literature review for history

HIST495 Introduction to Historical Interpretation (History Honors)

• Getting Started
• Consulting Reference Materials for Overview/Background Information
• Finding Primary Sources
• Finding Secondary Sources (Books and Articles)
• Locating Book Reviews

Guidelines and Examples

3 simple steps to get your literature review done (nus libraries).

• Creating an Annotated Bibliography
• Strategies for Building Your Bibliography
• Special Collections and Archives Outside of the US
• Rose Library, Emory University and Other Archives Within Georgia
• Writing & Citing
• Library Assignments
• Introduction to Literature Reviews (UNC)
• Literature Review Guidelines (Univ. of Mary Washington)
• Organizing Research for Arts and Humanities Papers and Theses: Writing A Literature Review
• Write a Literature Review (JHU)
• Example from the University of Mary Washington

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HIST 300 - Introduction to Historical Studies: Historiographic Essay (Literature Review)

• Getting Started
• Ask-a-Librarian
• Annotated Bibliography
• Spartanburg Community College Annotated Bibliography Examples
• Historiographic Essay (Literature Review)
• What are Reference Sources and When Should I Use Them?
• Developing Keywords and Related Ideas
• Types of Searches
• Evaluating Websites for Credibility
• Search Strategies for Books
• Finding Credible Sources
• Online Statistical Resources
• Finding Articles from Citations
• Citation Mining
• Primary Sources for China scholarship
• Important Journals on Modern China
• U.K. Parliamentary Papers
• Historic Newspapers and Digital Newspaper Collections
• Objectivity and Bias - Newspapers
• How to Google for Primary Sources
• Using Google and Google Scholar
• Chicago Style Citation Basics
• New York Times - complimentary online access
• Library Session Online Evaluation Links

What is a Historiographic Essay / Historiographic Review?

A Historiographic Essay (also known as a Historiographic Review or, outside of the history discipline, a Literature Review ) is a systematic and comprehensive analysis of books, scholarly articles, and other sources relevant to a specific topic that provides a base of knowledge. Literature reviews are designed to identify and critique the existing literature on a topic, justifying your research by exposing gaps in current research. 

This investigation should provide a description, summary, and critical evaluation of works related to the research problem or question, and should also add to the overall knowledge of the topic as well as demonstrating how your research will fit within a larger field of study.  A literature review should offer critical analysis of the current research on a topic and that analysis should direct your research objective. This should not be confused with a book review or an annotated bibliography; both are research tools but very different in purpose and scope.  A Literature Review can be a stand alone element or part of a larger end product, so be sure you know your assignment.  Finally, don't forget to document your process, and keep track of your citations!

Process of a Literature Review

The process of writing a literature review is not necessarily a linear process, you will often have to loop back and refine your topic, try new searches and altar your plans. The info graphic above illustrates this process.  It also reminds you to continually keep track of your research by citing sources and creating a bibliography.

• Know what the review is for; each assignment will offer the purpose for the review.  For example, is it for “background”, or a “pro and con discussion”, "integration", “summarizing”, etc.
• Create a “search plan”, decide where you will search for information, what type of information you will need.
• Research   - Preform Searches; choose sources and collect information to use in your paper.  Make sure you cite the sources used.
• Think  - Analyze information in a systematic manner and begin your literature review (e.g., summarize, synthesize, etc.). Make sure you cite the sources used.
• Complete  - Write your paper, proof & revise and create your finished bibliography.

Elements in a Literature Review

• Elements in a Literature Review txt of infographic

What to Avoid

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• CAREER FEATURE
• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Credit: Getty

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

WENTING ZHAO: Be focused and avoid jargon

Assistant professor of chemical and biomedical engineering, Nanyang Technological University, Singapore.

When I was a research student, review writing improved my understanding of the history of my field. I also learnt about unmet challenges in the field that triggered ideas.

For example, while writing my first review 1 as a PhD student, I was frustrated by how poorly we understood how cells actively sense, interact with and adapt to nanoparticles used in drug delivery. This experience motivated me to study how the surface properties of nanoparticles can be modified to enhance biological sensing. When I transitioned to my postdoctoral research, this question led me to discover the role of cell-membrane curvature, which led to publications and my current research focus. I wouldn’t have started in this area without writing that review.

