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

BACKGROUND: The optimal technique for intrathoracic esophagogastric anastomosis in esophagectomy remains undetermined. This study evaluates different anastomotic techniques in robot-assisted minimally invasive esophagectomy (RAMIE) and their impact on anastomotic leakage rates. MATERIALS AND METHODS: This observational, retrospective, comparative cohort study analyzed data obtained from the Upper GI International Robotic Association (UGIRA) Esophageal Registry. All consecutive patients with a histologically proven esophageal malignancy who underwent RAMIE with intrathoracic esophagogastrostomy were included. The anastomotic technique was performed based on the clinical judgement and expertise of each individual surgeon. For comparison, the four most common techniques were included: circular end-to-side, linear side-to-side, handsewn end-to-side, and handsewn end-to-end. The primary endpoint of this study was the occurrence of anastomotic leakage, defined by the Esophagectomy Complications Consensus Group as a full-thickness gastrointestinal defect involving the esophagus, anastomosis, staple line, or conduit, regardless of its presentation or method of identification. RESULTS: Between 2016 and September 2023, 1518 patients were included. Univariable analysis demonstrated that the linear stapled side-to-side anastomosis was associated with the lowest anastomotic leakage rate (14.0%), while the handsewn end-to-end anastomosis had the highest (32.8%) (p < 0.001). The anastomotic leakage rates for circular end-to-side and handsewn end-to-side anastomoses were 19.4% and 26.9%, respectively. Multivariable analysis confirmed that anastomotic technique was independently associated with anastomotic leakage. Specifically, handsewn anastomoses were associated with a higher risk of anastomotic leakage for both end-to-side (OR 1.675, 95% CI 1.195-2.348, p = 0.003) and end-to-end (OR 2.181, 95% CI 1.403-3.390, p < 0.001) techniques compared to circular end-to-side anastomoses. CONCLUSIONS: In RAMIE, linear side-to-side and circular end-to-side stapled anastomoses are associated with lower anastomotic leakage rates compared to handsewn techniques. While acknowledging the multifactorial complexity of anastomotic leakage, these findings favor the use of mechanical stapling in clinical practice.

• Klíčová slova
• Anastomotic leakage, Anastomotic technique, Minimally invasive esophagectomy, RAMIE,
• MeSH
• anastomóza chirurgická metody   škodlivé účinky   MeSH
• ezofagektomie * metody   škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony škodlivé účinky   metody   MeSH
• nádory jícnu * chirurgie   MeSH
• netěsnost anastomózy * etiologie   epidemiologie   MeSH
• retrospektivní studie MeSH
• roboticky asistované výkony * škodlivé účinky   metody   MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• srovnávací studie MeSH

PURPOSE: The surgical treatment of endometriosis, which is routinely performed by minimally invasive approach, is developing towards an increasing complexity in deep endometriosis. While RAS appears to be gaining importance, there are few real-life data on its use for patients with endometriosis. The aim of this study is to investigate the current use of RAS in certified endometriosis centers in Central Europe. METHODS: In this international multicentric cross-sectional study, an online branching survey was sent to certified endometriosis centers in Austria, the Czech Republic, Germany, and Switzerland. This survey contained 47 questions including proportion of use, indications, advantages and barriers, technical aspects, and training in RAS. RESULTS: Of the 97 centers contacted, 66% (n = 64) participated. RAS is used for the treatment of endometriosis in 60.8% (n = 31) of the centers with access to a SR, which corresponds to 48.4% of all participating centers. In Austria, 81.8% (n = 9) of centers have SR access, respectively, 88.9% (n = 8) use RAS for endometriosis; in Switzerland, 91.6% (n = 11) and 36.4% (n = 4); and in Germany, 74.4% (n = 29) and 62.1% (n = 18). The reported advantages of RAS include precision (80%, n = 40), instrument mobility (74%, n = 37), and visualization (72%, n = 36). Compared to CLS, RAS is preferred in multidisciplinary cases (84.6%, n = 22), and overweight patients (61.5%, n = 16) and deep endometriosis (61.5%, n = 16). Specific anatomical indications for RAS vs. CLS include FU (57.7%, n = 15), C (53.9%, n = 14), and FB (50%, n = 13) (#Enzian classification). Patient outcomes of RAS compared to CLS are rated as advantageous in 69.2% (n = 18). The main barriers for RAS for centers without an SR include costs (100%, n = 12) and lack of scientific evidence (33.3%, n = 4). 69.2% (n = 18) have dedicated robotic teams, 42.3% (n = 11) have a second console, 69.2% (n = 18) have a simulator, and 34.6% (n = 9) have training programs. A total of 65.4% (n = 17) believes that RAS will replace CLS in selected cases, and 73.1% (n = 19) would prefer RAS if costs were equal. CONCLUSION: This study demonstrates that RAS is already being used in approximately half of the participating endometriosis centers. While the proportion of RAS procedures compared to CLS is increasing, it still remains comparatively low. Country-specific differences in the use of RAS are evident and are most likely linked to healthcare system structures. Participating centers report both technical and general surgical advantages, as well as specific benefits in cases of deep endometriosis. The main barriers include costs and a lack of scientific evidence. Further research is needed to evaluate the long-term role of RAS in the management of endometriosis.

