Dedicated Robotic‐Assisted Microsurgery Platforms in Plastic and Reconstructive Surgery: A Systematic Review

Research landscape of robot-assisted reconstructive and plastic surgery.

Robot-assisted technologies have progressively transformed plastic and reconstructive surgery by enabling enhanced precision, minimally invasive access, and complex microsurgical reconstruction. Despite increasing clinical adoption, a comprehensive data-driven synthesis of global research focused exclusively on original studies remains limited. This study systematically mapped the intellectual structure, collaboration networks, and thematic evolution of robot-assisted plastic and reconstructive surgery using advanced bibliometric approaches. A total of 484 original research articles published between 1996 and 2025 were retrieved from the Scopus database using an optimized search strategy, while secondary document types were excluded to ensure analytical consistency. Descriptive, network, and thematic analyses were performed using Bibliometrix for performance indicators and conceptual mapping, VOSviewer for collaboration and keyword networks, and CiteSpace for co-citation clustering and timeline visualization. The field demonstrated strong growth (annual growth rate 15.89%), with a mean citation impact of 21.6 citations per article and variable field-weighted citation performance across leading authors and institutions. Research output involved 2077 authors across 210 sources, characterized by high collaboration intensity and increasing international participation. The United States dominated productivity and citation impact, followed by China and several European countries. Thematic analyses identified robotic microsurgery as a central research focus, alongside expanding applications in breast reconstruction and transoral robotic surgery, with emerging integration of artificial intelligence.

Head and Neck Free Flap Reconstruction: Current Landscape and Emerging Technologies.

OBJECTIVE To synthesize contemporary developments in head and neck oncologic free flap reconstruction, with emphasis on perioperative physiologic optimization, digital integration, and functional recovery. DATA SOURCES MEDLINE (PubMed), Scopus, and Embase were searched for English-language human studies published between January 2020 and November 2025. Reference lists of relevant systematic reviews, consensus guidelines, and high-impact primary studies were manually reviewed to identify additional sources. REVIEW METHODS This structured state-of-the-art narrative review examined contemporary conceptual, physiologic, and technological developments rather than pooled quantitative outcomes. Priority was given to systematic reviews, consensus statements, randomized or quasi-experimental ERAS studies, high-volume cohort analyses, and translational research with direct relevance to oncologic free flap reconstruction. Evidence was synthesized thematically across perioperative optimization, intraoperative physiology, reconstructive strategy, salvage reconstruction, digital and artificial intelligence-enabled tools, and functional and survivorship outcomes. Studies limited to benign disease, trauma, pediatric populations, or isolated technical descriptions without perioperative or oncologic context were excluded. CONCLUSIONS Contemporary head and neck free flap reconstruction has evolved toward a more integrated, systems-oriented model that extends beyond technical reliability. ERAS pathways, frailty-informed assessment, refined intraoperative physiology, and contemporary salvage strategies have informed perioperative management in complex patient populations. Digital planning and emerging computational tools have improved precision and workflow efficiency in selected settings, although many applications remain investigational. Functional outcomes have also gained prominence as important measures of reconstructive success. IMPLICATIONS FOR PRACTICE Optimal outcomes depend on coordinated perioperative pathways, patient-specific physiologic optimization, judicious intraoperative management, and structured assessment of functional recovery and survivorship.

5G robotic telesurgery: Revolutionary medical approach (literature review)

Background . The problem of uneven distribution of quality medical resources and limited access to highly qualified surgical help for patients from distant regions has existed for a long time. 5G-based telesurgery opens up the prospects for overcoming geographical barriers. However, its clinical use is still at the starting stage. Aim . To analyze perioperative outcomes and safety profile of robot-assisted surgeries performed remotely using 5G-based systems. Materials and methods . Systematic search of sources in the PubMed, Embase, Web of Science and Cochrane Library databases was performed. The analysis included clinical trials added to the databases since their creation and until April 10, 2026. Special attention was paid to the articles on radical gastrectomy due to stomach cancer, as well as hepatopancreatobiliary and urological surgery. The key limitations of these interventions were identified. Descriptions of single-patient clinical cases were excluded from the analysis. Results . Oncological gastroenterology: 2 Chinese studies, prospective single-center ( n = 27) and retrospective ( n = 10), demonstrated that 100 % of resections were R0. Perioperative outcomes were similar to outcomes of non-remote robot-assisted surgery, delay of the roundtrip signal was only 31–91 ms. Hepatopancreatobiliary surgery: 3 studies ( n = 5, n = 6, n = 20) confirmed the possibility of remote cholecystectomy and liver resection with delay of 43–126 ms; episodic network disruptions were observed but they did not affect safety of the surgery. Urology: 5 studies (between 6 and 37 patients) involving radical prostatectomy, nephrectomy, adrenalectomy, and other interventions with success rates up to 100 % and identical perioperative outcomes as in non-remote surgeries (delay varied between 29.1 and 129.6 ms). All studies share the same limitations of small sample sizes, absence of data on long-term oncological outcomes, variability of network characteristics, absence of tactile feedback in robotized systems, absence of ethical and legal base, and uncertain economic efficiency. Conclusion . Feasibility and safety of robot-assisted surgeries performed remotely using 5G networks was demonstrated in cases of carefully selected patients. Perioperative outcomes of remote and non-remote robot-assisted surgeries are similar. However, telesurgery is still at the early stage of validation and carries many uncertainties and limitations; currently, it cannot replace non-remote robot-assisted surgery.

Single-port robot-assisted nipple-sparing mastectomy: a systematic review

Tele-robot-assisted prostatectomy: the first systematic review and single-arm meta-analysis

Transoral Robotic Surgery in Head and Neck Oncology: A Scoping Review of Evidence, Technological Advancements, and Future Trajectories.

Robotic surgery has transformed head and neck cancer (HNC) treatment. This scoping review synthesizes evidence on transoral robotic surgery (TORS), focusing on applications, limitations, and future directions. Following PRISMA-ScR guidelines, this review used the PCC framework (Population: HNC patients; Concept: technological advancements; Context: any clinical setting). A systematic search of five databases and gray literature was conducted. Two independent reviewers screened records and extracted data from clinical trials and reviews. From 5411 records, 21 studies were included. Evidence confirms TORS provides excellent local disease control and functional benefits (e.g., shorter hospitalization, improved swallowing) over open surgery, albeit with a distinct complication profile (e.g., hemorrhage). A significant finding is the scarcity of high-quality randomized trials comparing TORS to radiotherapy or open surgery. Technologically, evolution from multiport to single-port and flexible systems has improved access, though limitations like absent haptic feedback persist. Emerging trends focus on AI integration for precision and developing smaller instruments. Robotic surgery is a viable, evolving approach for HNC with demonstrable functional advantages. Its future depends on overcoming technological limits, establishing cost-effectiveness, and validating efficacy through robust comparative studies. AI integration is a promising frontier for enhancing surgical precision and personalization.