We have already found several short-term advantages and disadvantages of robotic surgery. However, the long-term benefits remain still unknown, when compared to those of conventional endoscopic surgery. In this symposium, long-term benefits including the nutritional recovery or postoperative complications as well as the long-term survival results of robotic surgery in the upper GI tract, will be discussed clarifying the evidence levels.

Throughout the history of esophageal cancer surgery, the transition from conventional open transthoracic and transabdominal procedures to minimally invasive esophagectomy has brought about major changes in patient positioning, surgical techniques, and anesthetic management.
More recently, the rapid adoption of robot-assisted surgery has led to the emergence of innovative surgical techniques that are uniquely achievable with robotic platforms. This session will focus on surgical techniques unique to robot-assisted surgery and discuss the future direction of esophageal cancer surgery.

Gastric cancer surgery has undergone remarkable advances, evolving from laparoscopic to robotic approaches. The introduction of robotic surgery has enabled delicate and precise maneuvers that were previously difficult to perform, raising expectations for further improvements in surgical safety, oncologic adequacy, and minimally invasive treatment.
At the same time, a comprehensive assessment of its true clinical significance requires a multifaceted evaluation extending beyond short-term surgical outcomes to include long-term prognosis, postoperative function, quality of life, surgical education and training, and cost-effectiveness. In this session, our distinguished speakers will draw on their extensive experience and the latest evidence to discuss how robotic surgery has transformed gastric cancer surgery and what new possibilities it has opened up. We hope that this session will provide an opportunity for all of us to consider the true nature of the “breakthroughs” brought about by robotic surgery and the future direction of gastric cancer surgery.

In the early stages of robotic surgery, the number of available robot models was limited. However, with the advent of new robotics technologies, there has been a proliferation of surgical assistance robots designed for use in the upper gastrointestinal tract. Depending on the model, these robots feature various characteristics, such as single-port capability, independent arms, haptic feedback, and the use of pivot systems. Furthermore, some high-volume centers possess multiple robots, which raises the question of how to select the appropriate one for each specific case. In this session, we invite participants to deliberate on the efficacy of these novel robots in upper gastrointestinal surgery, the precautions necessary for their utilization, and the methodology for selecting the most suitable model when multiple types are available.

Robotic surgery has rapidly gained acceptance as a minimally invasive approach for colorectal cancer, particularly rectal cancer, and evidence regarding its short-term outcomes has continued to accumulate. However, its long-term oncological outcomes, local recurrence, postoperative function, late complications, patient-reported outcomes, and cost-effectiveness have not yet been fully established.
This symposium will examine the long-term outcomes of robotic surgery for colon and rectal cancer, including comparisons with laparoscopic and open surgery. We welcome submissions presenting large-scale retrospective studies, prospective studies, nationwide database analyses, clinical trials with long-term follow-up, and other investigations that provide meaningful insights for clinical practice. Through these presentations, we aim to clarify the true benefits, limitations, and future perspectives of robotic surgery for colorectal cancer.

Treatment strategies for advanced rectal cancer have changed significantly with advances in multidisciplinary care. In recent years, numerous reports—primarily from overseas—have demonstrated the efficacy of Total Neoadjuvant Therapy (TNT), and its indications are expanding. On the other hand, a major challenge is that fibrosis and tissue changes following neoadjuvant therapy increase the difficulty of surgery. Robot-assisted surgery, leveraging its stable field of view and high maneuverability in the deep pelvis, is expected to be useful in complex pelvic surgeries—including rectal resection and lateral lymph node dissection—following TNT. In this session, we would like to discuss the current status and challenges of robot-assisted surgery following TNT.