Collection: Careers toolkit

A common problem for students writing their first reviews is being overly ambitious. When I wrote mine, I imagined producing a comprehensive summary of every single type of nanomaterial used in biological applications. It ended up becoming a colossal piece of work, with too many papers discussed and without a clear way to categorize them. We published the work in the end, but decided to limit the discussion strictly to nanoparticles for biological sensing, rather than covering how different nanomaterials are used in biology.

My advice to students is to accept that a review is unlike a textbook: it should offer a more focused discussion, and it’s OK to skip some topics so that you do not distract your readers. Students should also consider editorial deadlines, especially for invited reviews: make sure that the review’s scope is not so extensive that it delays the writing.

A good review should also avoid jargon and explain the basic concepts for someone who is new to the field. Although I trained as an engineer, I’m interested in biology, and my research is about developing nanomaterials to manipulate proteins at the cell membrane and how this can affect ageing and cancer. As an ‘outsider’, the reviews that I find most useful for these biological topics are those that speak to me in accessible scientific language.

Bozhi Tian likes to get a variety of perspectives into a review. Credit: Aleksander Prominski

BOZHI TIAN: Have a process and develop your style

Associate professor of chemistry, University of Chicago, Illinois.

In my lab, we start by asking: what is the purpose of this review? My reasons for writing one can include the chance to contribute insights to the scientific community and identify opportunities for my research. I also see review writing as a way to train early-career researchers in soft skills such as project management and leadership. This is especially true for lead authors, because they will learn to work with their co-authors to integrate the various sections into a piece with smooth transitions and no overlaps.

After we have identified the need and purpose of a review article, I will form a team from the researchers in my lab. I try to include students with different areas of expertise, because it is useful to get a variety of perspectives. For example, in the review ‘An atlas of nano-enabled neural interfaces’ 2 , we had authors with backgrounds in biophysics, neuroengineering, neurobiology and materials sciences focusing on different sections of the review.

After this, I will discuss an outline with my team. We go through multiple iterations to make sure that we have scanned the literature sufficiently and do not repeat discussions that have appeared in other reviews. It is also important that the outline is not decided by me alone: students often have fresh ideas that they can bring to the table. Once this is done, we proceed with the writing.

I often remind my students to imagine themselves as ‘artists of science’ and encourage them to develop how they write and present information. Adding more words isn’t always the best way: for example, I enjoy using tables to summarize research progress and suggest future research trajectories. I’ve also considered including short videos in our review papers to highlight key aspects of the work. I think this can increase readership and accessibility because these videos can be easily shared on social-media platforms.

ANKITA ANIRBAN: Timeliness and figures make a huge difference

Editor, Nature Reviews Physics .

One of my roles as a journal editor is to evaluate proposals for reviews. The best proposals are timely and clearly explain why readers should pay attention to the proposed topic.

It is not enough for a review to be a summary of the latest growth in the literature: the most interesting reviews instead provide a discussion about disagreements in the field.

Careers Collection: Publishing

Scientists often centre the story of their primary research papers around their figures — but when it comes to reviews, figures often take a secondary role. In my opinion, review figures are more important than most people think. One of my favourite review-style articles 3 presents a plot bringing together data from multiple research papers (many of which directly contradict each other). This is then used to identify broad trends and suggest underlying mechanisms that could explain all of the different conclusions.

An important role of a review article is to introduce researchers to a field. For this, schematic figures can be useful to illustrate the science being discussed, in much the same way as the first slide of a talk should. That is why, at Nature Reviews, we have in-house illustrators to assist authors. However, simplicity is key, and even without support from professional illustrators, researchers can still make use of many free drawing tools to enhance the value of their review figures.

Yoojin Choi recommends that researchers be open to critiques when writing reviews. Credit: Yoojin Choi

YOOJIN CHOI: Stay updated and be open to suggestions

Research assistant professor, Korea Advanced Institute of Science and Technology, Daejeon.

