Perioperative outcomes of Senhance robotic surgery versus conventional laparoscopy in appendectomy and cholecystectomy

Perioperative outcomes of Senhance robotic surgery versus conventional laparoscopy in appendectomy and cholecystectomy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Perioperative outcomes of Senhance robotic surgery versus conventional laparoscopy in appendectomy and cholecystectomy Junshin Fujiyama, Hiroki Kobayashi, Itsuki Inada, Shunji Kato, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8956659/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The clinical performance of Senhance robotic surgery in routine appendectomy and cholecystectomy has not been fully established. Methods Appendectomy and cholecystectomy cases performed between October 2022 and October 2025 were retrospectively examined, with outcomes compared according to surgical approach. Results For appendectomy (30 vs. 30), the Senhance group showed shorter operative duration and reduced hospitalization. In cholecystectomy (107 vs. 107), operative duration and hospital stay were likewise shorter with Senhance. Complication and conversion rates were comparable. Conclusions Within this single-center experience, Senhance robotic surgery demonstrated favorable perioperative outcomes without increased morbidity. Senhance robotic surgery laparoscopic surgery cholecystectomy appendectomy Introduction The use of robotic platforms in minimally invasive general surgery has increased in recent years, including procedures such as appendectomy and cholecystectomy. However, evidence regarding the perioperative impact of different robotic platforms in these procedures remains limited. The Senhance robotic system (Asensus Surgical, Durham, NC, USA) incorporates articulation and haptic feedback while maintaining laparoscopic-based operative concepts〔1–3〕. Whether these technical characteristics translate into measurable clinical advantages in daily practice is still uncertain. This study compared perioperative outcomes between Senhance robotic surgery and conventional laparoscopy for appendectomy and cholecystectomy at a single institution. Methods We reviewed all appendectomy and cholecystectomy procedures performed between October 2022 and October 2025. Surgical approach (Senhance or laparoscopy) defined group allocation. Collected parameters included age, sex, BMI, operative duration, estimated blood loss, length of stay, and complications graded ≥ II according to Clavien–Dindo. Open conversion was recorded. Group differences were evaluated using the Mann–Whitney U test or Fisher’s exact test. A p value < 0.05 was considered significant. Ethical approval This retrospective study was approved by the Ethics Committee of Saiseikai Shiga Hospital (Approval No. 835) and conducted in accordance with the Declaration of Helsinki. Results Patient Characteristics Age, sex, and BMI distributions were similar across the Senhance and laparoscopic groups in both appendectomy (Table 1a) and cholecystectomy (Table 1b). Appendectomy Operative duration was shorter in the Senhance group. Hospitalization time was also reduced. Complication rates were comparable. No open conversion occurred. Cholecystectomy The Senhance cohort showed reduced operative duration. Hospital stay was shorter. Although male distribution differed, complication rates remained comparable. No conversion to open surgery was observed. Discussion Operative duration and hospitalization were shorter in patients treated with Senhance for both procedures, whereas blood loss, complications, and conversion rates remained similar. These findings suggest that Senhance can be implemented without compromising perioperative safety in a laparoscopic-experienced center. Limitations include the retrospective design and single-institution setting. Broader evaluation will require prospective multicenter studies. Conclusion Senhance robotic surgery appears to represent a feasible option for appendectomy and cholecystectomy. Operative time and postoperative hospital stay were shorter with Senhance, without increases in morbidity or conversion rates. Declarations Funding: The authors received no specific funding for this study. Conflict of Interest: The authors declare no conflicts of interest. Informed Consent: The requirement for informed consent was waived due to the retrospective nature of the study. Author Contributions JF designed the study and drafted the manuscript. HK, II, and SK collected the data. TI, TK, and MM supervised the study. All authors reviewed and approved the final manuscript. References Spinoglio G, et al. The Senhance robotic platform for general surgery: a multi-institutional experience. J Robot Surg. 2022;16(4):759–766. Nishimura T, et al. Early experience with Senhance robotic-assisted surgery in Japan. Asian J Endosc Surg. 2021;14(2):234–240. Horgan S, et al. Robotic-assisted laparoscopic general surgery: current status and future perspectives. Surg Endosc. 