In colorectal surgery, multiple robotic surgical systems—including the da Vinci platforms (Xi, SP, and 5), hinotori, and Hugo RAS—have been introduced into clinical practice. Each system has distinct features in terms of arm configuration, console design, instrument articulation, visualization, force or haptic feedback, energy devices, docking, bedside assistance, and training capabilities. Platform selection is also influenced by institutional factors, including acquisition and operating costs, operating room environment, staffing, and surgical volume. Moreover, clinical outcomes and usability depend on the surgeon’s experience, learning curve, surgical procedure, and team workflow, making it difficult to compare platforms solely in terms of technical superiority. This session will share clinical experience and outcomes with these robotic platforms in colorectal cancer surgery and compare their strengths and limitations from the perspectives of safety, operability, procedure-specific indications, minimally invasive benefits, education, team management, and cost-effectiveness. Through these discussions, we aim to explore how the unique features of each platform can be translated into patient benefit and to clarify future directions for appropriate platform selection and further standardization of robotic colorectal surgery.

Robot-assisted surgery for rectal cancer provides high-resolution 3D imaging and articulated instruments, allowing for precise anatomical identification and surgical manipulation within the narrow pelvic cavity. However, in extended surgeries involving multiorgan resection, unique challenges and pitfalls remain, such as the difficulty of surgical field exposure for bulky tumors and the risk of tissue injury or positive resection margins due to the lack of tactile feedback. This session invites video presentations demonstrating institutional innovations and surgical tips to overcome these limitations. Furthermore, we aim to discuss the validity and clinical utility of robot-assisted extended surgery, focusing not only on short-term outcomes but also on long-term oncological prognoses, including local control and survival rates.

Robotic pancreaticoduodenectomy (RPD) has become increasingly standardized in recent years; however, in RPD for malignancy—particularly pancreatic cancer—reliable dissection from the superior mesenteric artery (SMA) is an essential step for securing an adequate resection margin. The approach to the SMA varies among institutions, and the recognition of the dissection plane and the extent of lymphadenectomy are critical issues, relating not only to surgical safety but also to oncological curability. In this session, we would like to invite presentations on the SMA approach in RPD for pancreatic cancer from each institution, demonstrating the technical refinements that take advantage of the precision of the robotic platform, and to facilitate a discussion including surgical outcomes such as the R0 resection rate.

Robotic liver resection has rapidly gained widespread adoption since its insurance coverage began in 2022 in Japan. Surgical techniques have become relatively stabilized, and the application of robotic surgery to more complex procedures is expanding. The number of available robotic platforms has also increased, leading to the development of platform specific techniques and procedure selections, and the usefulness of the two surgeon method has been highlighted.
On the other hand, standardized techniques for highly complex procedures have yet to be fully established. Moreover, evidence comparing laparoscopic and robotic liver resection in Japan remains limited, and discussions are still insufficient regarding which procedures or disease conditions may demonstrate clear advantages of robotic liver resection. Considering international trends, expectations are growing for institutions to share their experiences and propose roadmaps for applying robotic surgery to biliary or vascular reconstruction during hepatectomy and even liver transplantation. We hope to deepen discussions on these issues based on the experiences accumulated at each center.

In robotic cardiac surgery, the patients-side surgeon directly ensures patient safety as the hands of the console surgeon. However, they face unique tactical and psychological pressures, such as the heavy responsibility of assisting without haptic feedback, visual and sensory gaps with the console, and the constant stress of potential emergency conversions to open surgery. This symposium highlights the specific struggles of those on the frontline and explores practical solutions to support their critical role.

Robotic cardiac surgery has steadily gained wider acceptance, and its application has recently been expanded to cardiac tumor resection. Although current indications are primarily limited, further evaluation is needed regarding patient selection, surgical techniques, safety, and the benefits of minimally invasive surgery. In this session, leading Japanese surgeons will share their latest experience and insights, followed by a discussion of the current status, remaining challenges, and future perspectives of robotic cardiac tumor resection.

Robot-assisted aortic valve replacement (RAVR) has entered a new phase of clinical implementation in Japan. Nevertheless, several important challenges remain. In this session, we are honored to welcome leading surgeons from Japan and abroad to share their surgical techniques, clinical experience, technical considerations, outcomes, and future perspectives. Together, we will discuss the safe dissemination and further development of RAVR, as well as its future direction in Japan.

Pulmonary segmentectomy for primary lung cancer has been increasingly adopted in Japan. According to the 2024 nationwide survey, a total of 10,181 segmentectomies were performed, including 7,909 by video-assisted thoracoscopic surgery (VATS) and 2,586 by robotic-assisted thoracic surgery (RATS), reflecting the steadily increasing adoption of the robotic approach. Robotic-assisted pulmonary lobectomy was reimbursed under the Japanese national health insurance system in April 2018, followed by robotic-assisted pulmonary segmentectomy in April 2020, and RATS segmentectomy has since become an established surgical option for early-stage lung cancer.
Now that more than five years have passed since its reimbursement, it is an appropriate time to comprehensively evaluate the true value of robotic-assisted pulmonary segmentectomy by assessing not only short-term perioperative outcomes but also mid- and long-term oncologic results.
In this session, we welcome to speakers to present their institutional experience and mid- to long-term outcomes of robotic-assisted pulmonary segmentectomy. Through these presentations, we aim to discuss the safety, oncologic efficacy, durability, appropriate indications, and future role of this procedure from multiple perspectives.

Robotic surgery offers excellent visualization and precise instrument control, but unexpected bleeding, organ injury, or device-related problems may rapidly create a critical situation. At such moments—the “Moment of Truth”—the judgment, technical skill, and preparedness of both the surgeon and the entire surgical team are put to the test.
Serious complications are rarely caused by a single event. Preoperative assessment, port placement, tissue exposure, dissection planes, energy-device use, and team communication may all contribute. The key is to recognize warning signs, prevent escalation, and respond promptly with an effective recovery strategy.
This session will focus on critical events encountered during robotic surgery, including their causes, prevention, immediate management, repair techniques, and conversion when necessary. By sharing practical lessons from difficult cases, we aim to improve the safety and reliability of robotic surgery.

Robot-assisted thoracic surgery (RATS) has rapidly gained widespread adoption in recent years. Beyond conventional multi-port RATS, a variety of approaches have been reported, including dual-port RATS (D-RATS), uniportal RATS, and single-port surgery using the da Vinci SP system. Furthermore, new surgical concepts—such as fused surgery that relies on the active participation of an assistant—are being proposed.
Alongside technological advancements in robotic surgical systems, establishing educational and training frameworks to safely and efficiently develop the next generation of robotic surgeons has become a critical challenge.
In this session, we invite presentations from leading institutions regarding the diverse approaches to robotic thoracic surgery (multi-port, D-RATS, uniportal, and single-port) and associated educational strategies, with the aim of discussing future developments and challenges in the field.

The era of perioperative therapy demands not only less invasive surgery, but also higher-quality surgery. The true value of robotic-assisted surgery does not lie in the technology itself, but in whether it can improve oncologic quality, safety, functional preservation, and ultimately patient outcomes within a multidisciplinary treatment strategy. This panel discussion will address what can be achieved specifically through robotic-assisted surgery, when the robotic approach is truly necessary, and what evidence is still required. We welcome submissions on surgical techniques, lymph node dissection, sublobar resection, education, integration with perioperative therapy, and clinical research that will help shape the future of lung cancer surgery.

It has been nearly five years since transoral robotic surgery (TORS) for head and neck cancer was covered by the Japanese national health insurance system. In this symposium, three leading experts in head and neck robotic surgery will share their experience with different robotic platforms, including practical surgical techniques, technical tips, and the application of robotic surgery to thyroid procedures. We hope this symposium will provide an opportunity to review the current status and future perspectives of head and neck robotic surgery and offer practical insights that participants can apply in their daily clinical practice.

In recent years, robotic thyroidectomy in head and neck surgery and endocrine surgery has advanced rapidly, evolving with diverse approaches including transaxillary, bilateral axillo-breast (BABA), transoral, and gasless (with or without insufflation) techniques. This video workshop aims to deeply discuss the latest clinical outcomes, enhancements in cosmetic results, and surgical skills or innovations to ensure safety across these various approaches. In addition to cutting-edge presentations by invited experts, we widely welcome abstract submissions demonstrating institutional innovations, technical tips, and troubleshooting. We look forward to active discussions that will contribute to the standardization and future development of robotic thyroid surgery.

A multicenter clinical trial was initiated last year with the aim of having robot-assisted myomectomy (RAM) covered by insurance. However, under this year’s revision of medical fees, RAM was not covered by insurance. The clinical trial data are currently being analyzed, and some institutions continue to perform RAM as self-funded medical care. In this session, we will present the results of the clinical trial data analysis as well as surgical outcomes from individual institutions, and discuss future prospects.

The LACC study was a multicenter clinical trial mainly in the United States that sought to demonstrate the non-inferiority of radical hysterectomy for cervical cancer by laparoscopic/robotic surgery to open surgery, ended with negative results. In particular, very rare recurrence patterns were observed in laparoscopic/robotic surgery such as intraperitoneal dissemination, which suggested that the cervical cancer lesion was exposed intraperitoneally during surgery process. Many issues were pointed out various problems in this study design, and subsequently, clinical trials that improved these problems and demonstrated the non-inferiority of laparoscopic/robotic surgery to open surgery were reported from various countries. In particular, European multicenter clinical trials (RACC trial) specializing in robotic radical hysterectomy are expected to soon report a non-inferiority to open surgery.
Following Japanese insurance coverage for robotic radical hysterectomy in June 2026, this symposium will start by the presentations on the advanced medical clinical trial B for robotic radical hysterectomy that had been underway in Japan even before the LACC study report.
Thereafter, presentations on robotic surgical procedures that focus on removing the cervical cancer lesion without exposing during hysterectomy. Discussions are planned to promote the safe widespread of robotic radical hysterectomy in Japan going forward.

Robot-assisted orthopaedic surgery has become increasingly integrated into clinical practice, particularly in joint arthroplasty and spine surgery, offering improved accuracy, reproducibility, and surgical precision. However, robotic systems are designed to assist—not replace—the surgeon. Their successful application depends on meticulous preoperative planning, accurate registration, careful intraoperative verification, and a thorough understanding of system-specific limitations and potential pitfalls.

Despite remarkable technological advances, errors may still occur because of registration inaccuracies, technical issues, workflow deviations, or inappropriate clinical judgment. Therefore, the key to safe and effective robot-assisted surgery lies not in relying on the technology itself, but in maintaining vigilant human oversight throughout every step of the procedure.

This symposium will bring together experienced surgeons to share practical knowledge gained from real-world clinical experience. Speakers will discuss common pitfalls, troubleshooting strategies, and technical tips for preventing and managing intraoperative challenges. In addition to successful cases, the session will highlight complications, near misses, and lessons learned, providing valuable insights that are often absent from textbooks and conventional surgical training.

By openly discussing these experiences, we aim to provide participants with practical strategies that can be immediately translated into daily practice, ultimately improving both surgical safety and procedural accuracy.

The central message of this symposium is straightforward: robots can enhance surgical performance, but patient safety ultimately depends on the surgeon. Understanding when to trust the technology—and when to question and verify it—is essential for achieving the full potential of robot-assisted orthopaedic surgery.

In recent years, with the expansion of robot-assisted surgery, an increasing number of institutions have introduced multiple surgical robotic systems. Furthermore, the development and clinical introduction of new robotic platforms are progressing rapidly. In this multi-platform era, decisions regarding whether to adopt the same system or different systems require careful consideration based on the actual circumstances of each institution. New platforms offer a variety of unique functions and features, and operational strategies that can effectively utilize these capabilities are also essential. Meanwhile, robot-assisted surgery in urology covers a wide range of organs, and its purposes are highly diverse, including the treatment of both benign and malignant conditions, as well as functional preservation and functional improvement. For these various surgical procedures, the selective use of different platforms, including newly introduced ones, is carried out according to each institution's own policy. Such decisions require consideration not only of the functional characteristics of each device, but also of various factors such as cost, surgical slot availability, and staff allocation. In this symposium, we would like to share how various robotic systems are selectively used at each institution, along with their unique institutional policies, in the diversifying field of robot-assisted urologic surgery, and to discuss how to adapt to the ever-expanding multi-platform era.

Robot-assisted surgery has become the standard surgical approach for the treatment of renal cell carcinoma, with either radical nephrectomy or partial nephrectomy selected according to tumor size, stage, and other clinical factors. Robot-assisted partial nephrectomy requires advanced surgical expertise tailored to the tumor's characteristics and location, and numerous technical refinements have been developed for tumor excision and renal reconstruction. More recently, the indications for robot-assisted surgery have expanded to include selected cases of locally advanced renal cell carcinoma, such as tumors with inferior vena cava thrombus extension. Although favorable perioperative and oncological outcomes have been reported compared with open and conventional laparoscopic surgery, robot-assisted surgery also presents unique technical challenges and limitations. In this session, we will discuss the current state of the art in robot-assisted surgery for complex renal cancer cases, drawing on the latest evidence and the extensive experience of leading experts, and we look forward to a lively and insightful discussion.

The proportion of robot-assisted surgery in minimally invasive urologic surgery has continued to increase and has now surpassed that of conventional laparoscopic surgery in many procedures. As robot-assisted surgery becomes more widespread, the strategies for troubleshooting intraoperative complications have also evolved and differ from those used in conventional laparoscopy.
A variety of intraoperative complications may occur during urologic surgery, including vascular injury, urinary tract injury, bowel injury, and injury to solid organs. Furthermore, the types of complications encountered vary depending on the surgical field, such as the upper abdomen or the pelvis.
In this video workshop, invited experts and selected presenters will demonstrate practical troubleshooting strategies for managing these complications during robot-assisted urologic surgery. Through the presentation and discussion of representative cases, we aim to share technical tips and surgical judgment, promote effective management of intraoperative complications, and facilitate discussion on how to further improve the safety of robot-assisted urologic surgery.

Robot-assisted surgery has rapidly become widespread, characterized by an increasing number of adopting facilities, a growing installation base, and the broader introduction of new models. In response to this trend, the fiscal year 2026 medical fee schedule revision introduced enhanced reimbursement rates for specific procedures, expanded the scope of surgeries covered by national health insurance, and established a new additional reimbursement structure for the use of robotic equipment.
In this session, participants will discuss these developments from a multifaceted perspective. Key topics will include institutional initiatives to increase the volume of robot-assisted surgeries based on cost-effectiveness, strategies for achieving cost reductions, and the optimal allocation of roles between conventional endoscopic and robot-assisted surgeries.

Robotic surgery has rapidly expanded across a wide range of surgical specialties. To ensure its continued safety and quality, it is essential to establish structured educational systems that do not rely solely on the experience and individual efforts of surgeons. Training robotic surgeons requires a multifaceted approach, including simulation-based training, surgical observation, stepwise experience as an assistant and console surgeon, proctoring, and assessment using surgical videos. However, training methods and competency standards vary among specialties and organ-specific fields, and disparities among institutions remain an important challenge. In this symposium, we will share current practices and challenges in robotic surgeon training across different specialties and discuss educational methods, competency assessment, faculty development, and safety management that can be applied beyond the boundaries of individual departments.

Robotic surgery has rapidly expanded across surgical specialties and has contributed to improving the quality and safety of surgical treatment. Further advancement will require not only technological innovation, but also new clinical and organizational frameworks, including AI-assisted surgery, remote mentoring and support, and collaboration among hospitals and regions.
This cross-disciplinary symposium will discuss the future of robotic surgery from clinical, technological, educational, and organizational perspectives. Topics will include intraoperative AI support, surgical education, telesurgical mentoring/ support by experienced surgeons, and sustainable regional systems for providing robotic surgery. Through discussion across specialties, the symposium aims to explore the next generation of surgical care.

Robotic surgery enables surgeons to perform dissection and tissue division with stable visualization, tremor-free precision, and instruments equipped with EndoWrist technology. These features offer substantial benefits to both surgeons and patients. To maximize these advantages, however, surgeons must fully understand the operating principles and characteristics of the energy devices they use and apply them appropriately.
In this session, the speakers will present the key factors they consider when selecting energy devices, as well as the technical points and precautions they emphasize during dissection and tissue division. Through the presentation of surgical videos, they will also share their individual preferences and specific approaches to each device. The session aims to promote a practical and in-depth discussion on the safe and effective use of energy devices in robotic surgery.