The development of automatically controlled surgical robots（ACSR）is currently hindered by certain limitations such as their rigidity. The use of such robots in surgery presents a significant challenge in safeguarding the delicate structures of a patient’s soft blood vessels and nerves. Consequently, ACSR has not yet found practical application in surgical procedures. This study aimed to overcome these limitations to pioneer the first ACSR with successful practical application in surgery. We used ACSR in Le Fort I osteotomy in maxillofacial surgery. During Le Fort I osteotomy, it is critical for the robot to navigate and perform the procedure without damaging the descending palatine artery, which can lead to severe complications such as fatal bleeding or maxillary osteonecrosis. Although we are still in the basic experimental stage, we succeeded in automatically stopping the osteotomy just before reaching the assumed artery without the need to obtain numerical information from the model in advance（model-free detection). The proposed algorithm for automatic stopping employs a support vector machine to classify and identify the osteotomy reaction force, which is obtained using a reaction force estimation observer based on haptics-related measurement technology.

In breast-conserving surgery, the balance between cancer cure and the cosmetic outcome is crucial. Asymmetry in the position of the nipple-areolar complex（NAC）is considered to have a significant impact on postoperative cosmetic outcomes.
In this study, we retrospectively analyzed cases of breast-conserving surgery for upper, outer quadrant breast cancer conducted at our institution. We examined various factors to predict NAC displacement, including the tumor volume, tumor-to-breast volume ratio calculated using breast MRI analysis software on Fuji Film Medical SYNAPSE VINCENT^®， and other clinical factors. Our findings revealed significant differences in breast ptosis, maximum tumor diameter (assessed via breast ultrasound)， tumor volume, and ratio of the resected to breast volume. Even in cases of upper, outer quadrant breast cancer, consideration should be given to adjusting the position of NAC in patients suspected to have breast ptosis and who undergo large-volume resection.

Total breast reconstruction with fat grafting is a reconstruction method using only the patient’s own fat without the need to create large scars. Compared with autologous flap reconstruction, the procedure is simpler, but it has the disadvantage that it is difficult to predict the outcome, such as how much fat will grow, how many surgeries will be required, and whether the planned breast shape will be achieved. In this paper, we present specific cases and describe the practice of total breast reconstruction with fat grafting after total mastectomy and Nipple/Skin-Sparing Mastectomy（NSM/SSM）.

In 2022, the ‘Treatment procedures for fat grafting to the breast’ were published on the JOPBS website. Fat grafting is used to correct tissue problems caused by radiation injury in addition to the effect of soft tissue augmentation.
This article describes the indications and surgical techniques for reconstruction after breast-conserving therapy. Breast-conserving therapy is administered to treat tissue damage due to irradiation in addition to tissue defects caused by tumor resection. Fat grafting, using an autologous tissue graft that does not necessitate the making of a large wound, is one of the options for reconstruction after breast-conserving therapy.
It is important to have a thorough knowledge of the basic techniques and fat grafting.