I started writing the review ‘Biosynthesis of inorganic nanomaterials using microbial cells and bacteriophages’ 4 as a PhD student in 2018. It took me one year to write the first draft because I was working on the review alongside my PhD research and mostly on my own, with support from my adviser. It took a further year to complete the processes of peer review, revision and publication. During this time, many new papers and even competing reviews were published. To provide the most up-to-date and original review, I had to stay abreast of the literature. In my case, I made use of Google Scholar, which I set to send me daily updates of relevant literature based on key words.

Through my review-writing process, I also learnt to be more open to critiques to enhance the value and increase the readership of my work. Initially, my review was focused only on using microbial cells such as bacteria to produce nanomaterials, which was the subject of my PhD research. Bacteria such as these are known as biofactories: that is, organisms that produce biological material which can be modified to produce useful materials, such as magnetic nanoparticles for drug-delivery purposes.

Synchronized editing: the future of collaborative writing

However, when the first peer-review report came back, all three reviewers suggested expanding the review to cover another type of biofactory: bacteriophages. These are essentially viruses that infect bacteria, and they can also produce nanomaterials.

The feedback eventually led me to include a discussion of the differences between the various biofactories (bacteriophages, bacteria, fungi and microalgae) and their advantages and disadvantages. This turned out to be a great addition because it made the review more comprehensive.

Writing the review also led me to an idea about using nanomaterial-modified microorganisms to produce chemicals, which I’m still researching now.

PAULA MARTIN-GONZALEZ: Make good use of technology

PhD student, University of Cambridge, UK.

Just before the coronavirus lockdown, my PhD adviser and I decided to write a literature review discussing the integration of medical imaging with genomics to improve ovarian cancer management.

As I was researching the review, I noticed a trend in which some papers were consistently being cited by many other papers in the field. It was clear to me that those papers must be important, but as a new member of the field of integrated cancer biology, it was difficult to immediately find and read all of these ‘seminal papers’.

That was when I decided to code a small application to make my literature research more efficient. Using my code, users can enter a query, such as ‘ovarian cancer, computer tomography, radiomics’, and the application searches for all relevant literature archived in databases such as PubMed that feature these key words.

The code then identifies the relevant papers and creates a citation graph of all the references cited in the results of the search. The software highlights papers that have many citation relationships with other papers in the search, and could therefore be called seminal papers.

My code has substantially improved how I organize papers and has informed me of key publications and discoveries in my research field: something that would have taken more time and experience in the field otherwise. After I shared my code on GitHub, I received feedback that it can be daunting for researchers who are not used to coding. Consequently, I am hoping to build a more user-friendly interface in a form of a web page, akin to PubMed or Google Scholar, where users can simply input their queries to generate citation graphs.

Tools and techniques

Most reference managers on the market offer similar capabilities when it comes to providing a Microsoft Word plug-in and producing different citation styles. But depending on your working preferences, some might be more suitable than others.

Reference managers

Here is a comparison of the more popular collaborative writing tools, but there are other options, including Fidus Writer, Manuscript.io, Authorea and Stencila.

Collaborative writing tools

*Markdown and LaTex are code-based formatting languages favoured by physicists, mathematicians and computer scientists who code on a regular basis, and less popular in other disciplines such as biology and chemistry.

doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

Article   PubMed   Google Scholar  

Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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• How to Write a Literature Review | Guide, Examples, & Templates

How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

• Search for relevant literature
• Evaluate sources
• Identify themes, debates, and gaps
• Outline the structure
• Write your literature review

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.

• Quick Run-through
• Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

• Demonstrate your familiarity with the topic and its scholarly context
• Develop a theoretical framework and methodology for your research
• Position your work in relation to other researchers and theorists
• Show how your research addresses a gap or contributes to a debate
• Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

• Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
• Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
• Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
• Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

• Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
• Body image, self-perception, self-esteem, mental health
• Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

• Your university’s library catalogue
• Google Scholar
• Project Muse (humanities and social sciences)
• Medline (life sciences and biomedicine)
• EconLit (economics)
• Inspec (physics, engineering and computer science)

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

• What question or problem is the author addressing?
• What are the key concepts and how are they defined?
• What are the key theories, models, and methods?
• Does the research use established frameworks or take an innovative approach?
• What are the results and conclusions of the study?
• How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
• What are the strengths and weaknesses of the research?

