BACKGROUND: The integration of robotic technology into surgical procedures has gained considerable attention for its promise to enhance a variety of clinical outcomes. Robotic deep inferior epigastric perforator (DIEP) flap harvest has emerged as a novel approach for autologous breast reconstruction. This systematic review aims to provide a comprehensive overview of the current techniques, outcomes, and complications of robotic DIEP flap surgery. METHODS: A systematic literature search was conducted after PRISMA 2020 guidelines across databases including PubMed, Embase, Google Scholar, and Web of Science from 2000 to 2023. Articles exploring robotic DIEP flap harvest for breast reconstruction were assessed to compare operative techniques, clinical outcomes, and complications. The risk of bias was evaluated using ROBINS-I and the Newcastle-Ottawa scale. RESULTS: Fourteen studies involving 108 patients were included. Three studies used a totally extraperitoneal (TEP) technique, whereas 11 studies used a transabdominal preperitoneal (TAPP) approach. Preoperative planning utilized computed tomography angiography and magnetic resonance angiography imaging. The mean robotic operative time was 64 minutes, with total operative times averaging 574 minutes for TAPP and 497 minutes for TEP. The mean length of stay was 5 days, and the mean fascial incision length was 3 cm. Overall complication rate was 14.9%, with no significant difference compared with conventional DIEP flap procedures. CONCLUSION: Robotic DIEP flap harvest is a promising technique that may reduce postoperative pain and limiting abdominal donor site morbidity. Potential limitations include longer operative times, variable hospital stays, and increased costs.

• MeSH
• arteriae epigastricae * transplantace   MeSH
• délka operace * MeSH
• délka pobytu MeSH
• lidé MeSH
• mamoplastika * metody   MeSH
• odběr tkání a orgánů metody   MeSH
• perforátorový lalok * krevní zásobení   MeSH
• pooperační komplikace prevence a kontrola   MeSH
• roboticky asistované výkony * metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

INTRODUCTION: Robotic pancreaticoduodenectomy ranks among the routinely performed surgical procedures in world pancreatic centres. Since 2023, it has also been performed in the Czech Republic. CASE REPORT: We present a case of a 65-year-old patient with accidentally found dilatation of the pancreatic duct. During the examination, a small tumor in the head of the pancreas was diagnosed. A robotic pancreaticoduodenectomy was performed. Due to the perioperative suspicion of invasion into the portal vein, the resection was performed. The operation and the course of hospitalization were uncomplicated, the patient was discharged on the 9th postoperative day. CONCLUSION: Robotic pancreaticoduodenectomy is a method that combines the advantages of a minimally invasive approach and meets the requirements for safety and oncological radicality. Suspected venous invasion is not an obstacle to completing robotic surgery.

• Klíčová slova
• PDE, Pancreatic cancer, Whipple, mini-invasive pancreatic surgery, pancreatic cancer, robotic pancreaticoduodenectomy,
• MeSH
• lidé MeSH
• nádory slinivky břišní * chirurgie   patologie   MeSH
• pankreatoduodenektomie * metody   MeSH
• roboticky asistované výkony * MeSH
• senioři MeSH
• vena portae * chirurgie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: With the introduction of the Da Vinci Xi robotic system, there has been an exponential development of robot-assisted surgical interventions. The benefits of robotic surgery are also successfully used in the field of pancreatic surgery. We present a case report of a 24-year-old female with solid pseudopapillary neoplasia of the pancreas operated on using this robotic system. CASE REPORT: A young female patient with symptomatic solid pseudopapillary neoplasia of the cauda of the pancreas underwent robot-assisted spleen-preserving distal pancreatectomy (the Kimura procedure). The operation was performed according to the plan with the use of the Da Vinci Xi robotic system without complications. The post-operative course was smooth with subsequent discharge on the sixth postoperative day. Further postoperative development was favorable and the patient is in good general condition six months after the operation. CONCLUSION: Robot-assisted surgical procedures also bring a number of advantages to the field of pancreatic surgery, which can be achieved safely and minimally invasively even in anatomically unfavorable terrain with the help of a robotic system. Although presenting a technically challenging method, it is a safe method in the treatment of benign and low-grade malignant pancreatic neoplasia.

