study demonstrates that robotic assisted kidney transplantation is feasible. Currently technical and cost hindrances limit the routine use of robots. However, with ongoing improvement and future availability of this technology the prevention of patient-to-professional and professional-to-patient viral transmission may become a potential field of application.

Adult↗

Clinical investigation: endoscopic coronary artery bypass grafting with robotic assistance.

BACKGROUND: The current study reviews clinical feasibility experiences evaluating safety and efficacy of using robotic assistance to create a left internal mammary artery to left anterior descending artery (LIMA-to-LAD) anastomosis. METHODS: Between August and November 1999, 9 patients (aged 54-73 years) underwent robotically assisted endoscopic coronary artery bypass grafting (E-CABG) after institutional review board approval and informed consent were obtained. The robotics were transthoracically introduced in the fifth and sixth intercostal spaces. The LIMA-to-LAD anastomoses were endoscopically constructed with robotic assistance, and patency was assessed by flow measurement. RESULTS: Each anastomosis was performed robotically, without necessity for intraoperative intervention with traditional techniques. Robotic anastomosis times averaged 29.05 minutes. The robotic system added on average 41.28 minutes to the procedure. LIMA flows prior to anastomoses measured from 11.2 to 29.2 mL/min. LIMA flow measurements following anastomoses averaged 42.07 mL/min. There were no deaths or perioperative myocardial infarctions. CONCLUSIONS: Although E-CABG is an exhaustive and technically demanding procedure, it is feasible for a computerenhanced robotic telemanipulation system to safely and effectively provide substantial assistance to the surgeon completing a thoracoscopic coronary anastomosis.

Aged↗

[Robotic and telerobotic surgical systems for abdominal surgery].

The United States Food and Drug Administration (FDA) has approved four robotic surgical systems to be used in operations of clinical laparoscopy. The purpose of this article is to describe these four robotic surgical systems. In robotic laparoscopy surgery, AESOP and Endoassist replace the cameraman and provide a stable platform for the video telescope. AESOP is controlled by the surgeon's voice commands, whereas Endoassist responds to the movements of an infrared light adhered to the surgeon's head. During the telerobotic laparoscopic surgeries, the physician is seated in front of a computer console that is at a distance from the patient. The surgeon observes a virtual three-dimensional operating area and carries out the operation by controlling two tele-robotic arms, both of which hold the surgical instruments. These telerobotic arms simulate the movements of the surgeon's hands, with six degrees of freedom and two degrees of axial rotation. By combining the three-dimensional images and the movements which are similar to the manual movements of the surgical instruments, The complex laparoscopic procedures are facilitated. In June 2000, the tele-robotic surgical system Da Vinci was authorized by the FDA to act as an operating surgeon, but in October 2001, in the case of Zeus, it was only authorized to act as an assistant surgeon during laparoscopies,. Consequently, surgeons have reported great clinical experiences with Da Vinci. Tele-robotic, laparoscopic abdominal surgery is feasible, and its initial results are similar to those obtained from traditional laparoscopic surgery. Therefore, the tele-robotic and robotic surgical systems overcome some of the limitations inherent in traditional laparoscopic surgeries and they could increase the number of surgeons who could perform complex laparoscopies in the future.

Abdomen↗

[Robot-assisted laparoscopic surgery. Preliminary results at our Center].