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

• Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
• Themes: what questions or concepts recur across the literature?
• Debates, conflicts and contradictions: where do sources disagree?
• Pivotal publications: are there any influential theories or studies that changed the direction of the field?
• Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

• Most research has focused on young women.
• There is an increasing interest in the visual aspects of social media.
• But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

• Look at what results have emerged in qualitative versus quantitative research
• Discuss how the topic has been approached by empirical versus theoretical scholarship
• Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

• Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically evaluate: mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

Open Google Slides Download PowerPoint

If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

• To familiarize yourself with the current state of knowledge on your topic
• To ensure that you’re not just repeating what others have already done
• To identify gaps in knowledge and unresolved problems that your research can address
• To develop your theoretical framework and methodology
• To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• Summarize and synthesize: Give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: Don’t just paraphrase other researchers – add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
• Critically Evaluate: Mention the strengths and weaknesses of your sources
• Write in well-structured paragraphs: Use transition words and topic sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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History: Historiography and Historiographical Essays/Literature Reviews

• Beginning Your Historical Research
• Primary Sources
• Historiography and Historiographical Essays/Literature Reviews
• Books and Ebooks
• Dissertations and Theses
• Review Sources (Including Book Reviews)
• Latin America
• Middle East
• United States
• History of Science
• Annotated Bibliographies and Literature Reviews

Strategy to Search for Historiographical Sources

In addition to using the sources identified below, a useful strategy to search for historiographical literature in library catalogs and article databases is to search for:

 historiograph* (historiography OR historiographical) AND particular subject area(s) 

What is Historiography

History is a classical intellectual/research discipline with roots stretching back for centuries.  As Such, History has its own, complex tradition of literature review called “historiography.”  Simply defined, Historiography is the History of History – that is, the study of the History produced and written on a given project, including:

• Approaches/angles to studying that history
• Subthemes beneath a wider historical umbrella theme
• Different historical traditions, including Social History, Cultural History, Diplomatic and Political History, the History of Science, Intellectual History, and much more
• Theoretical Frameworks used to shape that history
• Existing used and unused sources to research particular histories

There are also many books dedicated to historiography – both as a discipline (that is, books dedicate to the general theory, philosophy and practice of historiography) as well as books reviewing historiographies of scholarship in particular areas of history. 

The American Historical Review is the seminal journal published in the United States dedicated to Historiography on all (not just U.S.) historical topics.

Reference Sources to Assist with Historiography

There are several excellent sources to identify key historians and key works in particular fields (whether subject, temporal, or geographically based).  These may also be helpful in preparing for qualifying exams as they provide overviews of the historiography on given topics as well as the frameworks and theoretical orientations associated and/or applied with/to them.  Unfortunately the print works below are dated; much new history has been written since their publication!

• The Encyclopedia of Historians and Historical Writing by Kelly Boyd Call Number: Geisel Floor2W Reference D14.E58 1999 Publication Date: 1999
• A Global Encyclopedia of Historical Writing by D. (Daniel) R. Wolf Call Number: Geisel Floor2W Reference D13.G47 1998 Publication Date: 1999
• The AHA Guide to Historical Literature Call Number: Geisel Floor2W Reference D2.A55 1995 Publication Date: 1995 More than Historical Essays, this contains Bibliographies in Different Fields

Oxford Bibliographies :  Annotated bibliographies and Bibliographic Essays on a wide range of subjects which not only point to excellent publications, but also provide examples of bibliographic essays, which are closely related to historiographical essays and literature reviews.

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• Last Updated: Aug 23, 2024 1:36 PM
• URL: https://ucsd.libguides.com/History

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Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
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• Choosing a Title
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• Theoretical Framework
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• Qualitative Methods
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A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE: Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 

How to write a good literature review 

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

Whether you’re exploring a new research field or finding new angles to develop an existing topic, sifting through hundreds of papers can take more time than you have to spare. But what if you could find science-backed insights with verified citations in seconds? That’s the power of Paperpal’s new Research feature!  

How to write a literature review faster with Paperpal?

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 
• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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Literature Review

What is a Literature Review?

It is…. a systematic and critical analysis of the literature on a specific topic. It describes trends, quality, relationships, inconsistencies and gaps in the research; and it details how the works enhance your understanding of the topic at large.