• Klíčová slova
• Deep endometriosis, Endometriosis, Endometriosis centers, Endometriosis surgery, MIGS, MIS, Minimally invasive surgery, RAL, RAS, Robot-assisted laparoscopy, Robot-assisted surgery, Robotic surgery, Robotic-assisted surgery,
• MeSH
• endometrióza * chirurgie   MeSH
• laparoskopie * metody   statistika a číselné údaje   MeSH
• lidé MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• roboticky asistované výkony * statistika a číselné údaje   metody   výchova   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika MeSH
• Německo MeSH
• Rakousko MeSH
• Švýcarsko MeSH

Micro- and nanoplastic pollution is pervasive worldwide, infiltrating drinking water and food chains, accumulating in the human body, and posing serious threats to public health and ecosystems. Despite these urgent challenges, effective strategies to curb the widespread presence of micro- and nanoplastics have not yet been sufficiently developed. Here, we present magnetically driven living bacterial microrobots that exhibit a nature-inspired three-dimensional (3D) swarming motion, allowing the dynamic capture and retrieval of aquatic micro- and nanoplastics originating from various commercial products. By combining autonomous propulsion with magnetically guided navigation, we enabled the multimodal swarming manipulation of magnetotactic bacteria-based living microrobots (MTB biobots). The actuation of a rotating magnetic field induces a fish schooling-like 3D swarming navigation, allowing the active capture of micro- and nanoplastics, which are then retrieved from the contaminated water by magnetic separation. Our results show that the 3D magnetic swarming of MTB biobots synergistically enhances the removal efficiencies of both model and real-world microplastics, demonstrating their practical potential in water treatment technologies. Overall, plastic-seeking living bacterial microrobots and their swarm manipulation offer a straightforward and environmentally friendly approach to micro- and nanoplastic treatment, providing a biomachinery-based solution to mitigate the pressing microplastic pollution crisis.

• Klíčová slova
• biohybrid microrobots, magnetically driven, magnetotactic bacteria, microplastics, nanoplastics, swarming behavior, water purification,
• MeSH
• chemické látky znečišťující vodu * izolace a purifikace   chemie   MeSH
• čištění vody * metody   MeSH
• magnetické pole MeSH
• mikroplasty * izolace a purifikace   chemie   MeSH
• robotika * MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• chemické látky znečišťující vodu * MeSH
• mikroplasty * MeSH

PURPOSE OF THE STUDY: This study aimed to evaluate patients' knowledge and opinions about robotic total hip arthroplasty (THA) and total knee arthroplasty (TKA). MATERIAL AND METHODS: In order to assess patients' knowledge and opinions about robotic THA and TKA surgery, a descriptive questionnaire consisting of a total of 17 questions assessing patients' demographic information (age, gender, education level, occupation, income level, marital status) and their knowledge and opinions about robotic surgery was designed and applied to 200 participants by face-to-face interviews. RESULTS: The mean age of participants was 62.6 ± 7.1 years (range: 43-82), with 53% female. Among participants, 39% were university graduates, 9% were healthcare professionals, and 61.5% had an income between 10,000-20,000 Turkish lira. 60% (n = 120) had information about robotic surgeries, primarily sourced from newspapers, TV (35%), and social media (33%). 68.3% believed robotic surgery positively impacts surgical outcomes, and 77.5% preferred robotic surgery for knee and hip procedures. Those informed via social media had a mean age of 57.6 ± 6.5 years, while those informed through patient recommendations had a mean age of 64.0 ± 6.9 years (p = 0.001). Higher education levels correlated with increased knowledge of robotic surgery (p = 0.001), as did private-sector employment and higher income (p = 0.001, p = 0.001). CONCLUSIONS: This study is an important step to understand the awareness and attitudes of robotic surgery among patients. There is a difference between the level of knowledge of the participants about robotic surgery and real scientific facts. Lack of knowledge and misconceptions about robotic surgery may affect patients' decision-making processes. Orthopaedic surgeons has responsibility to evaluate the new technological products in the light of strong scientific evidence when recommending to their patients. Also, media sources and social media platforms should maintain accurate information on emerging technologies.

