Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 5 appraisals
Science advances
Transforming static interfaces into tactile channels with steerable transdermal foci
Grasping objects such as handles, mice, and phones plays a central role in human-machine interaction, yet the contact surfaces of the hand, despite their exquisite tactile sensitivity, are rarely exploited as channels for information transfer. Here, we introduce transdermal all-directional targeting (TADT), a static-contact interface design strategy that converts passive grip surfaces into active tactile displays, allowing users to grasp stably while receiving spatially and temporally evolving information on the fingertips. TADT enhances sub-actuator-pitch energy delivery by integrating a microtextured skin-coupling interface with phase-controlled vibrotactile actuation, thereby generating steerable three-dimensional tactile foci beneath the skin, enabling >200-hertz vibration and sub-actuator-pitch spatial super-resolution. Psychophysical experiments show that TADT lowers detection thresholds by 30% and reduces power consumption by 80% compared with designs without TADT. Using static grip alone, users reliably identified six directional cues and completed nonvisual indoor navigation and virtual reality interaction tasks, demonstrating a compact, energy-efficient modality for expressive tactile communication.
12 July 2026
Read appraisal →Science advances
Toward autonomous robotic-assisted and microrobotic surgery
Autonomous robotic-assisted surgery (RAS) has emerged as a promising objective in biomedical technology, further enhanced by miniaturization toward microrobotic-assisted surgery (μ-RAS). This reduction in scale promises minimally invasive, partially or fully automated surgical procedures, with the potential to reduce patient recovery times, lower medical costs, and enable previously unavailable procedural options. This perspective highlights the specific advances in RAS that potentially map to the microscale (μ-RAS), organized across five surgical domains: endovascular, endoluminal, laparoscopic, ophthalmic, and orthopedic. We examine both clinical demands and technological advances in surgical robotics and identify the key innovations required for progress across these surgical fields. Our contribution is distinct in combining the perspectives of both surgical experts and bioengineering innovators, outlining a roadmap for the advancement and eventual integration of autonomous RAS and μ-RAS into mainstream surgical practice.
6 July 2026
Read appraisal →Journal of robotic surgery
Robot-Assisted versus non-robotic frame-based deep brain stimulation: a systematic review and meta-analysis of targeting accuracy and clinical outcomes
Deep brain stimulation (DBS) outcomes depend on accurate lead placement. Robot-assisted DBS (RA-DBS) has been increasingly adopted, yet its advantages over conventional non-robotic frame-based DBS (NRA-DBS) regarding targeting accuracy, operative efficiency, and clinical outcomes remain debated.To compare RA-DBS versus NRA-DBS for targeting accuracy and clinical outcomes in patients undergoing DBS for movement disorders.This meta-analysis and systematic review was registered in PROSPERO (CRD420261336001) and adhered to PRISMA. Patients with mobility disorders treated with RA-DBS versus frame-based NRA-DBS were included in comparative studies (RCTs and prospective/retrospective cohorts). Targeting accuracy measures (such as target point error, vector error, and radial error) and extreme targeting outliers were the main results. Operative time measurements, perioperative problems (such as cerebral bleeding), and motor improvement (UPDRS-III) were secondary outcomes. Fixed-effects or random-effects models based on heterogeneity were used to compute pooled odds ratios (OR) and weighted mean differences (MD) with 95% confidence intervals (CI). Nine high-quality comparative studies encompassing 495 patients (227 RA-DBS vs. 268 NRA-DBS) were synthesized. RA-DBS significantly minimized target point error (MD = -0.31 mm, 95% CI: -0.61 to -0.01; P = 0.04) and significantly reduced the incidence of clinically significant targeting outliers (OR = 0.15, 95% CI: 0.04 to 0.51; P = 0.002). Comprehensive three-dimensional vector error was marginally lower in the RA-DBS cohort (MD = -0.70 mm; P = 0.05), whereas two-dimensional radial error and total operating room time, surgical duration, anesthesia time, perioperative complications, and 12-month UPDRS-III motor improvements were statistically equivalent between groups. Subgroup analyses revealed that the spatial precision advantage of RA-DBS was geographically robust across East Asian and Western cohorts, whereas chronological efficiency was heavily dependent on the specific robotic platform used.Compared with conventional frame-based stereotaxy, robot-assisted DBS significantly enhances target point precision and reduces electrode deviations. However, these technical accuracy advantages do not translate into overall clinical superiority, as both approaches yield comparable operative efficiency, perioperative safety, and mid-term motor symptom relief.
23 June 2026
Read appraisal →Journal of robotic surgery
Telesurgery and remote surgery research: a bibliometric analysis of scientific growth, collaboration, and thematic evolution
Telesurgery and remote surgery have gained relevance in surgical innovation due to advances in robotics, telepresence, artificial intelligence, and high-speed communication networks. Despite this progress, the global evolution, collaborative structure, and thematic development of this field remain insufficiently characterized. A bibliometric study was conducted using records retrieved from Web of Science. Publications on telesurgery and remote surgery published up to 2025 were included. Bibliographic data were processed and analyzed using the bibliometrix package in R. Bibliometric indicators, citation metrics, country productivity, journal output, author contributions, collaboration networks, and keyword-based thematic patterns were assessed. A total of 476 publications on telesurgery were included, distributed across 290 journals. Scientific production showed sustained growth, with an annual growth rate of 20.59%, a mean document age of 6.06 years, and peak output in 2024. The average citation count was 28.54 citations per document. The United States and China were the leading contributors, with 151 and 120 publications, respectively, and also acted as the main hubs in the international collaboration network. The most cited studies focused on telerobotic systems for minimally invasive surgery, telerobotic neurovascular interventions, and ultra-reliable low-latency communications. Keyword analysis showed a progressive shift from early clinical feasibility and surgical applications toward connectivity, latency, robotic systems, extended reality, blockchain, and artificial intelligence. These trends indicate the transition of telesurgery from a clinically exploratory field to a technology-driven research domain. Telesurgery and remote surgery constitute a rapidly expanding and technologically driven research field. Future progress will require stronger international collaboration, real-world clinical validation, standardized outcome assessment, and strategies to reduce technological inequities across regions.
23 June 2026
Read appraisal →Journal of robotic surgery
Progress and perspectives in soft robotics for surgery and rehabilitation
Soft robotic systems have become a promising technology in the biomedical field due to their higher safety, dexterity and adaptability compared to traditional rigid robotic systems. This review focuses on recent advances in soft robotic systems applied to surgical assistance and rehabilitation. In surgery, soft grippers and flexible endoscopes show better adaptability, dexterity, and miniaturization, enabling safer and more precise manipulation of delicate tissues. In rehabilitation, wearable soft devices show great potential to help patients with neurological injuries to regain movement. Key innovations in actuation technology are examined, along with recent advances in multifunctional, self-healing, and environmentally responsive materials. Meanwhile, sensing systems are evolving from unimodal sensing to multimodal fusion, self-perception, and sense-drive integration, enabling robots to sense the body state and external environment with higher accuracy and realize closed-loop control. Finally, this paper points out that soft robots still face key challenges such as material durability, biosafety, and stability during clinical translation. In the future, the focus should be on the construction of systems with self-diagnosis, self-adaptive adjustment and closed-loop control, and promote the efficient landing and personalized application of soft robots from experimental research to real medical scenarios.
21 June 2026
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