Robotic telesurgery is a technology that doctors use advanced surgical robots and network communication technology to carry out surgery on patients in different places. Robotic telesurgery can sink high-quality medical resources to serve patients in remote areas， and can also be used for emergency rescue， disaster relief， battlefield and other special occasions to provide patients with timely， effective and high-quality surgical treatment， as well as reducing medical costs and patient transport risks. With the rapid development of the fifth generation wireless network， low latency and high broadband communication are provided for robotic telesurgery， and faster and more accurate real-time data transmission makes it possible to carry out complex surgery remotely. In this review， the current situation of robotic telesurgery at home and abroad is described， and the future of robotic telesurgery is prospected.

Objective To analyze the clinical efficacy of intelligent wireless endoscopy in transurethral resection of the prostate, so as to provide evidence for clinical application. Methods A retrospective analysis was conducted on the clinical data of 70 patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate at Tongling People's Hospital during Jan. 2023 and Dec. 2024. Based on the type of endoscopes used, patients were divided into a wireless endoscopy group and a traditional endoscopy group, with 35 patients in either group. Differences between the two groups were compared in terms of surgical preparation time, operation time, postoperative hospital stay, catheter indwelling time, intraoperative blood loss, surgical complications, and operating comfort during the procedure. Results All 70 operations were successfully completed without severe urinary incontinence. The wireless laparoscopy group demonstrated significantly shorter surgical preparation time compared to the traditional laparoscopy group [(12.14±2.39)min vs. (14.89±0.80)min, P＜0.001].There was no statistically significant difference in the operation time between the two groups [(93.51±34.49)min vs. (101.71±34.87)min, P=0.326]. There were no statistically significant differences between the two groups in postoperative hospital stay, catheter indwelling time, intraoperative blood loss, and surgical complications (P＞0.05). The wireless endoscopy group demonstrated significantly higher operating comfort compared to the traditional endoscopy group [(3.94±0.77) vs. (2.57±0.61), P＜0.001]. Conclusion The use of intelligent wireless endoscopy for transurethral resection of the prostate is comparable to traditional endoscopy in surgical efficacy and patient safety, but it can shorten preoperative preparation time and improve operator comfort.

Objective To explore the preliminary experience and clinical outcomes of domestic(Jingfeng)robot-assisted laparoscopic radical cystectomy and detubularized sigmoid neobladder construction, and to evaluate the technical feasibility, safety, and postoperative functional recovery. Methods A retrospective analysis was conducted on 12 patients undergoing surgery in our department during Jun. and Dec.2024. The operation time, intraoperative blood loss, postoperative complications, and hospital stay were recorded to assess the surgical efficacy and safety.Results All 12 procedures were successfully completed. The average operation time was 460(390-540)minutes, including 213(170-250)minutes for radical cystectomy with lymph node dissection and 247(200-300)minutes for neobladder reconstruction and anastomosis. Intraoperative blood transfusion was required in 2 cases, and postoperative hemoglobin levels decreased by 22(7-46)g/L in 10 patients. All surgical margins were negative. No major complications of Clavien-Dindo Ⅲ or above occurred postoperatively. The average hospital stay was 9(7-14)days, and bowel function recovered within 2.58(2-3)days. During the follow-up of 2 to 6 months, 11 patients achieved daytime urinary continence, and 6 had normal continence. All patients had no obvious obstruction or hydronephrosis in the upper urinary tract. Conclusion Domestic robot-assisted laparoscopic radical cystectomy and detubularized sigmoid neobladder reconstruction is technically feasible, with advantages in precision, minimal invasiveness, and favorable postoperative recovery. Initial results demonstrate its potential in lymph node dissection, nerve preservation, and urinary continence restoration, suggesting it can become a valuable option for bladder cancer treatment.