It is NOT…. simply an annotated bibliography that summarizes and/or assesses each article. There is not one, correct way to approach and write a literature review. It can be a stand-alone paper or part of a thesis/dissertation. Format and requirements can vary between disciplines, purpose and intended audience.

A literature review is an overview of existing literature (books, articles, dissertations, conference proceedings, and other sources) in a particular scholarly area. With a lit review, you will:

• Gather information about your topic, including the sources used by others who have previously conducted research
• Find out if your specific research question has already been answered
• Find out what areas or perspectives have not yet been covered by others on your topic
• Analyze and evaluate existing information

The literature review will assist you in considering the validity and scope of your research question so that you can do the necessary revision and fine tuning to it. It provides the foundation to formulate and present strong arguments to justify your chosen research topic.

• How to Write a Literature Review  (University of California, Santa Cruz)

Check out these books from the library for further guidance:

• Després, Carole. "The meaning of home: literature review and directions for future research and theoretical development." Journal of architectural and planning research 8, no.2, (Summer 1991): 96-155.
• Steiner, Frederick R. "Philadelphia, the holy experiment: A literature review and analysis." Ekistics , 49, (1982): 298-305.

Reckoning with Authorities

As you are developing your Lit Review, part of your objective is to identify the leading authorities within the field or who address your topic or theme. Some tips for identifying the scholars:

Old Fashioned Method:

• Keep notes on footnotes and names as you read articles, books, blogs, exhibition catalogs, etc. Are there names or works that everyone references? Use the catalog to track these reference down.
• Consider looking for state of the field articles often found either in a discipline's primary journal or in conference proceedings - keynote speakers.
• Look for book reviews.

Publication Metrics:

• These resources include information about the frequency of citations for an article/author.
• These resources are not specifically for Architecture or Planning. Remember therefore to be critical and careful about the assumptions you make with regard to the results!

The Web of Science platform currently also provides temporary access to several databases that are not part of the Core Collection, including Biosis Citation Index, Data Citation Index, and Zoological Record.

Use this link to access Google Scholar, and see our Google Scholar Guide for information on using this resource.

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Testicular tumor in a case of, undescended testes, persistent mullerian duct syndrome and transverse testicular ectopia: Report of a case and review of the literature

A 20-year-old with normal male body features and secondary sexual characteristics presented with a right testicular swelling. Imaging revealed a right testicular mass, leading to a diagnosis of classical seminoma. During inguinal orchiectomy, a solid testicular mass was found on the right side along with two spermatic cords, one attached to the mass and the other to a structure resembling a testes. Examination showed the presence of other testes and a rudimentary uterus, indicating a rare case of a testicular tumor coexisting with undescended testes and transverse testicular ectopia (TTE) in a Pseudohermaphrodite with “persistent mullerian duct syndrome” (PMDS).

1. Introduction and literature review

Disorder of sexual differentiation (DSD) is one of the rarities in medicine. Inspite of that, the physician or the operating surgeon, should always consider them between the lists of the possible differential diagnosis. The condition named “persistent mullerian”s duct syndrome” (PMDS) – is a one type of “Disorders of Sexual Differentiation” (DSD). It is diagnosed when the mullerian duct structures identified, in otherwise phenotypically and genetically normal man. 1 Thought to result from absence of mullerian duct inhibiting factor synthesis or release, or from a defect in its receptor. 2 It was firstly reported in 1939 by Nilson, 3 consequently additional cases has been added to literature since then. The number of reported cases today reached the 150 cases. 2 The condition has many sub-types, one of them called “Hernia uteri inguinalis “- PMDS type 1 – is one of the rarities, when the mullerian duct structures descend within the hernia sac, as it is in our case 4

On the other hand, the disorder of “Transverse Testicular Ectopia” (TTE), is one form of undescended testes, when both testicles descended in the same inguinal canal. It was firstly reported by Von Lenhossek in 1886, 5 and up to date,a total of 260 cases were reported. The combination of both (TTE) and (PMDS), is even more rare, to our knowledge, about only 57 cases has been reported. 6

Three different sub-types of the condition has been identified, type –one – associated with inguinal hernia (40–50 %), type –two- by PMD structures (as in our case) (30 %), and type –three- with other congenital anomalies, such as,hypospadias, pseudohermaphrodism and scrotal abnormalities.

The gene “SRY box transcription factor” (SOX 9) is the testicular gene responsible for the production of “Anti mullerian hormone kinase “(AMH kinase), which is responsible for regression of the mullerian duct structures at approximately the 8 weeks gestation. 7 The molecular regulation of this, is that, there are two receptors for (AMH kinase) (serine/threonine). Type two identifies the ligand specificity, and type one fires signaling cascades. 8

The presentation of the condition in male patient could be in one of the following forms:

• 1 Testes is in the position of the ovary, and the inguinal sac is empty (60–70 %).
• 2 One testes in inguinal canal with attached mullerian duct structures (Hernia uteri inguinalis 30-20 %).
• 3 Both testes in the same inguinal canal, in one processes vaginalis – (TTE – represents about 10 %) - as in our case.

In the first both testes and PMD structures are impalpable inside the abdomen, with empty scrotal sac, in the second there is cryptorchidism in one side with PMD structures within it in the same hernia sac, lastly the last type both testicles with PMD structures are in the same hernia sac. 9

2. Case presentation

2.1. history of present illness.

The case involves a 20-year-old male with missed undescended testes (UDT). The patient experienced gradual onset right scrotal swelling over six months, which increased in size without pain or tenderness. Additionally, a swelling in the right inguinal area was noted, correlating in size with the scrotal mass, which was also painless. The patient reported significant weight loss. Family history includes a brother diagnosed with testicular malignancy at 24 years, treated successfully with surgery and chemotherapy. There was no systemic symptoms of infection or distant metastases. The physical examination revealed a large scrotal mass on the right side measuring 10 × 6 cm, with a hard consistency, irregular margin, and no tenderness. The spermatic cord was separately palpable, but the proximal part and epididymis could not be differentiated from the mass, while the overlying scrotal skin appeared normal. Additionally, multiple enlarged firm right inguinal lymph nodes of variable size were found, fixed and not tender to palpation. On the left scrotum, no testes were palpable, but the scrotal skin appeared well developed.

2.2. Laboratory tests

2.3. Imaging studies

2.3.1. ultrasound.

• - Testes identified at the mid inguinal canal about (3 × 2 × 3 cm).
• - Right hemi scrotum showed hypo echoic complex solid mass, with central cystic component (8 × 10 × 4 cm).
• - About five separate enlarged lymph nodes in the Right inguinal region, the largest measuring (2 × 2 × 3 cm) with surrounding fluid.
• - Mild amount of peritoneal ascites between the bowel lobes.

2.4. CT scan abdomen and pelvis

With IV and Oral contrast. Showing the RT heterogeneous

Testicular mass and Huge Heterogeneous solid retroperitoneal.

Par aortic lymph Nodes mass with Central necrosis ( Figure-1 ).

Axial views of the CT scan abdomen and pelvis with IV and Oral contrast. Showing huge heterogeneous solid retroperitoneal par aortic lymph nodes mass with Central necrosis.

2.5. MRI abdomen and pelvis

• - Testes located at the distal inguinal canal (3.3 × 2.2 × 3.2 cm) of low signal intensity on T1W1 and T2W1, heterogeneous enhancement and restricted diffusion on DW1.
• - Right hemi scrotum showed peripherally enhancing complex mass, with central non enhancing component, representing tissue necrosis (2.7 × 2.3 × 2.1 cm).

Axial views of the MRI scan abdomen and pelvis with contrast. Showing the RT low signal intesity (T1W1-T2W2) testicular mass and huge heterogeneous solid retroperitoneal par aortic lymph nodes mass with Central necrosis.

On the bases of the previously mentioned history, physical examination, laboratory and imaging findings, the decision was made for operative treatment. The patient received Neoadjovant chemotherapy according to the Standard Regimen.

2.6. Operative findings

Gross Specimen of the RT testicular exophytic whitish mass typical of Seminoma (300 gm), with sperrmatic cord (3cm), scrotal sac (looks like Uterus, 4cm), and LT testes impeded within the tumor (1.5cm).

