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Background: The da Vinci surgical systems (X and Xi) are fourth‐generation systems marketed by Intuitive Inc. The X system is less expensive than the Xi system. This study compared the surgical outcomes of patients who underwent hysterectomy using the X and Xi systems. Methods: Data from 172 patients who underwent robot‐assisted total hysterectomies by four surgeons between April 2019 and March 2023 were retrospectively analyzed in a single‐center study. The patients were divided into two groups based on the surgical system used. Approval was granted by the Institutional Review Board of the Tottori University Hospital (22A134). All patients provided opt‐out consent in accordance with the institutional guidelines. Results: Operative time (126.6 ± 29.5 for X, 138.2 ± 38.5 for Xi, p =.227) and console time (92.9 ± 27.0 for X, 105.5 ± 34.7 for Xi, p =.089) were insignificantly shorter in group X than in group Xi after propensity score matching for age, body mass index, nulliparity, previous history of abdominal or pelvic surgery, preoperative diagnosis, and surgical approach. No significant differences between X and Xi were observed in a subgroup analysis of patients who underwent robot‐assisted total laparoscopic hysterectomy without lymphadenectomy (operative time: 199.0 ± 26.5 for X, 221.5 ± 45.1 for Xi, p =.227; console time: 162.1 ± 25.0 for X, 178.3 ± 0.314 for Xi, p =.314). Conclusion: Perioperative outcomes for the X and Xi da Vinci surgical systems were equivalent. The cost‐effective X system may allow the widespread use of robotic surgeries. [ABSTRACT FROM AUTHOR]

Introduction: Hybrid total laparoscopic hysterectomy combines conventional laparoscopic surgery and robot‐assisted devices: the camera and assistant forceps are operated by a robotic device, whereas the surgeon performs laparoscopic procedures, enabling surgery with a completely fixed field of view and significantly reducing errors in forceps grasping and needle misalignment. Here, we examined whether using two arms of the Hugo™ robot‐assisted surgery system, one for the camera and one for the assistant, would improve surgical accuracy compared with conventional total laparoscopic hysterectomy. Materials and Surgical Technique: The surgical system reduced surgeon errors in grasping the forceps during training and stabilized forceps operation. Compared with conventional laparoscopic surgery, the use of the surgical system did not result in different operative durations. The stable surgical procedure was considered a major advantage. Discussion: This new technique involving new equipment can improve surgeon training and performance. In the future, we will develop new techniques to improve surgical performance. [ABSTRACT FROM AUTHOR]

Few studies have compared the efficacy of robot-assisted, laparoscopic, and open surgeries for endometrial cancer. When considering the position of robotic surgery in Japan, it was necessary to determine whether it was effective or not. We aimed to compare the efficacy and safety of these three types of surgeries for early-stage endometrial cancer. In total, 175 patients with endometrial cancer of preoperative stage IA, who had undergone laparotomic (n = 80), laparoscopic (n = 40), or robot-assisted (n = 55) modified radical hysterectomy at our hospital from 2010 to 2022, were included; surgical outcomes, perioperative complications, and prognoses were compared. Total operative and console times for robot-assisted surgery between patients who did or did not undergo pelvic lymphadenectomy were assessed. The robot-assisted group had the shortest total operative time. The estimated blood loss was lower in the laparoscopic and robot-assisted groups than in the laparotomy group. In advanced postoperative stage IA cases, there were no differences in progression-free and overall survival among the three groups. In the robot-assisted group, the operative time decreased as the number of operations increased; the learning curve was reached after 10 cases each of patients with and without pelvic lymphadenectomy. The frequency of perioperative complications of Clavien–Dindo classification Grade 1 or higher was the lowest in the robot-assisted group (p = 0.02). There were no complications of Clavien–Dindo classification Grade 2 or higher in the robot-assisted group. Robot-assisted surgery for stage IA endometrial cancer, a minimally invasive procedure, has fewer operative times and complications than those of laparoscopic and open surgeries in a single institution in Japan. [ABSTRACT FROM AUTHOR]