The aim of our study was to evaluate the advantages and disadvantages of robot-assisted laparoscopic surgery, in terms of operative times, complications and length of hospital stay, using the Da Vinci Robotic Surgical System (Intuitive Surgical, Inc.). Twenty-five patients underwent robotic procedures. The indications were gastro-oesophageal reflux disease in 13 cases, achalasia in 2, cholelithiasis in 2, adrenal adenoma in Cushing syndrome in 6, pheochromocytoma in 2, and incidentaloma in 1. Robotic surgery was compared with the traditional laparoscopic approach. From January to September 2002 13 Nissen-Rossetti fundoplications, 2 Heller myotomies with Dor fundoplication, 2 cholecystectomies and 9 adrenalectomies (6 left adrenalectomies, 3 right adrenalectomies) were performed. There were no significant differences in age, preoperative body mass index (mean 28; range: 18-32) or sex between patients treated by robotic surgery and those treated by traditional laparoscopy. Operative times were significantly longer in the robotic surgery group (97.1 minutes, range: 77-126 minutes, versus 82.5 minutes, range: 65-100 minutes, for Nissen-Rossetti fundoplication; 132.8 minutes, range 104-181 minutes, versus 82.1 minutes, range 55-120 minutes, for adrenalectomy). There were no intraoperative complications. Conversion to traditional laparoscopy was necessary owing to technical difficulties in 4/9 adrenalectomies (44.4%; 3 left, 1 right). There was no significant difference in length of hospital stay (3.2 days, range 2-7 days, for Nissen-Rossetti fundoplication; 5.7 days, range 4-9 days, for adrenalectomy). Our study confirms the safety and feasibility of robot-assisted laparoscopic surgery. However, operative times were longer and costs higher, with no difference in outcomes. Given the current level of technology and experience, robotic surgery would not appear to afford any advantage over standard laparoscopic approaches.

Adrenalectomy↗

[Robotic fundoplication for gastro-oesophageal reflux disease].

Presented as a possible "second" revolution in general surgery after the introduction of laparoscopy during the last few years, the robotic approach to mini-invasive surgery has not yet witnessed wide, large-scale diffusion among general surgeons and is still considered an "experimental approach". In general surgery, the laparoscopic treatment of gastrooesophageal reflux is the second most frequently performed robot-assisted procedure after cholecystectomy. A review of the literature and an analysis of the costs may allow a preliminary evaluation of the pros and cons of robotic fundoplication, which may then be applicable to other general surgery procedures. Eleven articles report 91 cases of robotic fundoplication (75 Nissen, 9 Thal, 7 Toupet). To date, there is no evidence of benefit in terms of duration of surgery, rate of complications and hospital stay. Moreover, robotic fundoplication is more expensive than the traditional laparoscopic approach (the additional cost per procedure due to robotics is 1,882.97 euros). Only further technological upgrades and advances will make the use of robotics competitive in general surgery. The development of multi-functional instruments and of tactile feedback at the console, enlargement of the three-dimensional laparoscopic view and specific "team" training will enable the use of robotic surgery to be extended to increasingly difficult procedures and to non-specialised environments.

Animals↗

Making the transition from standard gynecologic laparoscopy to robotic laparoscopy.

OBJECTIVES: To determine the feasibility of using a simple procedure, a bilateral tubal ligation, as a transition procedure when adopting robotic laparoscopy for gynecologic surgery. METHOD: To obtain robotic credentialing and gain experience with the robotic system, the surgeons first went through robotic training, then 4 women desiring permanent sterilization had robotically assisted laparoscopic bilateral tubal ligations performed, using the Parkland method. RESULTS: Total operating room time varied from 1 hour 25 minutes to 2 hours 31 minutes. Improvement in operating time for each surgeon was noted with each successive case. Best times in robotic cases were similar to those of standard laparoscopy. CONCLUSION: Robotically assisted laparoscopic tubal ligation using the Parkland method is a satisfactory procedure to provide transition for gynecologic surgeons and operating room personnel to gynecologic robotic surgery.

Adult↗

A novel drill set for the enhancement and assessment of robotic surgical performance.

BACKGROUND: There currently exist several training modules to improve performance during video-assisted surgery. The unique characteristics of robotic surgery make these platforms an inadequate environment for the development and assessment of robotic surgical performance. METHODS: Expert surgeons (n=4) (>50 clinical robotic procedures and >2 years of clinical robotic experience) were compared to novice surgeons (n=17) (<5 clinical cases and limited laboratory experience) using the da Vinci Surgical System. Seven drills were designed to simulate clinical robotic surgical tasks. Performance score was calculated by the equation Time to Completion + (minor error) x 5 + (major error) x 10. The Robotic Learning Curve (RLC) was expressed as a trend line of the performance scores corresponding to each repeated drill. RESULTS: Performance scores for experts were better than novices in all 7 drills (p<0.05). The RLC for novices reflected an improvement in scores (p<0.05). In contrast, experts demonstrated a flat RLC for 6 drills and an improvement in one drill (p=0.027). CONCLUSION: This new drill set provides a framework for performance assessment during robotic surgery. The inclusion of particular drills and their role in training robotic surgeons of the future awaits larger validation studies.