• Klíčová slova
• patient's perspectives., robotics surgery, total hip arthroplasty, total knee arthroplasty,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * metody   psychologie   MeSH
• průzkumy a dotazníky MeSH
• roboticky asistované výkony * psychologie   metody   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• totální endoprotéza kolene * metody   psychologie   MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Turecko MeSH

BACKGROUND: Socially assistive robots (SARs) hold promise for supporting older adults (OAs) in hospital settings by promoting social engagement, reducing loneliness, and enhancing emotional well-being. They may also assist health care professionals by delivering information, managing routines, and alleviating workload. However, their acceptability and usability remain major challenges, particularly in dynamic real-world care environments. OBJECTIVE: This study aimed to evaluate the acceptability and usability of a SAR in a geriatric day care hospital (DCH) and to identify key factors influencing its adoption by OAs and their informal caregivers. METHODS: Over the course of 1 year, 97 participants (n=65, 67%, OA patients and n=32, 33%, informal caregivers) took part in a mixed methods evaluation of ARI, a socially assistive humanoid robot developed by PAL Robotics. ARI was deployed in the waiting area of a geriatric day care robot in Paris (France), where it interacted with users through voice-based dialogue. After each session, participants completed 2 standardized assessments, the Acceptability E-scale (AES) and the System Usability Scale (SUS), administered orally to ensure accessibility. Open-ended qualitative feedback was also collected to capture subjective experiences and contextual perceptions. RESULTS: Acceptability scores significantly increased across waves (wave 1: mean 15.4/30, SD 5.81; wave 2: mean 20.9/30, SD 5.25; wave 3: mean 22.5/30, SD 4.23; P<.001). Usability scores also improved (wave 1: mean 47.9/100, SD 24.18; wave 2: mean 57.4/100, SD 22.46; wave 3: mean 69.3/100, SD 16.03; P<.001). A strong positive correlation was observed between acceptability and usability scores (r=0.664, P<.001). Qualitative findings indicated improved ease of use, clarity, and user satisfaction over time, particularly following the integration of a large language model (LLM) in wave 2, leading to more coherent, natural, and context-aware interactions. CONCLUSIONS: Successive system enhancements, most notably the integration of an LLM, led to measurable gains in usability and acceptability among patients and informal caregivers. These findings underscore the importance of iterative, user-centered design in deploying SARs in geriatric care environments. TRIAL REGISTRATION: Approved by the French national ethics committee (CPP Ouest II, IRB: 2021/20) as it did not involve randomization or clinical intervention.

• Klíčová slova
• acceptability, gerontology, hospital environment, human-robot interaction, informal caregivers, large language model, older adults, socially assistive robot, usability,
• MeSH
• lidé středního věku MeSH
• lidé MeSH
• pomůcky pro sebeobsluhu * MeSH
• robotika * přístrojové vybavení   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• velké jazykové modely 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
• Geografické názvy
• Francie MeSH

Inspired by Richard Feynman's 1959 lecture and the 1966 film Fantastic Voyage, the field of micro/nanorobots has evolved from science fiction to reality, with significant advancements in biomedical and environmental applications. Despite the rapid progress, the deployment of functional micro/nanorobots remains limited. This review of the technology roadmap identifies key challenges hindering their widespread use, focusing on propulsion mechanisms, fundamental theoretical aspects, collective behavior, material design, and embodied intelligence. We explore the current state of micro/nanorobot technology, with an emphasis on applications in biomedicine, environmental remediation, analytical sensing, and other industrial technological aspects. Additionally, we analyze issues related to scaling up production, commercialization, and regulatory frameworks that are crucial for transitioning from research to practical applications. We also emphasize the need for interdisciplinary collaboration to address both technical and nontechnical challenges, such as sustainability, ethics, and business considerations. Finally, we propose a roadmap for future research to accelerate the development of micro/nanorobots, positioning them as essential tools for addressing grand challenges and enhancing the quality of life.

• Klíčová slova
• collective behavior, functionality, intelligence, micro/nanorobots, nanotechnology, propulsion, smart materials, technological translation,
• MeSH
• lidé MeSH
• nanotechnologie * metody   MeSH
• robotika * přístrojové vybavení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Self-propelled nano- and micromachines have immense potential as autonomous seek-and-act devices in biomedical applications. In this study, we present microrobots constructed with inherently biocompatible materials and propulsion systems tailored to skin-related applications. Addressing the significant treatment challenge posed by methicillin-resistant Staphylococcus aureus (MRSA) skin infections, we demonstrate that photocatalytic titanium dioxide microrobots decorated with silver or platinum can effectively and rapidly eradicate MRSA biofilms grown on skin-mimicking membranes and porcine skin tissues. These microrobots are powered by hydrogen peroxide or ultraviolet light─agents considered toxic in high concentrations but commonly used in controlled amounts for skin disinfection and naturally encountered by the skin. By examining the effects of different metal coatings on the propulsion abilities of the microrobots, we show that these chemically propelled devices can eliminate biofilms without causing significant damage to the surrounding skin tissues, as confirmed by histological analysis. This work paves the way for the use of microrobots in skin-related biomedical applications, particularly in cases where traditional antibiotics are ineffective.

