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PubMed2026

Robotic-assisted transbronchial biopsy versus computed tomography-guided transthoracic needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis of direct comparative studies.

Robotic-assisted bronchoscopy (RAB) and computed tomography-guided transthoracic biopsy (CTTB) are competing strategies for sampling peripheral pulmonary lesions (PPLs). Whether they differ in yield or safety is uncertain. To our knowledge, this is the first systematic review restricted to direct comparisons. We searched MEDLINE, Europe PMC, Scopus, Web of Science and ClinicalTrials.gov from inception to 7 July 2026 for studies directly comparing RAB with CTTB in adults with PPLs. The primary outcome was strict 2024 American Thoracic Society/American College of Chest Physicians diagnostic yield. Risk of bias was assessed with ROBINS-I and certainty with GRADE. A cohort-genealogy step identified, per outcome, the largest set of cohorts sharing no patients; only that set was pooled, with Hartung-Knapp and Mantel-Haenszel sensitivity analyses. Five retrospective studies from one US health system were eligible. Four share patients; at most three cohorts are mutually independent. Across those three, diagnostic yield was comparable (risk ratio [RR] 0.99, 95% confidence interval [CI] 0.93-1.06; I²=24%; Hartung-Knapp 0.87-1.13), with an identical relative effect under strict and intermediate definitions although absolute yields fell from 88% to 74-84% under strict criteria. Pneumothorax requiring a chest tube and/or admission was about three-quarters less frequent with RAB across all three cohorts (RR 0.25, 95% CI 0.14-0.46; I²=0%; Hartung-Knapp 0.07-0.96). Strict yield (RR 0.99) and any pneumothorax (RR 0.06) were reported by two cohorts each and neither survives the few-studies correction. RAB took about 50 min longer than CTTB where same-session staging endobronchial ultrasound was counted in the robotic time, but only about 8 min longer than CTTB where it was not. Only one cohort reported yield by lesion size category and none reported yield by bronchus sign or lung zone, so lesion-level subgroups could not be pooled. Certainty was low for pleural complications and very low elsewhere. Low-certainty evidence indicates that RAB is associated with fewer pleural complications, with no statistically detectable difference in diagnostic yield; equivalence was not formally established. Because all evidence is retrospective, confined to one health system, and almost never stratified by lesion size or accessibility, these findings are hypothesis-generating and require a multicenter randomized trial.

Humans↗

PubMed2026

Robot-assisted bladder diverticulectomy in adults: a systematic review and pooled analysis of perioperative and functional outcomes.

Robot-assisted bladder diverticulectomy (RABD) is used for symptomatic acquired bladder diverticula, but evidence is dispersed across small single-centre series and the only dedicated systematic review dates from 2010. We reviewed contemporary perioperative and functional outcomes of RABD. Following a protocol registered on the Open Science Framework ( https://doi.org/10.17605/OSF.IO/54CFT ), PubMed, Embase, the Cochrane Library, Scopus and Web of Science were searched from inception to 30 August 2026 (initial search June 2026, re-run and broadened for this version), following PRISMA 2020. Eligible studies were original series of five or more adults undergoing robot-assisted bladder diverticulectomy reporting extractable outcomes. Two reviewers independently screened, extracted data and appraised risk of bias with the Joanna Briggs Institute checklist for case series, with third-reviewer adjudication. Binary outcomes were pooled as proportions with Wilson 95% confidence intervals (CI); continuous outcomes were summarised as patient-number-weighted descriptive values, because mixed median/mean reporting and clinical heterogeneity precluded a formal pooled-effect meta-analysis. Twelve studies (146 patients) were included and all outcomes were extracted from the full-text reports. A transperitoneal route was used throughout. There were no conversions to open surgery (0/129; 95% CI 0-2.9%). Major complications (Clavien-Dindo ≥ III) occurred in 3.0% (4/135; 95% CI 1.2-7.4%). Patient-number-weighted descriptive values (combining study-level medians and means, and therefore not a pooled mean) were: operative time 163 min, blood loss 99 mL, length of stay 3.6 days and catheter duration 7.7 days. Symptom scores and post-void residual improved in every reporting series, significantly in five. The single non-randomised comparison with open surgery reported fewer major complications after RABD (5% [1/20] vs. 50% [3/6], p = 0.007), but the open arm comprised only six patients and this finding should not be regarded as comparative evidence. Across these series, RABD was feasible with low reported short-term morbidity in selected patients: no conversions to open surgery were recorded in the studies reporting conversion status, the major-complication rate was low, and symptom scores and post-void residual improved in every series that measured them. A minority of patients had an incidentally detected intradiverticular tumour; oncological outcomes were not an endpoint of this review. Evidence remains limited by small, heterogeneous, mostly retrospective series, so these findings should be read as descriptive; prospective comparative data are warranted.

Humans↗

PubMed2026

How I do it: 3-Suture robotic pyeloplasty: Step-by-step technique.

Robot-assisted pyeloplasty is now a gold standard in the treatment of pediatric ureteropelvic junction obstruction. We describe a standardized "3-suture" technique designed to facilitate the pyelo-ureteral anastomosis. We used this technique in 65 paediatric patients aged 3-17 years. Early major complications (Clavien-Dindo grade III) occurred in 3 patients (4.6%). The median operative time was 150 min. Surgical success was achieved in 96% of cases at a median follow-up of 9.5 months. This 3-suture approach offers a highly reproducible method for robotic pyeloplasty, facilitating accurate anatomical reconstruction with excellent surgical outcomes.

Humans↗

PubMed2005

Technologic advances in Robotic Surgery.

Medical science has achieved enormous accomplishments during the past couple of decades. These advances encompass the list of techniques involving manipulations of DNA and stem cells to minimally invasive techniques. The recent advances in integration of computer sciences, biomechanics and electronic miniaturization have made it possible to make the surgical techniques less invasive and highly precise. Much progress has been made in integrating robotic technologies with surgical instrumentation, as evident by thousands of successful robot-assisted surgical procedures. Such advances will enable continued progress in surgical instrumentation and, ultimately, surgical care.

Humans↗

PubMed1997

Robotic radiosurgery with noncylindrical collimators.

In radiosurgery, a moving beam of radiation acts as an ablative surgical instrument. Conventional systems for radiosurgery use a cylindrical radiation beam of fixed cross section. The radiation source can be moved only along simple, standardized paths. A new radiosurgical system based on a six-degree-of-freedom robotic arm has been developed to overcome limitations of conventional systems. We address the following question: Can dose distributions generated by robotic radiosurgery be improved by using noncylindrical radiation beams? This includes static noncylindrical collimators and collimators of adaptable cross section. Geometric methods for planning the shape of the beam in addition to planning beam motion are developed. Design criteria considered in this context are treatment time, radiation penumbra, and transparency of interactive treatment planning. An experimental evaluation compares distributions generated with our new radiosurgical system using cylindrical beams to distributions generated with beams of adaptable, noncylindrical shapes.

Computer Simulation↗

PubMed1998

Robotic three-dimensional positioning of a stimulation electrode in the brain.

Functional stereotactic cerebral operations are currently performed with straight electrodes. After physiological exploration, correction of the initial target is frequently necessary and requires multiple penetrations of the brain. This paper describes a robotic three-dimensional electrode probe that can reach targets located within a cylindrical volume from a single approach trajectory. It has been mounted on the neurosurgical robot Minerva, and includes a string electrode, which can protrude out of the side window of a straight cannula and offers a high intrinsic accuracy of 0.25 mm. A simple man-machine interface allows the surgeon to select reference and target points and to activate the probe from a graphics workstation. This paper also analyzes the accuracy of the probe as well as of the whole operating system, food gelatin being used to simulate brain matter.

Brain↗

PubMed1998

Robot-assisted surgery system with kinesthetic feedback.

The better understanding of the systems of the human body and their specific functions has led to minimally invasive and microsurgical procedures being carried out on an ever smaller scale. New therapies will require precision of 10 microm or better, which will only be achievable with robotic teleoperators. Experience with existing robot-assisted surgery systems shows that the human-machine interface is a critical component for acceptance of this technology, but no universally satisfactory interface has yet been found. Therefore, this article investigates a new concept based on kinesthetic motion feedback and presents details of the implementation of a first prototype.

Feedback↗

PubMed1995

Registration and immobilization in robot-assisted surgery.