Clinical Competence↗

Comparative analysis of early perioperative outcomes following radical cystectomy by either the robotic or open method.

OBJECTIVE: We analyzed early perioperative outcomes following radical cystectomy by the robotic method compared with the conventional open method. METHODS: All relevant clinical information was entered in a Microsoft Access Database and queried. P < 0.05 were considered statistically significant. RESULTS: The study cohort comprised 37 consecutive patients undergoing radical cystectomy; 24 (64.9%) cases were performed by the conventional open method and 13 (29.7%) by the robotic method. Body mass index, age, sex, blood transfusion rate, and median decrease in hemoglobin were comparable between the 2 groups. The robotic method resulted in significantly lower median estimated blood loss, shorter hospital stay, and longer operating time compared with the open group (P < 0.05). Four (16.7%) perioperative complications occurred in the open group compared with 2 (15.4%) in the robotic group (P = 1.0). The incidence of organ-confined (< or =T2N0Mx) disease was 9 (37.5%) and 7 (53.8%) in the open and robotic groups, respectively (P = 0.49). CONCLUSIONS: Radical cystectomy by the robotic method produces early perioperative results comparable to those of the open method. Although intraoperative estimated blood loss and hospital stay were significantly lower in the robotic group, operative time was longer which likely reflects our early operative experience with radical cystectomy by the robotic method.

Adult↗

Robotic system for i.v. antineoplastic drug preparation: description and preliminary evaluation under simulated conditions.

A robotic system for preparing doses of i.v. antineoplastic drugs is described, and measurements made with the system are compared for accuracy and reproducibility with those made by pharmacists and technicians. System hardware consists of a robotic arm, a 16-bit microcomputer, a bar-code reader, a voice synthesizer, and an electronic balance. The software includes a menu-driven main program, executable files for each robotic activity, and an interface to allow control to pass between the program and the files. The program has routines for matching the software to the hardware; for entering information about the patient, the name of the drug ordered, and the dose; for checking the dose; for selecting the number and size of the vials to be used; for specifying the manipulations of the robotic arm; for printing labels; and for maintaining records. The robot fills an order by getting and placing a vial, inserting a needle into it and withdrawing the drug, weighing the vial, agitating the container to dissolve its contents, reading a bar code, placing a syringe in a syringe manipulator, and getting an i.v. container and injecting the drug into it. Detection of any errors by a series of self-checks arrests execution of an order. No significant differences in accuracy and precision were found between the robotic system and humans performing the same tasks under simulated conditions. The robotic system required less time than humans and eliminated the possibility of direct human contact with the i.v. admixture. Under simulated conditions, a robotic system developed to assist in the preparation of i.v. antineoplastic drugs was as accurate as a manual system and was more time efficient.

Antineoplastic Agents↗

Robotic Needle Insertion for CT-guided Percutaneous Biopsy of Thoracoabdominal Lesions: A Prospective Multicenter Randomized Trial.

Purpose To compare safety and feasibility between a novel CT-guided robotic system and the conventional freehand technique for puncture biopsy of thoracoabdominal lesions. Materials and Methods In this prospective multicenter randomized trial, individuals with suspected lesions were enrolled between July 2023 and April 2024 across three university teaching hospitals and randomized to the robot-assisted group (n = 82) or the freehand group (n = 83). Procedure outcomes included the technical success rate, targeting error, number of CT scans and needle adjustments, puncture time, and complications. Descriptive and inferential statistics were calculated. Results A total of 165 participants (mean age, 60 years &#xb1; 10 [SD]; 83 male) were included. Compared with the freehand group, the robot-assisted group demonstrated a higher technical success rate (97.56% [80 of 82] vs 62.65% [52 of 83], P < .001), lower targeting error (mean Euclidean deviation: 1.7 mm &#xb1; 1.1 vs 4.5 mm &#xb1; 3.9, P < .001), and fewer CT scans (mean, 4.3 &#xb1; 1.9 vs 5.2 &#xb1; 2.3; P = .002) and needle adjustments (mean, 0.7 &#xb1; 0.7 vs 1.6 &#xb1; 1.6; P = .003). Despite differences in geometric precision, both groups achieved 100% (82 of 82 and 83 of 83) diagnostic yield. The median puncture time was comparable between groups (5.5 minutes &#xb1; 4.3 vs 4.8 minutes &#xb1; 7.0, P = .50). During lung biopsies, the robot-assisted approach yielded fewer complications compared with the freehand approach (4.88% [four of 82] vs 16.87% [14 of 83], P = .014). Conclusion Compared with the freehand approach, robot-assisted biopsy yielded greater precision and reduced adjustments and complications while demonstrating noninferior diagnostic efficacy and comparable duration. Keywords: Robotic Needle Insertion, Biopsy, Thoracoabdominal Lesions, Robot-assisted Biopsy, CT-guided Intervention, Percutaneous Needle Biopsy, Randomized Controlled Trial, Algorithm Development, CT, Clinical Testing, Interventional-Body, Biopsy/Needle Aspiration, Percutaneous, Thorax, Abdomen/GI, Liver, Lung, Kidney &#xa9;RSNA, 2026.

Humans↗

Learning to perform a new movement with robotic assistance: comparison of haptic guidance and visual demonstration.

BACKGROUND: Mechanical guidance with a robotic device is a candidate technique for teaching people desired movement patterns during motor rehabilitation, surgery, and sports training, but it is unclear how effective this approach is as compared to visual demonstration alone. Further, little is known about motor learning and retention involved with either robot-mediated mechanical guidance or visual demonstration alone. METHODS: Healthy subjects (n = 20) attempted to reproduce a novel three-dimensional path after practicing it with mechanical guidance from a robot. Subjects viewed their arm as the robot guided it, so this "haptic guidance" training condition provided both somatosensory and visual input. Learning was compared to reproducing the movement following only visual observation of the robot moving along the path, with the hand in the lap (the "visual demonstration" training condition). Retention was assessed periodically by instructing the subjects to reproduce the path without robotic demonstration. RESULTS: Subjects improved in ability to reproduce the path following practice in the haptic guidance or visual demonstration training conditions, as evidenced by a 30-40% decrease in spatial error across 126 movement attempts in each condition. Performance gains were not significantly different between the two techniques, but there was a nearly significant trend for the visual demonstration condition to be better than the haptic guidance condition (p = 0.09). The 95% confidence interval of the mean difference between the techniques was at most 25% of the absolute error in the last cycle. When asked to reproduce the path repeatedly following either training condition, the subjects' performance degraded significantly over the course of a few trials. The tracing errors were not random, but instead were consistent with a systematic evolution toward another path, as if being drawn to an "attractor path". CONCLUSION: These results indicate that both forms of robotic demonstration can improve short-term performance of a novel desired path. The availability of both haptic and visual input during the haptic guidance condition did not significantly improve performance compared to visual input alone in the visual demonstration condition. Further, the motor system is inclined to repeat its previous mistakes following just a few movements without robotic demonstration, but these systematic errors can be reduced with periodic training.

Journal Article↗

Robots in food systems: a review and assessment of potential uses.

Management personnel in foodservice, food processing, and robot industries were surveyed to evaluate potential job functions for robots in the food industry. The survey instrument listed 64 different food-related job functions that participants were asked to assess as appropriate or not appropriate for robotic implementation. Demographic data were collected from each participant to determine any positive or negative influence on job function responses. The survey responses were statistically evaluated using frequencies and the chi-square test of significance. Sixteen of the 64 job functions were identified as appropriate for robot implementation in food industries by both robot manufacturing and food managers. The study indicated, first, that food managers lack knowledge about robots and robot manufacturing managers lack knowledge about food industries. Second, robots are not currently being used to any extent in the food industry. Third, analysis of the demographic data in relation to the 16 identified job functions showed no significant differences in responses.

Adult↗

Robotic surgery for gastric gastrointestinal stromal tumors: a systematic review.

Robotic surgery is used for selected gastric gastrointestinal stromal tumours (GISTs), particularly when location makes conventional wedge resection difficult. We synthesised technical, perioperative, pathological, functional and oncological outcomes. PubMed/MEDLINE, Scopus and the Cochrane Library were searched from inception to 14 August 2026. Primary reports with at least three eligible robotic gastric-GIST patients were included. Two reviewers independently selected studies, extracted data and completed design-specific JBI appraisal. Because outcome definitions, denominators and reporting were heterogeneous, findings were synthesised narratively in accordance with SWiM guidance rather than pooled. Twenty-three studies, including six comparative cohorts, were included. Institutional robotic cohorts contained 3-45 eligible patients; one national registry included 1,567 robotic cases. Tumour size ranged from 2.68&#x2009;&#xb1;&#x2009;1.55 to 7.9&#x2009;&#xb1;&#x2009;1.8&#xa0;cm among studies reporting means. Most institutional reports described R0 resection in all eligible patients; exceptions were 23/24 and 24/25, while the registry reported 1,425/1,567 R0 resections. Grade III morbidity occurred in 2/25 patients in one function-preserving series. Registry 30- and 90-day mortality after robotic resection were 0.5% and 0.8%, respectively. Comparative studies did not demonstrate superior postoperative or oncological outcomes with robotic surgery. Robotic gastric-GIST resection appears feasible in selected patients and may facilitate organ-preserving surgery at anatomically challenging sites. Current observational evidence does not establish comparative functional, oncological or economic superiority.

Humans↗

Artificial intelligence enabled social robotic interventions (PARO) in Australian dementia care: A systematic review and meta-analysis.

BACKGROUND: Although there is a growing body of research indicating that Personal Robot/Social Robot could be used in various aspects of care for individuals with dementia, little is known about how well these types of interventions work in an actual hospital setting in Australia. AIMS & OBJECTIVES: The objective of the present systematic review and meta-analysis is to assess the effectiveness of PARO-based socially assistive robotic intervention in terms of its effectiveness outcomes towards the reduction of dementia-related behavioural and psychological symptoms in Australian based healthcare settings. METHODS: A systematic search was conducted across five electronic databases, including MEDLINE (PubMed), EMBASE, CINAHL, PsycINFO, and the Cochrane Library, to identify randomised controlled trials (RCTs) investigating PARO-based socially assistive robotic interventions for dementia in Australian healthcare settings. This review was registered with PROSPERO (CRD420251251916) and followed the PRISMA 2020 guidelines. In addition, the Cochrane Risk of Bias tool (RoB 2) was used to evaluate the risk of bias across all studies. Pooled standardised mean differences (SMD) with 95&#xa0;% confidence intervals (CI) were calculated for agitation, anxiety, and depression. Heterogeneity across studies was evaluated using the I2 statistic. RESULTS: Six RCTs involving 1444 participants were identified for inclusion in this review. AI-enabled socially assistive robotic interventions, specifically the PARO therapeutic robot, significantly reduced agitation and anxiety when compared to standard treatment or control conditions. The pooled analysis showed that agitation [SMD&#xa0;=&#xa0;-0.44 (95&#xa0;% CI: -0.70, -0.18) p&#xa0;=&#xa0;0.0008] and anxiety [SMD&#xa0;=&#xa0;-0.59 (95&#xa0;% CI: -0.91, -0.27) p&#xa0;=&#xa0;0.0003] were reduced significantly, while the decrease in depression [SMD&#xa0;=&#xa0;-0.44 (95&#xa0;% CI: -0.95, -0.07) p&#xa0;=&#xa0;0.09] scores was non-significant among dementia patients receiving PARO-based socially assistive robotic interventions as compared to the control. The overall risk of bias across all six studies was considered low to moderate. CONCLUSION: PARO-based socially assistive robotic interventions may provide preliminary evidence of effectiveness in reducing agitation and anxiety in individuals with dementia in Australian healthcare, but the evidence regarding the reduction of depression remains unclear. Therefore, additional high-quality trials with consistent methodology and extended follow-up will be necessary to determine both the short-term and long-term clinical efficacy and practicality of implementing these interventions into practice.

Humans↗