• Klíčová slova
• Pancreas, distal pancreatectomy, pancreas, pancreatic neoplasm, robotic surgery,
• MeSH
• léčba šetřící orgány MeSH
• lidé MeSH
• mladý dospělý MeSH
• nádory slinivky břišní * chirurgie   MeSH
• pankreatektomie * metody   MeSH
• papilární karcinom * chirurgie   MeSH
• roboticky asistované výkony * MeSH
• slezina MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVES: In an effort to maintain the technical aspects of traditional prosthetic surgical aortic valve replacement (AVR) while reducing invasiveness and facilitate options for concomitant operations, transaxillary lateral mini-thoracotomy endoscopic robotic-assisted aortic valve replacement (RAVR) has been introduced. The present data highlight the contemporary international collaborative experience. METHODS: All consecutive patients undergoing standardized RAVR across 10 international sites (1/2020-7/2024) were evaluated using a central database with 1 year follow-up. RESULTS: A total of 300 patients were analysed with a median predicted risk of 1.6% with aortic stenosis in 85.7%, nearly half with bicuspid valves. Biological prostheses were implanted in 220 (73.3%) with a median valve size 23 mm, 10% receiving aortic root enlargement, with 17% of all patients undergoing concomitant procedures. Median cross-clamp 120 min with no conversions to sternotomy. Median length of stay was 5 days, 4.3% with prolonged ventilation, 1.7% renal failure, 1.0% stroke and 8.3% required re-thoracotomy for evacuation of haemothorax. There were two 30-day operative mortalities (0.7%). The new permanent pacemaker rate for the full cohort was 2.6%. Of 163 patients with complete 1-year clinical and echocardiographic follow-up, mean aortic valve gradient was 10 mmHg and all but 2 patients (1.2%) had trace to no prosthetic or paravalvular insufficiency. CONCLUSIONS: RAVR is safe and effective, providing the reproducible benefits of surgical AVR while affording a less invasive approach that permits the opportunity for concomitant procedures. For low and intermediate risk patients with aortic valve disease, RAVR is a potential reproducible alternative for patients and heart teams.

• Klíčová slova
• Robotic valve surgery, Robotic-assisted aortic valve replacement,
• MeSH
• aortální chlopeň * chirurgie   MeSH
• aortální stenóza * chirurgie   MeSH
• chirurgická náhrada chlopně * metody   škodlivé účinky   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• následné studie MeSH
• roboticky asistované výkony * metody   škodlivé účinky   mortalita   statistika a číselné údaje   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční chlopně umělé MeSH
• torakotomie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

Minimally invasive surgery is the method of choice in endometrial cancer. Experience in procedures assisted by a robotic system is growing rapidly. One of the new bipolar ones is a Vessel Sealer, with sealing and cutting function. The aim of the study was to compare robotic surgery assisted with the da Vinci X system with use of the Vessel Sealer or without it. The study included 25 patients with high-risk endometrial cancer after completed pelvic and paraaortic lymphadenectomy with mean age 60.07 ± 10.67 (range 34.69-83.23) years divided into two groups: one with use of the Vessel Sealer; the second one only with monopolar scissors and subdivided by one-site versus dual docking. Duration of the operation was significantly associated with previous surgery (p < 0.005). Use of the Vessel Sealer was associated with lower blood loss during surgery (p < 0.05). The number of removal pelvic lymph nodes was higher in case of Vessel Sealer with no relation to BMI. Experience in robotic surgery allowed for shortened operation time and led to better outcomes. The Vessel Sealer used in robotic surgery appears to reduce blood loss during surgery and operation time, especially in the case of previous surgery, however, it increases costs of the procedure.

• Klíčová slova
• Bipolar device, Endometrial cancer, Paraaortic lymphadenectomy, Robotic surgery,
• MeSH
• délka operace MeSH
• dospělí MeSH
• krvácení při operaci prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfadenektomie * metody   MeSH
• nádory endometria * chirurgie   patologie   MeSH
• roboticky asistované výkony * metody   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVES: Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item. METHODS: A systematic review was performed to identify the impact of each single ERAS item on RC outcomes. Embase and Medline (through Pubmed) were searched systematically. Relevant articles were selected and graded. For each ERAS item, a level of evidence was determined. An e-Delphi consensus was then performed amongst an international panel with renowned experience in RC to provide recommendations based on expert opinion. KEY FINDINGS AND LIMITATIONS: Preoperative medical optimization and avoiding bowel preparation are highly recommended. Robotic-assisted RC with intracorporeal urinary diversion is moderately recommended and can help in applying other ERAS items, such as early mobilization. Medical thromboprophylaxis should be administered and nasogastric tube should be removed at the end of surgery. Perioperative fluid restriction as well as opioid-sparing anesthesia protocols should be implemented. Generally, consensus was reached on most ERAS items, with the exception of epidural anesthesia (no consensus), resection site drainage (consensus against), and type of urinary drainage. Limitations include the lack of a multidisciplinary approach to the present consensus, giving however a highly specialized surgical opinion on ERAS. CONCLUSIONS: and clinical implications: The current study updates ERAS recommendations for patients undergoing RC and suggests application of ERAS by a panel of experts in the field.