• Klíčová slova
• Janus particles, biofilm, microrobots, skin infection, titanium dioxide,
• MeSH
• antibakteriální látky * farmakologie   chemie   MeSH
• biofilmy účinky léků   MeSH
• kůže * mikrobiologie   účinky léků   MeSH
• methicilin rezistentní Staphylococcus aureus * účinky léků   fyziologie   MeSH
• peroxid vodíku chemie   farmakologie   MeSH
• platina chemie   farmakologie   MeSH
• prasata MeSH
• robotika * přístrojové vybavení   MeSH
• stafylokokové infekce kůže * farmakoterapie   mikrobiologie   MeSH
• stříbro chemie   farmakologie   MeSH
• titan chemie   farmakologie   MeSH
• ultrafialové záření MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky * MeSH
• peroxid vodíku MeSH
• platina MeSH
• stříbro MeSH
• titan MeSH
• titanium dioxide MeSH Prohlížeč

Ensuring food quality and safety according to stringent global standards requires analytical procedures that are accurate, cost-effective, and efficient. This present innovative high-throughput microrobots designed for the detection of antioxidants in food samples. These microrobots consist of photocatalytic bismuth subcarbonate anchored on silica-coated magnetite nanoparticles. Upon exposure to UV light, they generate reactive oxygen species via photocatalysis, which oxidize the colorless dye into a green-colored radical cation. The presence of antioxidants inhibits this reaction, allowing for the quantification of antioxidant activity. The magnetic Fe₃O₄/SiO₂ core enables steering of the microrobots using a transverse rotating magnetic field, facilitating automated assays on a custom-designed 3D-printed sensing platform. This results demonstrate that these magneto-photocatalytic microrobots can perform automated, high-throughput assessments of food quality, representing a significant advancement in food analysis technology.

• Klíčová slova
• food analysis, microrobots, nanorobots,
• MeSH
• analýza potravin * metody   přístrojové vybavení   MeSH
• antioxidancia analýza   MeSH
• kvalita jídla * MeSH
• magnetické nanočástice chemie   MeSH
• oxid křemičitý chemie   MeSH
• řízení kvality MeSH
• robotika * přístrojové vybavení   MeSH
• rychlé screeningové testy * metody   přístrojové vybavení   MeSH
• ultrafialové záření MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antioxidancia MeSH
• magnetické nanočástice MeSH
• oxid křemičitý MeSH

The objective of this study is to undertake a narrative review of the oncological adequacy of mediastinal lymphadenectomy performed via robot-assisted thoracic surgery (RATS) in comparison with video-assisted thoracic surgery (VATS) and thoracotomy for non-small cell lung cancer (NSCLC). The focus of the review is on lymph node yield, nodal station dissection, and nodal upstaging rates. A narrative review of literature published in the last decade was conducted using PubMed, Cochrane, and Web of Science databases. Studies examining mediastinal lymphadenectomy outcomes for RATS, VATS, or thoracotomy were included in the discussion. The analysis of 19 studies from diverse geographical regions showed that in six out of nine comparative studies, RATS demonstrated superior lymph node retrieval compared to VATS, with statistically significant differences. RATS achieved comparable or superior nodal station dissection rates and showed particular advantages in upstaging from clinical N0 to pathological N2 status. Additionally, RATS demonstrated favourable perioperative outcomes with reduced morbidity and mortality rates compared to conventional approaches. RATS represents a reliable and oncologically sound approach to mediastinal lymphadenectomy, with potential advantages over conventional techniques. Its enhanced visualization and precision make it an increasingly utilised option for NSCLC treatment in centres with robotic capabilities.

• Klíčová slova
• Lung cancer, Mediastinal lymphadenectomy, Robotic-assisted surgery, Summary, Thoracic surgery,
• MeSH
• hrudní chirurgie video-asistovaná metody   MeSH
• lidé MeSH
• lymfadenektomie * metody   MeSH
• mediastinum chirurgie   MeSH
• nádory plic * chirurgie   patologie   MeSH
• nemalobuněčný karcinom plic * chirurgie   patologie   MeSH
• roboticky asistované výkony * metody   MeSH
• torakotomie metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH