1.Embracing minimally invasive approaches to colorectal cancer resection.
Nan Zun TEO ; James Weiquan LI ; James Chi Yung NGU ; Tiing Leong ANG
Singapore medical journal 2025;66(Suppl 1):S38-S46
The clinical burden of colorectal cancer (CRC) is high. Population-based screening and early detection are essential to improve the long-term clinical outcome. Nonetheless, a significant proportion of patients still present at an advanced stage, including with acute large bowel obstruction. Image-enhanced endoscopy and artificial intelligence can improve the detection and diagnosis of colonic adenomas and early cancer. Endoscopic resection is regarded as the preferred curative treatment option for colonic adenoma and T0 and T1 CRC limited to the superficial submucosa. Emergency colonic stenting as bridge to interval curative surgery is increasingly accepted as a first-line option when technically feasible. Minimally invasive resection techniques such as laparoscopic colectomy and robot-assisted colorectal surgery have also come of age. These techniques reduce post-treatment morbidity, shorten the recovery process and can be cost-effective while maintaining long-term oncological cure. These outcome measures are relevant to our patients; therefore, minimally invasive approaches to curative resection should be embraced.
Humans
;
Colorectal Neoplasms/surgery*
;
Minimally Invasive Surgical Procedures/methods*
;
Laparoscopy/methods*
;
Colectomy/methods*
;
Robotic Surgical Procedures/methods*
;
Treatment Outcome
;
Colonoscopy/methods*
2.Chinese expert consensus on MRI-guided thermal ablation for liver tumors (2025 edition).
Chinese Journal of Internal Medicine 2025;64(11):1084-1095
Image-guided thermal ablation (IGTA) has been widely used in the treatment of liver tumors. MRI-guided thermal ablation of liver tumors offers several advantages, including the absence of ionizing radiation; excellent soft-tissue contrast; multi-parametric and multiplanar imaging; non-invasive, real-time temperature monitoring of the thermal field during the procedure; and accurate post-procedural assessment of therapeutic efficacy. To standardize and promote MRI-guided thermal ablation for liver tumors in China, advance the technological development of IGTA for tumor treatment, and enhance the efficacy of "precision ablation" for hepatic tumors, this expert consensus (2025 edition) was collaboratively developed by national experts from multiple societies and committees through multidisciplinary discussions. The contributing groups included the Society of Tumor Ablation Therapy of the Chinese Anti-Cancer Association, the Ablation Expert Committee of the Chinese Society of Clinical Oncology (CSCO), the Tumor Ablation Subgroup of the National Health Commission Comprehensive Interventional Therapy Quality Control Center, the Expert Group on Tumor Ablation Therapy of the Chinese Medical Doctors Association, and the Tumor Ablation Committee of the Chinese College of Interventionalists. The main contents of the consensus include: (1) indications, contraindications, and characteristics of MRI-guided thermal ablation for liver tumors; (2) MRI magnets, guidance sequences, and MRI-compatible thermal ablation equipment and instruments; and (3) protocols for MRI-guided thermal ablation of liver tumors, efficacy assessment, and the prevention and management of complications.
Humans
;
Liver Neoplasms/surgery*
;
Magnetic Resonance Imaging
;
Consensus
;
China
;
Catheter Ablation/methods*
;
Ablation Techniques/methods*
;
Surgery, Computer-Assisted
3.Clinical analysis of mandibular tumor resection with free fibula transplantation and implant implantation via the intraoral approach.
Jiancheng LI ; Mingming YAN ; Zhenghao MA ; Ruixue TIAN ; Xuji WANG ; Kai HU ; Lina JIANG
West China Journal of Stomatology 2025;43(2):212-219
OBJECTIVES:
To investigate the clinical application of the digital-assisted reconstruction of the mandible and tumors with free fibula transplantation and immediate implantation via the intraoral approach.
METHODS:
Twelve patients with benign mandibular tumors were collected. Three-dimensional mandibular reconstruction was performed digitally before surgery to simulate mandibular tumor resection, fibula resection and reconstruction, and implant implantation. The intraoperative resection of the mandibular tumor was conducted through the intraoral approach under the guidance of a guide plate, and fibula resection, molding, reconstruction, and oral fixation were immediately performed. Implant implantation was performed during the second phase of implant surgery and denture restoration was performed 1-2 months after surgery.
RESULTS:
The types of mandibular defects were BrownⅠ (one case), Ⅰc (four cases), Ⅱ (one case), Ⅱc(three cases), and Ⅲ (three cases). The length of the fibular bone was 12-22 cm. The number of fibular molding amputations was as follows: two cases in two segments, six cases in three segments, three cases in four segments, and one case in five segments. All of these cases underwent folding fibular reconstruction of mandibular and alveolar bone defects. A total of 44 implants were implanted, and none failed after operation.
CONCLUSIONS
The intraoral approach is a reliable method for the resection of mandibular benign tumors, with few postoperative complications and the ability to position and fix accurately the reconstructed folded fibula under digital design. The immediate implantation of the transplanted fibula does not affect the blood supply and has a high success rate. It is an effective and reliable method for the resection and reconstruction of mandibular benign tumors.
Humans
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Fibula/transplantation*
;
Mandibular Neoplasms/surgery*
;
Mandibular Reconstruction/methods*
;
Bone Transplantation/methods*
;
Male
;
Middle Aged
;
Female
;
Mandible/surgery*
;
Adult
;
Free Tissue Flaps
;
Surgery, Computer-Assisted
4.Interpretation of the group standard: Clinical Protocol for Bone Harvesting and Grafting under Digital Guidance in Oral Implantology.
West China Journal of Stomatology 2025;43(6):755-762
In recent years, digital bone harvesting and grafting technology in dental implantology has emerged as a cutting-edge advancement in the field of oral medicine, gaining widespread application in the treatment of complex bone defect cases. By integrating digital imaging, virtual design, and precise surgical guidance, this technology has significantly enhanced the success rate of dental implants and improved patient outcomes. However, the rapid development of this technology has also highlighted the lack of standardized clinical protocols, necessitating the establishment of unified guidelines through expert consensus. This article provides a detailed overview of the development process of the group standard Clinical Protocol for Bone Harvesting and Grafting under Digital Guidance in Oral Implantology and offers an in-depth interpretation of its key components, aiming to serve as a valuable reference for clinical practice and academic research.
Humans
;
Bone Transplantation/methods*
;
Surgery, Computer-Assisted/methods*
;
Dental Implantation/methods*
;
Tissue and Organ Harvesting/methods*
;
Clinical Protocols
5.Case of tooth autotransplantation with robotic surgery assistance.
Yunkun LIU ; Jia SONG ; Xiaoyu CHEN ; Chuyang ZHANG ; Shang CHEN ; Jian ZHANG ; Zhiyu GU
West China Journal of Stomatology 2025;43(6):881-887
Tooth autotransplantation is a restoration technology that grafts the patient's own teeth to the missing tooth area, usually by using the third molar to replace a nonnormally functioning molar for the purpose of "turning waste into treasure". Robotic surgical assistance has been widely used in the fields of breast cancer, liver cancer, and orthopedics; however, its application in the dental field, particularly in tooth autotransplantation, remains relatively rare. This paper reports a case of tooth autotransplantation with the assistance of a domestic autonomous oral surgery robot, providing a reference for the application of robotic surgery assistance in tooth autotransplantation.
Humans
;
Molar, Third/transplantation*
;
Robotic Surgical Procedures/methods*
;
Transplantation, Autologous
6.Influence of network latency and bandwidth on robot-assisted laparoscopic telesurgery: A pre-clinical experiment.
Ye WANG ; Qing AI ; Taoping SHI ; Yu GAO ; Bin JIANG ; Wuyi ZHAO ; Chengjun JIANG ; Guojun LIU ; Lifeng ZHANG ; Huaikang LI ; Fan GAO ; Xin MA ; Hongzhao LI ; Xu ZHANG
Chinese Medical Journal 2025;138(3):325-331
BACKGROUND:
Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood.
METHODS:
A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000 km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons.
RESULTS:
All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866 min. The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions.
CONCLUSIONS
This telesurgery system demonstrated safety and reliability. A total of 320 ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.
Animals
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Robotic Surgical Procedures/methods*
;
Laparoscopy/methods*
8.Expert consensus on laparoscopic and robotic-assisted pancreatoduodenectomy with resection and reconstruction of portal-superior mesenteric vein (2025).
Chinese Journal of Surgery 2025;63(6):461-470
Pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction can provide radical surgical opportunities for patients with venous invasion and enable them to benefit from the surgery. With the development of minimally invasive concepts and surgical techniques, laparoscopic and robot-assisted pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction is being increasingly widely carried out. This surgical procedure is highly technically demanding, and the perioperative management of patients is complex. However, there is a lack of high-quality and high-level evidence-based clinical studies in this regard. In order to better standardize the clinical application of laparoscopic or robot-assisted pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction in China, the Study Group of Minimally Invasive Treatment for Pancreatic Cancer in China Anti-Cancer Association, guided by problems and based on evidence, formed 17 recommendations through full discussions among experts. The recommendations involve the safety, oncological benefits, and perioperative patient management of the minimally invasive approach to pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction.
Humans
;
Pancreaticoduodenectomy/methods*
;
Mesenteric Veins/surgery*
;
Laparoscopy
;
Portal Vein/surgery*
;
Robotic Surgical Procedures
;
Pancreatic Neoplasms/surgery*
;
Consensus
9.Technical guidelines for minimally invasive surgery in liver transplant recipients(2025).
Chinese Journal of Surgery 2025;63(10):859-865
Liver transplantation is an effective treatment for end-stage liver disease. Liver transplantation is technically complex and associated with significant trauma. In recent years,minimally invasive surgical techniques,such as laparoscopy and robotic surgery,have rapidly developed and been widely applied across various surgical fields. Minimally invasive surgery offers advantages including reduced trauma,less bleeding,and faster postoperative recovery,and has become a mainstream trend in surgical development. In the field of liver transplantation,laparoscopic and robotic donor hepatectomy techniques for living donor liver transplantation have made significant progress. However, due to difficulties in exposing the anastomotic sites of the donor liver and challenges in vascular anastomosis,the application of minimally invasive techniques in donor liver implantation has progressed relatively slowly. With advancements in laparoscopic and robotic surgical techniques and related instruments,laparoscopic donor liver implantation has gradually become feasible. Currently,multiple liver transplant centers worldwide have begun to progressively perform laparoscopic or robot-assisted liver transplantation in recipients,demonstrating potential advantages in reducing surgical trauma and accelerating postoperative recovery. However,there is currently a lack of guidelines or consensus on the application of minimally invasive surgery in liver transplant recipients. Therefore,Branch of Organ Transplantation of Chinese Medical Association,Surgery Group of Chinese Society of Surgery of Chinese Medical Association,and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association invited experts in the field to discuss clinical issues. Combining published guidelines,consensus statements,and research advancements,they formulated the "Technical guidelines for minimally invasive surgery in liver transplant recipients(2025)", aiming to provide reasonable guidance and references for clinical practitioners in the field of liver transplantation.
Humans
;
Liver Transplantation/methods*
;
Minimally Invasive Surgical Procedures/methods*
;
Laparoscopy
;
Robotic Surgical Procedures
;
Practice Guidelines as Topic
10.Clinical application standard of dynamic navigation technology in implant surgery.
Chinese Journal of Stomatology 2025;60(2):105-108
Dynamic navigation technology can "real-time guide" the implantologist to place the implant in the alveolar bone of the missing tooth area according to the preoperative design of the optimal site and path, making the whole implant surgery process more safe and precise. In order to further promote the standardized application of oral implant dynamic navigation technology, China Association of Gerontology and Geriatrics has convened distinguished experts to engage in deliberations and develop the standard. This standard covers the basic requirements, indications and contraindications, operation procedures, common complications and treatment measures, and accuracy verification. This standard can be used as a reference for the use of dynamic navigation technology in implant surgery.
Humans
;
Dental Implantation, Endosseous/standards*
;
Surgery, Computer-Assisted/standards*
;
Dental Implants
;
Surgical Navigation Systems/standards*

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