{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:24:10Z","timestamp":1786980250529,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The University of Osaka"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rigid suction\u2013coagulation probes constrain the wrist-like articulation that is central to robotic surgery. We therefore designed a 5-mm single-use flexible suction ball coagulator (flex-SBC) with a modified core design to restore dexterity and assessed its mechanical performance and early clinical feasibility, including the effect of the common robotic gripping strategies on suction flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Preclinical. The new 7\u2009\u00d7\u20097 core embedded in silicone was compared with the conventional 1\u2009\u00d7\u20097 core design. Shaft pliability was quantified by sagging displacement and rebound force testing. Suction flow at \u2212\u00a020, \u2212\u00a030, and \u2212\u00a040\u00a0kPa was measured, and the impact of grip location (electrode base vs silicone shaft) and forceps type (fenestrated or Maryland bipolar) was analyzed statistically. Clinical. The flex-SBC was used in 12 consecutive robotic gastrectomies with prospective collection of device performance, adverse events, and surgeon rating on seven-domain via three-point Likert scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Preclinical. Adopting the 7\u2009\u00d7\u20097 increased mean sagging displacement from 15.6\u2009\u00b1\u20091.8 to 39.3\u2009\u00b1\u20093.2\u00a0mm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and reduced rebound force from 0.288\u2009\u00b1\u20090.014 to 0.059\u2009\u00b1\u20090.004\u00a0N (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mean flow rates were 6.76\u2009\u00b1\u20090.88, 8.87\u2009\u00b1\u20090.43, and 10.58\u2009\u00b1\u20090.40\u00a0mL\/sec at \u2212 20, \u2212 30, and \u2212 40\u00a0kPa, respectively\u2014approximately half those of a rigid probe (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but still exceeding published thresholds for effective evacuation. Gripping the silicone shaft, especially with Maryland forceps, sharply reduced flow (60% reduction;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0011). Clinical. All operations were completed without device-related malfunctions, injuries, or conversions. Of 84 survey ratings, connection setup, suction efficiency, tissue safety, and overall satisfaction were \u201csatisfactory\u201d in 100%; maneuverability was \u201csatisfactory\u201d in 65% and \u201caverage\u201d in 35%. No \u201cunsatisfactory\u201d scores were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The flex-SBC bends where the robot bends, enabling safe, practical use across robot-assisted upper-GI surgery. Grip technique influences device\u00a0performance, providing important implications\u00a0training. Larger comparative trials should clarify whether these ergonomic gains translate into shorter operating times and improved oncologic precision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12138-w","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T19:12:18Z","timestamp":1757531538000},"page":"6955-6962","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Flexible suction\u2013coagulation probe restores dexterity in robot-assisted surgery: bench-to-bedside evaluation"],"prefix":"10.1007","volume":"39","author":[{"given":"Yuki","family":"Ushimaru","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Shibamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitomo","family":"Yanagimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namiko","family":"Ban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Tagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Hosaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Gotohda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Eguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Doki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8635-7585","authenticated-orcid":false,"given":"Kiyokazu","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"issue":"11","key":"12138_CR1","doi-asserted-by":"publisher","first-page":"8592","DOI":"10.1007\/s00464-022-09492-4","volume":"36","author":"Y Ushimaru","year":"2022","unstructured":"Ushimaru Y, Odagiri K, Akeo K, Ban N, Hosaka M, Yamashita K, Saito T, Tanaka K, Yamamoto K, Makino T et al (2022) Efficacy of electrocoagulation hemostasis: a study on the optimal usage of the very-low-voltage mode. 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