Objective To evaluate the feasibility of intravesical instillation of urokinase and heparin sodium in the treatment of bladder clot irrigation.Methods This report discusses the diagnosis and treatment of three patients with bladder blood clot tamponade confirmed by abdominal and pelvic computed tomography(CT)scans enrolled from our hospital during Jun. to Sep. 2024, and discuss the relevant literature.Results A solution containing urokinase(20 000 IU)and heparin sodium(125 000 U)was instilled through a three-way catheter and retained for 30 minutes before drainage. Complete clot dissolution was achieved in all cases, with immediate relief of hypogastric distension and pain. Post-procedural CT showed restored bladder lumen patency. Hemoglobin levels decreased by 2-5 g/L without complications.Conclusion This preliminary trial demonstrated that intravesical instillation of urokinase-heparin provides a safe and effective minimally invasive alternative for bladder clot in irrigation cases.

Objective To compare the efficacy,economic burden,psychological impact,and quality of life between surgical and medical castration following radical prostatectomy(RP)in patients with very high-risk prostate cancer(VHR PCa).Methods Clinical data of 167 patients with VHR PCa who underwent RP in the Department of Urology,the First Affiliated Hospital of Anhui Medical University during Jul.2019 and Mar.2024 were retrospectively collected.Patients were divided into two groups:the surgical castration group(n=44)and medical castration group(n=123).The effects of different castration methods on the biochemical recurrence(BCR)were analyzed with Cox proportional hazards models.The survival curves of BCR-free and progress to castration-resistant prostate cancer(CRPC)were plotted with the Kaplan-Meier method.The differences in functional assessment of cancer therapy-prostate(FACT-P)and hospital anxiety and depression scale(HADS)between the two groups were evaluated with linear regression model.Results The total costs were significantly lower in the surgical castration group than in the medical castration group[(47 422.0±3 998.3)yuan vs.(59 017.2±8 014.1)yuan,P＜0.001].One month postoperatively,the surgical castration group had significantly lower prostate-specific antigen(PSA)level[0.028(0.010,0.159)ng/mL vs.0.100(0.029,0.895)ng/mL,P=0.002].However,no significant differences were observed in the PSA level between the two groups at 3,6,and 12 months postoperatively,or in PSA nadir and time to nadir(P＞0.05).Cox regression analysis suggested a potentially higher risk of BCR in the medical castration group(HR=2.23),but the difference was not statistically significant(P=0.112).The 1-and 3-year BCR-free survival rates were higher in the surgical castration group(90.9％vs.85.4％;86.4％vs.70.7％,respectively),whereas 1-and 3-year progression-free survival rates were comparable between the two groups(97.7％vs.97.6％;95.5％vs.91.9％),with no significant differences(P＞0.05).No significant differences were found in FACT-P[(57.3±10.2)vs.(57.3±7.6)]or HADS[(12.6±5.1)vs.(11.3±4.8)]scores between the two groups(P＞0.05).Conclusion In VHR PCa patients,surgical castration performed following RP is not inferior to drug castration in terms of PSA control,and potential delay of BCR.It had a lower cost and does not significantly increase the psychological burden.As an underutilized strategy,surgical castration can become an optional option for individualized treatment.

Objective To summarize the technical procedures and preliminary experience of gasless laparoscopic radical cystectomy,and to evaluate its technical feasibility,safety and clinical effects.Methods A retrospective analysis was conducted on 5 patients undergoing gasless laparoscopic radical cystectomy in our hospital during May 2024 and Mar.2025.The clinical and pathological data,operation time,blood loss,intraoperative arterial PCO2 and hemoglobin level,postoperative recovery and complications were collected and analyzed.Results By using the abdominal wall lifting technique to establish the operating space of the lower abdomen without pneumoperitoneum,all operations were successfully completed,with no conversion to pneumoperitoneum surgery or open surgery.The operation time was 154-200 minutes,and the intestinal function recovered 2.4(2-3)days after the operation.No severe complication was observed perioperatively.During up to 6-month follow-up,no ileus,thrombosis,tumor recurrence or metastasis were observed.Condusion Our preliminary experience shows that gasless laparoscopic radical cystectomy is safe and feasible for selected patients and may reduce the incidence of pneumoperitoneum-related complications.