2020;34(3):1043–1050. Tables Table 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Table 1. Comparison of perioperative outcomes between Senhance robotic surgery and conventional laparoscopic surgery in appendectomy and cholecystectomy. Values are expressed as median (interquartile range) or number (%). Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8956659","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":599604969,"identity":"d128750d-2f0a-414b-924c-f489c1d9ca8d","order_by":0,"name":"Junshin Fujiyama","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2klEQVRIiWNgGAWjYDACZgYGCRDNxt4AJA0sSNDCz3MApEWCOIvAyiRnJMDZ+IHBcd6DN3+23bPbcPP51Q0/CiQY+Nu7E/BrOcyXbM3bVpy84XZO2c0eoMMkzpzdgFeL2WEeM2nGtoRkg9s5aTd4gFoMJHIJa5H8CdJy80zazT/EapHgbUuwk5zBfuw2UbbYH+YxtuY5l5DAz5PDdlvGQIKHoF8k+88Y3vxRlmDPxn782c03f2zk+Nt78WuBgcQGBh4DEIOHKOVgBzIwsD8gWvUoGAWjYBSMLAAAE69FCuwax7YAAAAASUVORK5CYII=","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":true,"prefix":"","firstName":"Junshin","middleName":"","lastName":"Fujiyama","suffix":""},{"id":599604971,"identity":"495a8543-aeff-4c05-943c-dda380812c15","order_by":1,"name":"Hiroki Kobayashi","email":"","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hiroki","middleName":"","lastName":"Kobayashi","suffix":""},{"id":599604974,"identity":"414b849f-e9f9-4b3f-81b7-0410b97f6912","order_by":2,"name":"Itsuki Inada","email":"","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":false,"prefix":"","firstName":"Itsuki","middleName":"","lastName":"Inada","suffix":""},{"id":599604975,"identity":"e12db81c-e887-43f2-a707-3fee9bc5abbb","order_by":3,"name":"Shunji Kato","email":"","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shunji","middleName":"","lastName":"Kato","suffix":""},{"id":599604976,"identity":"648b57f3-75af-47d1-982d-4ff2d92d641e","order_by":4,"name":"Takeshi Ishimoto","email":"","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":false,"prefix":"","firstName":"Takeshi","middleName":"","lastName":"Ishimoto","suffix":""},{"id":599604977,"identity":"6010b5d8-8a6b-44cb-983c-42d2fd4ea772","order_by":5,"name":"Tatsuya Kumano","email":"","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tatsuya","middleName":"","lastName":"Kumano","suffix":""},{"id":599604978,"identity":"ad712c52-de7b-4f19-a910-6925f8563d65","order_by":6,"name":"Mamoru Masuyama","email":"","orcid":"","institution":"Saiseikai Shiga Hospital","correspondingAuthor":false,"prefix":"","firstName":"Mamoru","middleName":"","lastName":"Masuyama","suffix":""}],"badges":[],"createdAt":"2026-02-24 11:10:56","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8956659/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8956659/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104403887,"identity":"f3c71185-cd15-4b73-8789-677aedb89d55","added_by":"auto","created_at":"2026-03-11 12:19:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":347382,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8956659/v1/60a5da8a-b4f5-47b8-9df2-2554f31ce7ff.pdf"},{"id":103861628,"identity":"95d50f2a-2c1f-4eda-8a26-6605779651cf","added_by":"auto","created_at":"2026-03-03 20:09:55","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":47187,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Comparison of perioperative outcomes between Senhance robotic surgery and conventional laparoscopic surgery in appendectomy and cholecystectomy.\u003cbr\u003e\nValues are expressed as median (interquartile range) or number (%).\u003c/p\u003e","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-8956659/v1/993ba0d3162818721d8f92e3.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Perioperative outcomes of Senhance robotic surgery versus conventional laparoscopy in appendectomy and cholecystectomy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe use of robotic platforms in minimally invasive general surgery has increased in recent years, including procedures such as appendectomy and cholecystectomy. However, evidence regarding the perioperative impact of different robotic platforms in these procedures remains limited.\u003c/p\u003e \u003cp\u003eThe Senhance robotic system (Asensus Surgical, Durham, NC, USA) incorporates articulation and haptic feedback while maintaining laparoscopic-based operative concepts〔1\u0026ndash;3〕. Whether these technical characteristics translate into measurable clinical advantages in daily practice is still uncertain.\u003c/p\u003e \u003cp\u003eThis study compared perioperative outcomes between Senhance robotic surgery and conventional laparoscopy for appendectomy and cholecystectomy at a single institution.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eWe reviewed all appendectomy and cholecystectomy procedures performed between October 2022 and October 2025. Surgical approach (Senhance or laparoscopy) defined group allocation.\u003c/p\u003e \u003cp\u003eCollected parameters included age, sex, BMI, operative duration, estimated blood loss, length of stay, and complications graded\u0026thinsp;\u0026ge;\u0026thinsp;II according to Clavien\u0026ndash;Dindo. Open conversion was recorded.\u003c/p\u003e \u003cp\u003eGroup differences were evaluated using the Mann\u0026ndash;Whitney U test or Fisher\u0026rsquo;s exact test. A p value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This retrospective study was approved by the Ethics Committee of Saiseikai Shiga Hospital (Approval No. 835) and conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003ePatient Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge, sex, and BMI distributions were similar across the Senhance and laparoscopic groups in both appendectomy (Table 1a) and cholecystectomy (Table 1b).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAppendectomy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOperative duration was shorter in the Senhance group. Hospitalization time was also reduced. Complication rates were comparable. No open conversion occurred.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCholecystectomy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Senhance cohort showed reduced operative duration. Hospital stay was shorter. Although male distribution differed, complication rates remained comparable. No conversion to open surgery was observed.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOperative duration and hospitalization were shorter in patients treated with Senhance for both procedures, whereas blood loss, complications, and conversion rates remained similar.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;These findings suggest that Senhance can be implemented without compromising perioperative safety in a laparoscopic-experienced center.\u003c/p\u003e\n\u003cp\u003eLimitations include the retrospective design and single-institution setting. Broader evaluation will require prospective multicenter studies.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eSenhance robotic surgery appears to represent a feasible option for appendectomy and cholecystectomy. Operative time and postoperative hospital stay were shorter with Senhance, without increases in morbidity or conversion rates.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e The authors received no specific funding for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e The authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent:\u003c/strong\u003e The requirement for informed consent was waived due to the retrospective nature of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e JF designed the study and drafted the manuscript. HK, II, and SK collected the data. TI, TK, and MM supervised the study. All authors reviewed and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSpinoglio G, et al. The Senhance robotic platform for general surgery: a multi-institutional experience. J Robot Surg. 2022;16(4):759\u0026ndash;766.\u003c/li\u003e\n \u003cli\u003eNishimura T, et al. Early experience with Senhance robotic-assisted surgery in Japan. Asian J Endosc Surg. 2021;14(2):234\u0026ndash;240.\u003c/li\u003e\n \u003cli\u003eHorgan S, et al. Robotic-assisted laparoscopic general surgery: current status and future perspectives. Surg Endosc. 2020;34(3):1043\u0026ndash;1050.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Senhance, robotic surgery, laparoscopic surgery, cholecystectomy, appendectomy","lastPublishedDoi":"10.21203/rs.3.rs-8956659/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8956659/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe clinical performance of Senhance robotic surgery in routine appendectomy and cholecystectomy has not been fully established.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAppendectomy and cholecystectomy cases performed between October 2022 and October 2025 were retrospectively examined, with outcomes compared according to surgical approach.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFor appendectomy (30 vs. 30), the Senhance group showed shorter operative duration and reduced hospitalization. In cholecystectomy (107 vs. 107), operative duration and hospital stay were likewise shorter with Senhance. Complication and conversion rates were comparable.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eWithin this single-center experience, Senhance robotic surgery demonstrated favorable perioperative outcomes without increased morbidity.\u003c/p\u003e","manuscriptTitle":"Perioperative outcomes of Senhance robotic surgery versus conventional laparoscopy in appendectomy and cholecystectomy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-03 20:09:34","doi":"10.21203/rs.3.rs-8956659/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4c226207-d86e-43af-9f7a-a26086aff144","owner":[],"postedDate":"March 3rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-08T13:09:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-03 20:09:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8956659","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8956659","identity":"rs-8956659","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}