Robotic systems for computer-assisted surgery involve both tools and techniques that are new to the surgical arena. Registration and immobilization in particular are key problems. Registration is the spatial alignment of the coordinate frames of the robot, an anatomic object (e.g., a bone), and the preoperative plan (a computer model). Immobilization is necessary to maintain that alignment. We discuss various approaches to registration and immobilization and solutions appropriate for an orthopedic surgical system.

Ankle Joint↗

PubMed1995

Neurosurgical robot Minerva: first results and current developments.

We describe the development and approach to clinical application of the neurosurgical robot Minerva, including the mechanical structure of the robot and the software developed to perform intracranial neurosurgical operations with accuracy, smoothness, and safety. The first eight operations have been undertaken on patients requiring stereotactic brain biopsy. We describe the ongoing developments, including improved sterilization features, force sensors, nonlinear electrostimulation probe, and implantation of living encapsulated cells, all of which have entered a test phase. The goals are increased safety and capability to perform simple three-dimensional operations. This research should ease the way for new complex operations that are difficult to perform manually today.

Biopsy↗

PubMedDate not supplied

Robotic solid phase extraction and high performance liquid chromatographic analysis of ranitidine in serum or plasma.

A fully automated assay for the analysis of ranitidine in serum and plasma, with and without an internal standard, was validated. It utilizes robotic solid phase extraction with on-line high performance liquid chromatographic (HPLC) analysis. The ruggedness of the assay was demonstrated over a three-year period. A Zymark Py Technology II robotic system was used for serial processing from initial aspiration of samples from original collection containers, to final direct injection onto the on-line HPLC system. Automated serial processing with on-line analysis provided uniform sample history and increased productivity by freeing the chemist to analyse data and perform other tasks. The solid phase extraction efficiency was 94% throughout the assay range of 10-250 ng/mL. The coefficients of variation for within- and between-day quality control samples ranged from 1 to 6% and 1 to 5%, respectively. Mean accuracy for between-day standards and quality control results ranged from 97 to 102% of the respective theoretical concentrations.

Biological Availability↗

PubMed1998

High-throughput robotic system for sequencing of microbial genomes.

A high-throughput robotic workstation system was used for double-stranded plasmid DNA template preparation and sequencing reaction setup to streamline the sequencing process in genome projects. All 96-well miniprep kits that were tested provided high quality plasmid DNA suitable for fluorescent DNA sequencing. After quantitation in a 96-well UV spectrophotometer, the plasmid DNA was used as template to automatically set up sequencing reactions. The setup was controlled by spread sheets that were imported into the robotic system. We utilized this integrated system to prepare all necessary shotgun templates for our contributions to a number of large-scale genome projects as well as a full-length cDNA sequencing project.

Arabidopsis↗

PubMed2001

URobotics--Urology Robotics at Johns Hopkins.

URobotics (Urology Robotics) is a program of the Urology Department at the Johns Hopkins Medical Institutions dedicated to the development of new technology for urologic surgery (http://urology.jhu.edu/ urobotics). The program is unique in that it is the only academic engineering program exclusively applied to urology. The program combines efforts and expertise from the medical and engineering fields through a close partnership of clinical and technical personnel. Since its creation in 1996, the URobotics lab has created several devices, instruments, and robotic systems, several of which have been successfully used in the operating room. This article reviews the technology developed in our laboratory and its surgical applications, and highlights our future directions.

Baltimore↗

PubMed1989

Automated robotic extraction and subsequent analysis of diclofenac in plasma samples.

Diclofenac sodium (Voltaren;sodium[O-(2,6-dichloroanilino)phenyl]acetate), an effective, well-tolerated anti-inflammatory agent, is almost completely metabolized in humans and animals. The present article describes an automated procedure involving liquid-liquid extraction and subsequent HPLC analysis to determine unchanged diclofenac in human plasma. This procedure offers several advantages over current manual GC and HPLC methods. The transfer of the original manual procedure to an automated robotic system, with custom-made modules for solvent evaporation and HPLC injection, is described, and a comparison between the manual and automated procedure is drawn. The robotic method gave satisfactory accuracy and precision in the range of 0.02 to 3 micrograms/mL, with a quantitation limit of 0.02 micrograms/mL.