Through a questionnaire survey of teachers of special classes for children with low vision in Japan's primary and lower secondary schools, this study aims to clarify the basic data of children in these classes, the realities of their learning situations, and the realities of the instruction they receive from their teachers. A special class for children with low vision is a class specially organised in primary and lower secondary schools to deliver an education that is appropriate to children with low vision. Basic data items for children covered grade, sex, and visual acuity and also the written characters, low-vision devices, and textbooks that they use in their studies. The survey also elicited responses about the information and communication technology (ICT) devices that teachers use in their teaching, their number of years' teaching experience, their number of years' experience teaching children who are visually impaired, and the content or topic of training that they desire to improve their specialisation in the education of children who are visually impaired. In addition to obtaining statistics on basic items related to children's sex and visual acuity, the results revealed change in children's actual situations over the years through comparison with the results of previous studies. Specifically, the percentage of children with visual acuity under 20/66 increased, and the usage rate of braille decreased. We also learned that while usage rates of enlarged textbooks and ICT devices are increasing, the rate of using low-vision devices is decreasing. In addition, it was revealed that a majority of teachers had less than 3 years' experience in education for children who are visually impaired, regardless of general teaching experience, and that there is a considerable need for training in basic knowledge. [ABSTRACT FROM AUTHOR]

Background: There are few studies on serum vascular endothelial growth factors and receptors (VEGF/VEGFRs) in patients with uterine cervical cancer (CC). The aim of this study was to determine whether VEGF/VEGFRs could be used as prognostic biomarkers in patients with CC. Methods: A total of 107 patients with stage IB to IIB CC, who underwent radical hysterectomy at Tottori University Hospital between 2006 and 2015, were included in this study. Serum samples were collected prior to radical hysterectomy, and levels of VEGF-A, VEGF-C, VEGFR-1, and VEGFR-2 were analyzed by enzyme-linked immunosorbent assays. We evaluated the association between the levels of these angiogenic factors and clinicopathologic variables. Survival analysis of 93 patients treated between 2006 and 2013 was performed. Results: The levels of VEGF-A in patients with bulky tumor, pelvic lymph-node involvement (PLNI), and parametrial infiltration (PI) were significantly higher than those in patients without these factors (P = 0.022, P = 0.020, and P = 0.0013, respectively). The overall survival (OS) of patients with high VEGF-A and VEGFR-2 defined by median levels was significantly lower than the OS of patients with low levels of VEGF-A and VEGFR-2 (P = 0.014, P = 0.012, respectively). Multivariate analysis revealed that PLNI, serum VEGF-A levels, and serum VEGFR-2 levels were independent prognostic factors for OS (hazard ratio for VEGF-A 3.42, 95% CI 1.07–13.2; hazard ratio for VEGFR-2 6.37, 95% CI 1.59–43.5). Conclusion: Our results suggest that serum VEGF-A and VEGFR-2 may be promising prognostic biomarkers for CC. [ABSTRACT FROM AUTHOR]

To design a method for predicting outbreaks of paralytic shellfish poisoning (PSP) in scallop fishing grounds, the relationship between the distribution of the toxic dinoflagellate Alexandrium tamarense and the dynamics of the Soya Warm Current (SWC) was examined in the Okhotsk Sea off Hokkaido. Surveys were conducted from May to June to clarify the transportation mechanism of A. tamarense from the oceanic area to the coastal area. The sea-level difference (SLD) between Wakkanai and Abashiri was monitored as an index of the strength of the SWC southeastward flow in an alongshore belt to examine the possible occurrence of A. tamarense in the coastal area during temporal weakening of the SWC. A bottom-mounted acoustic Doppler current profiler (ADCP) was used for direct observations of the SWC. The results indicated that PSP occurred when low-salinity water contaminated with A. tamarense extended to the coast during temporal weakening of the SWC due to a decrease of the SLD. Our results strongly indicate that predictions can be realized by monitoring the decrease of SLD as an index of temporal weakening of the SWC after surveys of the distribution of A. tamarense in the oceanic area before the period of PSP occurrence. [ABSTRACT FROM AUTHOR]