Feasibility and Preliminary Effects of a Pressure Sensor-Based Exergame on Cognitive and Sensorimotor Frailty in Low-Income Older Adults Receiving Public Community Care Services: Pilot Randomized Cont

The development of robotic technology has expanded the armamentarium of minimally invasive colorectal surgery and has progressively gained acceptance in clinical practice. The robotic platform provides several technical features, including articulated instruments, stable three-dimensional imaging, and enhanced operator comfort, which may facilitate dissection and reconstruction during technically demanding procedures, particularly within the narrow confines of the pelvis. These characteristics have generated considerable interest in the potential of robotics to optimize surgical performance and improve perioperative outcomes. However, whether these technical advantages translate into meaningful clinical benefits remains a subject of ongoing debate. Evidence from randomized controlled trials, systematic reviews, and meta-analyses has generally demonstrated similar results between robotic and laparoscopic colorectal surgery with regard to postoperative complications, mortality, and oncological quality indicators [–]. At the same time, robotic procedures are consistently associated with increased procedural and infrastructure-related costs. Consequently, the balance between clinical benefit and economic burden continues to represent a major issue when evaluating the role of robotic platforms in contemporary colorectal surgery [–]. Most economic evaluations comparing robotic and laparoscopic colorectal surgery rely on analyses performed at a single point in time and therefore provide only a partial representation of procedural value []. Such studies frequently neglect the progressive changes in surgeon performance that occur with accumulated experience. As a result, important determinants of cost and efficiency, including operative duration, conversion rates, postoperative outcomes, and resource consumption, may not be adequately captured. This issue is particularly relevant in robotic surgery, where proficiency develops gradually through a recognized learning process and performance metrics tend to improve as case volume increases [].