{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T02:06:25Z","timestamp":1779501985263,"version":"3.53.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Laparoscopic cholecystectomy is a high-volume procedure with relatively short operative times, leaving limited margin for further reduction in mean duration. However, variability in operative performance, compounded by anatomical variation and differing degrees of inflammation, may substantially affect operative duration and operating room efficiency. The Maestro\u2122 Platform is a bedside, AI-powered, co-manipulated surgical assistance system designed to improve visualization, stability, and ergonomics during MIS while preserving surgeon autonomy, standard laparoscopic instrumentation, and conventional operative technique. This study aims to assess the operative and perioperative outcomes of Maestro-assisted versus conventional laparoscopic cholecystectomy, with a focus on variability in operative time. This study prospectively included 79 Maestro-assisted cholecystectomies procedures. Those cases were retrospectively compared with 79 consecutive baseline laparoscopic cholecystectomies performed by the same surgical team. Demographic data, operative time, length of stay and 30-day complications were analyzed. Statistical Process Control (SPC) charts were generated to evaluate the process stability and variability for operative times. The Maestro demonstrated a 35% reduction in operative time variability (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The SPC charts show significantly reduced variability and greater process stability with the Maestro Platform than conventional laparoscopy. Postoperative outcomes were comparable. No device-related complications or conversions occurred. Maestro-assisted cholecystectomy demonstrated operative time and perioperative outcomes comparable to conventional laparoscopy, while showing a significant reduction in operative time variability. For short procedures, this improved predictability may offer substantial workflow and scheduling advantages, such as more on-time starts and reduced overtime hours.\n                  <\/jats:p>","DOI":"10.1007\/s11701-026-03478-3","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T01:38:03Z","timestamp":1779500283000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integration of a collaborative robotic platform in laparoscopic cholecystectomy: safety, feasibility, and operative time variability"],"prefix":"10.1007","volume":"20","author":[{"given":"Azagury","family":"Dan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercoli","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leclerc","family":"Fabrice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reitano","family":"Elisa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"3478_CR1","first-page":"81","volume":"15","author":"DA Osborne","year":"2006","unstructured":"Osborne DA, Alexander G, Boe B, Zervos EE (2006) Laparoscopic cholecystectomy: past, present, and future. Surg Technol Int 15:81\u201385","journal-title":"Surg Technol Int"},{"issue":"3","key":"3478_CR2","doi-asserted-by":"publisher","first-page":"e251705","DOI":"10.1001\/jamanetworkopen.2025.1705","volume":"8","author":"CL Mullens","year":"2025","unstructured":"Mullens CL, Sheskey S, Thumma JR, Dimick JB, Norton EC, Sheetz KH (2025) Patient Complexity and Bile Duct Injury After Robotic-Assisted vs Laparoscopic Cholecystectomy. JAMA Netw Open 8(3):e251705","journal-title":"JAMA Netw Open"},{"key":"3478_CR3","doi-asserted-by":"crossref","unstructured":"Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH (2023) Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy. JAMA Surg. ;158(12):1303\u20131310. Erratum in: JAMA Surg. 2025;160(5):604","DOI":"10.1001\/jamasurg.2023.4389"},{"issue":"7","key":"3478_CR4","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1001\/jamasurg.2025.1291","volume":"160","author":"NA Woldehana","year":"2025","unstructured":"Woldehana NA, Jung A, Parker BC, Coker AM, Haut ER, Adrales GL (2025) Clinical Outcomes of Laparoscopic vs Robotic-Assisted Cholecystectomy in Acute Care Surgery. JAMA Surg 160(7):755\u2013762","journal-title":"JAMA Surg"},{"issue":"10","key":"3478_CR5","doi-asserted-by":"publisher","first-page":"7812","DOI":"10.1007\/s00464-023-10296-3","volume":"37","author":"GB Cadi\u00e8re","year":"2023","unstructured":"Cadi\u00e8re GB, Himpens J, Poras M, Pau L, Boyer N, Cadi\u00e8re B (2023) First human surgery using a surgical assistance robotics device for laparoscopic cholecystectomies. Surg Endosc 37(10):7812\u20137818","journal-title":"Surg Endosc"},{"issue":"9","key":"3478_CR6","doi-asserted-by":"publisher","first-page":"3561","DOI":"10.1007\/s11695-024-07409-9","volume":"34","author":"GB Cadi\u00e8re","year":"2024","unstructured":"Cadi\u00e8re GB, Himpens J, Poras M, Boyer N, Cadi\u00e8re B (2024) Feasibility and Safety Study of the Use of a New Robot (Maestro\u2122) for Laparoscopic Surgery. Obes Surg 34(9):3561\u20133568","journal-title":"Obes Surg"},{"issue":"7","key":"3478_CR7","first-page":"874","volume":"14","author":"PV Conrad","year":"2024","unstructured":"Conrad PV, Mehdorn AS, Alkatout I, Becker T, Beckmann JH, Pochhammer J (2024) The Combination of Laparoscopic and Robotic Surgery: First Experience with the Dexter Robotic System\u2122 in Visceral Surgery. Life (Basel) 14(7):874","journal-title":"Life (Basel)"},{"issue":"5","key":"3478_CR8","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1002\/wjs.12531","volume":"49","author":"AS Hotz","year":"2025","unstructured":"Hotz AS, Seeger N, Gantner L, Grieder F, Breitenstein S (2025) Implementation of a Robotic Surgical Program With the Dexter Robotic Surgery System: Initial Experiences in Cholecystectomy. World J Surg 49(5):1221\u20131227","journal-title":"World J Surg"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03478-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-026-03478-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03478-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T01:38:04Z","timestamp":1779500284000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-026-03478-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3478"],"URL":"https:\/\/doi.org\/10.1007\/s11701-026-03478-3","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]},"assertion":[{"value":"1 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dan Azagury is an external advisor for Moon Surgical. Henry Mercoli is an external advisor and holds an indirect equity interest in Moon Surgical.Elisa Reitano and Fabrice Leclerc have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This investigation was conducted within the framework of a post\u2011market clinical registry evaluating Maestro at one center. The registry was duly declared to the French Data Protection Authority (CNIL, reference n\u00b0223283).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Dan Azagury is an external advisor for Moon Surgical. Henry Mercoli is an external advisor and holds an indirect equity interest in Moon Surgical. Elisa Reitano and Fabrice Leclerc have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}],"article-number":"524"}}