• Klíčová slova
• Complications, Cystectomy, Enhanced recovery after surgery, Guidelines,
• MeSH
• časné pohybování MeSH
• chirurgové MeSH
• cystektomie * metody   MeSH
• diverze moči metody   MeSH
• lidé MeSH
• nádory močového měchýře chirurgie   MeSH
• roboticky asistované výkony MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• urychlená pooperační rehabilitace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

Limited evidence exists about preserving neurovascular bundles during radical prostatectomy (RP) for high-risk prostate cancer (HRPCa) patients. Hence, we validated an existing algorithm predicting contralateral extraprostatic extension (cEPE) risk in unilateral high-risk cases. This algorithm aims to assist in determining the suitability of unilateral nerve-sparing RP. Among 264 patients, 48 (18%) had cEPE. The risk of cECE varied: 8%, 17.2%, and 30.8% for the low, intermediate, and high-risk groups, respectively. Despite a higher risk of cECE among individuals classified as low-risk in the development group compared to the validation group, our algorithm's superiority over always/never nerve-sparing RP was reaffirmed by decision curve analysis. Therefore, we conclude that bilateral excision may not always be justified in men with unilateral HRPCa. Instead, decisions can be based on our suggested nomogram.

• MeSH
• algoritmy * MeSH
• hodnocení rizik MeSH
• individualizovaná medicína metody   MeSH
• léčba šetřící orgány * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prostaty * chirurgie   patologie   MeSH
• nomogramy MeSH
• prostata * chirurgie   inervace   patologie   MeSH
• prostatektomie * metody   MeSH
• roboticky asistované výkony * metody   MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH

Figure-ground organisation is a perceptual grouping mechanism for detecting objects and boundaries, essential for an agent interacting with the environment. Current figure-ground segmentation methods rely on classical computer vision or deep learning, requiring extensive computational resources, especially during training. Inspired by the primate visual system, we developed a bio-inspired perception system for the neuromorphic robot iCub. The model uses a hierarchical, biologically plausible architecture and event-driven vision to distinguish foreground objects from the background. Unlike classical approaches, event-driven cameras reduce data redundancy and computation. The system has been qualitatively and quantitatively assessed in simulations and with event-driven cameras on iCub in various scenarios. It successfully segments items in diverse real-world settings, showing comparable results to its frame-based version on simple stimuli and the Berkeley Segmentation dataset. This model enhances hybrid systems, complementing conventional deep learning models by processing only relevant data in Regions of Interest (ROI), enabling low-latency autonomous robotic applications.

• MeSH
• deep learning MeSH
• lidé MeSH
• neuronové sítě MeSH
• počítačová simulace MeSH
• robotika * přístrojové vybavení   metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

In the dynamic realm of translational nanorobotics, the endeavor to develop nanorobots carrying therapeutics in rational in vivo applications necessitates a profound understanding of the biological landscape of the human body and its complexity. Within this landscape, biological membranes stand as critical barriers to the successful delivery of therapeutic cargo to the target site. Their crossing is not only a challenge for nanorobotics but also a pivotal criterion for the clinical success of therapeutic-carrying nanorobots. Nevertheless, despite their urgency, strategies for membrane crossing in translational nanorobotics remain relatively underrepresented in the scientific literature, signaling an opportunity for further research and innovation. This review focuses on nanorobots with various propulsion mechanisms from chemical and physical to hybrid mechanisms, and it identifies and describes four essential biological membranes that represent the barriers needed to be crossed in the therapeutic journey of nanorobots in in vivo applications. First is the entry point into the blood stream, which is the skin or mucosa or intravenous injection; next is the exit from the bloodstream across the endothelium to the target site; further is the entry to the cell through the plasma membrane and, finally, the escape from the lysosome, which otherwise destroys the cargo. The review also discusses design challenges inherent in translating nanorobot technologies to real-world applications and provides a critical overview of documented membrane crossings. The aim is to underscore the need for further interdisciplinary collaborations between chemists, materials scientists and chemical biologists in this vital domain of translational nanorobotics that has the potential to revolutionize the field of precision medicine.

• MeSH
• buněčná membrána * metabolismus   chemie   MeSH
• lékové transportní systémy MeSH
• lidé MeSH
• nanotechnologie MeSH
• robotika MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Minimally invasive surgical techniques, including endoscopic and robotic procedures, continue to revolutionize patient care, for their ability to minimize surgical trauma, thus promoting faster recovery and reduced hospital stays. Yet, the suturing of soft tissues ensuring damage-free tissue bonding during these procedures remains challenging due to missing haptics and the fulcrum effect. Laser tissue soldering has potential in overcoming these issues, offering atraumatic seamless tissue fusion. To ensure the precision and safety of laser tissue soldering, the study introduces feedback-controlled fluorescent nanothermometry-guided laser tissue soldering using nanoparticle-protein solders within endoscopic and robotic contexts. Temperature-sensitive fluorescent nanoparticles embedded in the solder provide surgeons with immediate feedback on tissue temperatures during laser application, all while within the confines of minimally invasive (robotic) surgical setups. By integrating fluorescent nanothermometry-guided laser tissue surgery into endoscopic and robotic surgery, the study paves the way for a new approach for safe and atraumatic soft tissue joining, especially in regions where traditional suturing is unfeasible.

• Klíčová slova
• feedback control, laparoscopy, minimally invasive surgery, nanomaterials, suturing,
• MeSH
• lasery MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony * metody   MeSH
• nanočástice MeSH
• roboticky asistované výkony * metody   MeSH
• termometrie * metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH