# Clinical advantages of a new collaborative assistant robot (ANSUR surgical unit) in laparoscopic appendectomy and cholecystectomy

## TL;DR

This study evaluates a new robotic assistant (ANSUR) in laparoscopic surgeries, finding it safe and potentially helpful in reducing healthcare workforce demands.

## Contribution

The study introduces and evaluates the ANSUR surgical unit, a new collaborative assistant robot for laparoscopic procedures.

## Key findings

- ANSUR-assisted laparoscopic appendectomy had fewer complicated appendicitis cases compared to conventional methods.
- No conversion to open surgery occurred in ANSUR-assisted laparoscopic appendectomy or cholecystectomy.
- The setup time for ANSUR-assisted surgeries was short, with no significant differences in outcomes compared to conventional laparoscopic surgery.

## Abstract

To evaluate the efficacy of ANSUR-assisted laparoscopic appendectomy and cholecystectomy compared with conventional laparoscopic surgery (LS). The ANSUR surgical unit (ASAHI INTECC CO., LTD., Aichi, Japan) is a new collaborative assistant robot equipped with three arms. However, no studies have reported on ANSUR, and its clinical advantages remain unclear. We retrospectively evaluated the data of 145 patients who underwent laparoscopic appendectomy and 261 patients who underwent laparoscopic cholecystectomy, in both elective and emergency settings, at our institution between January 2023 and June 2025. ANSUR-assisted laparoscopic appendectomy was performed in 30 of 145 patients, and ANSUR-assisted laparoscopic cholecystectomy in 36 of 261 patients. In laparoscopic appendectomy, the proportion of complicated appendicitis in the ANSUR-assisted LS group was significantly lower than that in the conventional LS group (p = 0.006). However, no significant differences in the perioperative outcomes were observed between the two groups. In laparoscopic cholecystectomy, the proportion of emergency ANSUR-assisted LS cases was lower than that of conventional LS (p = 0.041). The intraoperative and postoperative outcomes of ANSUR-assisted LS were comparable to those of conventional LS. No conversion to open surgery occurred in either ANSUR-assisted laparoscopic appendectomy or cholecystectomy. The median setup time—defined as the interval between ANSUR roll-in and the start of surgery—was 5 min for laparoscopic appendectomy and 8 min for laparoscopic cholecystectomy. ANSUR is a feasible, preliminary, and safe collaborative assistive robot for laparoscopic appendectomy and cholecystectomy. Additionally, ANSUR is expected to have clinical benefit in reducing healthcare manpower constrains.

The online version contains supplementary material available at 10.1007/s11701-025-03102-w.