Objective To compare the efficacy,economic burden,psychological impact,and quality of life between surgical and medical castration following radical prostatectomy(RP)in patients with very high-risk prostate cancer(VHR PCa).Methods Clinical data of 167 patients with VHR PCa who underwent RP in the Department of Urology,the First Affiliated Hospital of Anhui Medical University during Jul.2019 and Mar.2024 were retrospectively collected.Patients were divided into two groups:the surgical castration group(n=44)and medical castration group(n=123).The effects of different castration methods on the biochemical recurrence(BCR)were analyzed with Cox proportional hazards models.The survival curves of BCR-free and progress to castration-resistant prostate cancer(CRPC)were plotted with the Kaplan-Meier method.The differences in functional assessment of cancer therapy-prostate(FACT-P)and hospital anxiety and depression scale(HADS)between the two groups were evaluated with linear regression model.Results The total costs were significantly lower in the surgical castration group than in the medical castration group[(47 422.0±3 998.3)yuan vs.(59 017.2±8 014.1)yuan,P＜0.001].One month postoperatively,the surgical castration group had significantly lower prostate-specific antigen(PSA)level[0.028(0.010,0.159)ng/mL vs.0.100(0.029,0.895)ng/mL,P=0.002].However,no significant differences were observed in the PSA level between the two groups at 3,6,and 12 months postoperatively,or in PSA nadir and time to nadir(P＞0.05).Cox regression analysis suggested a potentially higher risk of BCR in the medical castration group(HR=2.23),but the difference was not statistically significant(P=0.112).The 1-and 3-year BCR-free survival rates were higher in the surgical castration group(90.9％vs.85.4％;86.4％vs.70.7％,respectively),whereas 1-and 3-year progression-free survival rates were comparable between the two groups(97.7％vs.97.6％;95.5％vs.91.9％),with no significant differences(P＞0.05).No significant differences were found in FACT-P[(57.3±10.2)vs.(57.3±7.6)]or HADS[(12.6±5.1)vs.(11.3±4.8)]scores between the two groups(P＞0.05).Conclusion In VHR PCa patients,surgical castration performed following RP is not inferior to drug castration in terms of PSA control,and potential delay of BCR.It had a lower cost and does not significantly increase the psychological burden.As an underutilized strategy,surgical castration can become an optional option for individualized treatment.

Objective To summarize the technical procedures and preliminary experience of gasless laparoscopic radical cystectomy,and to evaluate its technical feasibility,safety and clinical effects.Methods A retrospective analysis was conducted on 5 patients undergoing gasless laparoscopic radical cystectomy in our hospital during May 2024 and Mar.2025.The clinical and pathological data,operation time,blood loss,intraoperative arterial PCO2 and hemoglobin level,postoperative recovery and complications were collected and analyzed.Results By using the abdominal wall lifting technique to establish the operating space of the lower abdomen without pneumoperitoneum,all operations were successfully completed,with no conversion to pneumoperitoneum surgery or open surgery.The operation time was 154-200 minutes,and the intestinal function recovered 2.4(2-3)days after the operation.No severe complication was observed perioperatively.During up to 6-month follow-up,no ileus,thrombosis,tumor recurrence or metastasis were observed.Condusion Our preliminary experience shows that gasless laparoscopic radical cystectomy is safe and feasible for selected patients and may reduce the incidence of pneumoperitoneum-related complications.

There are various complicated wired connections in traditional endoscopic systems, which have disadvantages such as prolonging the preoperative setup time, restricting the movement of laparoscope, hindering the intraoperative manipulation, potentially contaminating the operation area and causing safety hazards.Our team has developed a wireless intelligent ultra-high-definition endoscopic system for the first time, which has been widely applied in many urological surgeries, such as tumors, stones, transurethral prostate enucleation, laparoscopic pyeloureteroplasty, laparoscopic renal cyst top decompression and so on.This essay reviews the applications and advantages of this system in urology, and forecasts its prospects.

Prostatic diseases are with the high prevalence，significantly impair men’s health and quality of life，yet their pathogenesis remains intricate and multifactorial. In recent years，the gut microbiota has been extensively reported to influence extraintestinal organs through metabolic modulation and immune regulation，leading to the emergence of the “gut-organ axis” as a conceptual framework. We systematically outline the commonly recognized “gut-organ axes，” with a particular focus on recent advances in understanding the “gut-prostate axis” in the context of prostate cancer，benign prostatic hyperplasia，and chronic prostatitis. Drawing on findings from our research group，we propose future directions for the identification of microbial targets，mechanistic exploration，and clinical translation in this emerging field.