Autoanalysis↗

PubMed1988

Robotized scanning laser handpiece for the treatment of port wine stains and other angiodysplasias.

Port wine stains are currently treated by the argon laser with the "point-by-point" technique, or the "painting technique." In both cases, the quality of the results depends greatly on the dermatologist's experience. Furthermore, the first technique is slow, and the second is painful and requires anesthesia. Therefore, we have decided to design a robotized system with the following specifications: easy, fast, non-painful treatment giving a homogeneous and reproducible blanching. The system is made of a handpiece with the scanning mechanism and a control box with the microprocessor. The system is independent of the laser (no electrical connection) and has its own power meter. The deposit of energy was optimized in function of heat diffusion in the skin. Over a 12-month period, 123 patients were treated with the robotized handpiece. The treatment modalities and the results conformed to the above-mentioned specifications. Hypertrophic scars were not reported. Therefore, we think that this system will be an interesting tool for the laser treatment of port wine stains and other cutaneous angiodysplasias.

Adolescent↗

PubMed2005

Contact force measurement of instruments for force-feedback on a surgical robot: acceleration force cancellations based on acceleration sensor readings.

For delicate operations conducted using surgical robot systems, surgeons need to receive information regarding the contact forces on the tips of surgical instruments. For the detection of this contact force, one of the authors previously proposed a new method, called the overcoat method, in which the instrument is supported by sensors positioned on the overcoat pipe. This method requires cancellation of the acceleration forces of the instrument/holder attached to the overcoat sensor. In the present report, the authors attempt to use acceleration sensors to obtain the acceleration forces of the instrument/holder. The new cancellation method provides a force-detection accuracy of approximately 0.05-0.1 N for a dynamic response range of up to approximately 20 Hz, compared to approximately 1 Hz, which was achieved by using acceleration forces based on the theoretical robot motion.

Acceleration↗

PubMed2005

Laparoscope self-calibration for robotic assisted minimally invasive surgery.

For robotic assisted minimal access surgery, recovering 3D soft tissue deformation is important for intra-operative surgical guidance, motion compensation, and prescribing active constraints. We propose in this paper a method for determining varying focal lengths of stereo laparoscope cameras during robotic surgery. Laparoscopic images typically feature dynamic scenes of soft-tissue deformation and self-calibration is difficult with existing approaches due to the lack of rigid temporal constraints. The proposed method is based on the direct derivation of the focal lengths from the fundamental matrix of the stereo cameras with known extrinsic parameters. This solves a restricted self-calibration problem, and the introduction of the additional constraints improves the inherent accuracy of the algorithm. The practical value of the method is demonstrated with analysis of results from both synthetic and in vivo data sets.

Algorithms↗

PubMed2005

Robot-assisted image-guided targeting for minimally invasive neurosurgery: planning, registration, and in-vitro experiment.

This paper present a novel image-guided system for precise automatic targeting in keyhole minimally invasive neurosurgery. The system consists of a miniature robot fitted with a mechanical guide for needle/probe insertion. Intraoperatively, the robot is directly affixed to a head clamp or to the patient skull. It automatically positions itself with respect to predefined targets in a preoperative CT/MRI image following an anatomical registration with a intraoperative 3D surface scan of the patient facial features. We describe the preoperative planning and registration modules, and an in-vitro registration experiment of the entire system which yields a target registration error of 1.7 mm (std = 0.7 mm).

Craniotomy↗

PubMed2005

Soft-tissue motion tracking and structure estimation for robotic assisted MIS procedures.

In robotically assisted laparoscopic surgery, soft-tissue motion tracking and structure recovery are important for intraoperative surgical guidance, motion compensation and delivering active constraints. In this paper, we present a novel method for feature based motion tracking of deformable soft-tissue surfaces in totally endoscopic coronary artery bypass graft (TECAB) surgery. We combine two feature detectors to recover distinct regions on the epicardial surface for which the sparse 3D surface geometry may be computed using a pre-calibrated stereo laparoscope. The movement of the 3D points is then tracked in the stereo images with stereo-temporal constrains by using an iterative registration algorithm. The practical value of the technique is demonstrated on both a deformable phantom model with tomographically derived surface geometry and in vivo robotic assisted minimally invasive surgery (MIS) image sequences.

Algorithms↗