2.7. Histopathology results

2.7.1. macroscopic appearance.

Scrotal tissue weight 300 gm. , composed of three different structures, right spermatic cord of 3 cm length + scrotal sac looks like uterus 4 cm maximum diameter + right testes 3cm + left testes 1.5 cm + well circumscribe mass of 8 cm length maximum diameter.

2.7.2. Microscopic examination

One testes showed malignant neoplasm composed of sheets of uniform tumor cells divided into poor demarcated lobules by delicate fibrous septa with lymphocyte and plasma cells. The tumor cells are large, round, polyhedral with distinct cell membranes, abundant clear cytoplasm, large central nuclei, and prominent nucleoli. Focal necrosis noted, there is evidence of per tumor lymph vascular invasion and intratubular germ cell neoplasia. The surgical cut edge and spermatic cords are free of neoplasm the features are consistent with classical seminoma, the other testes is atrophied and involved with the neoplasm. Microscopy of hernia sac showed uterus, lined by atrophic endometrium ( Figure-4 ).

Microscopic slides of the histopathological specimen, showing Sheets of uniform tumor cells, divided by poorly demarcated lobules of fibrous septa with lymphocytes and plasma cells. Tumor cells are large, round and polyhedral with distinct cell borders, abundant clear cytoplasm large Central nuclei and prominent nucleoli. Central necrosis identified with Evidence of lymph vascular invasion and intratubular germ cell neoplasia.

3. Discussion

The definition of true hermaphrodite is when both testes and ovaries are located in the same individual. 10 In contrast female pseudo-hermaphroditism, the gonads are ovaries and the external genitalia shows musculinic properties. Male pseudo-hermaphroditism, the gonads are testes, but the internal genitalia failed to develop. 11 The presentation of male pseudo-hermaphroditism varies: 1- fully developed masculinized external genitalia and uterus (as in our case) 0.2- poorly developed external genitalia 0.3- Equivocal developed external genitalia 12

Male pseudo-hermaphroditism could passed undetected till adulthood. 13 PMDS is a subtype, in which mullerian duct structures persist. The first to report it, was Nelson in 1939. 3 some of the cases are found to have familial association 2

The causative factor of the condition is thought to be a defect in mullerian inhibiting factor (MIF), which is released by sertoli cells of the testes and leads to mullerian duct structures regression. The defect could be in the factor itself or its receptor. The condition is also associated with cryptorchidism, as it seems that, the MIF also affect the process of testicular descend. 2 So the individual will be phenotypically male subject, with normally developed external genitalia, but with fallopian tubes,uterus, upper vagina as internal genitalia and secondary sexual characteristics. 4

The PMDS could present in either phonotypical male or female. When the patient is phenotypically male-represents about 80–90 %, it could be either: 1- Unilateral cryptorchidism and contra-lateral inguinal herniation, this is further could be one of following types: 1-cryptorchidism with ipsilateral uterus and fallopian tube descend (uterine inguinale) 2- herniation of both testes, uterus and fallopian tube in the same inguinal canal (crossed testicular ectopia). 4 2- When the patient is phenotypically female represents about 10–20 %, there will be bilateral cryptorchidism, when both testes are fixed at the site of ovaries and connected to the round ligament. 4 Other classification of TTE is that.

• 1 Type −1, accompanied by hernia (40–50 %)
• 2 Type-2, associated with PMDS (30 %)
• 3 Type-3 –associated with other congenital anomalies (hypospadias,cryptorchidism, scrotal abnormalities)20 % 14

A condition known as mixed gonadal dysgenesis, is a disorder of abnormal sex chromosomes characterized by ambiguous genitalia with unilateral testicle and contralateral streak gonad, in addition to PMDS in the same side. 15

The condition is usually an intra-operative diagnosis, but it could be detected by U/S, CT scan and MRI. The prognosis depends on the condition of the testicular tissue and the close proximity between the vas difference and fallopian tube 1

The risk of malignancy of the an undescended testes associated with PMDS is 7–35 % more than that of normal population, (as in our case). There are multiple reported cases of seminoma, embryonal carcinoma, yolk sac tumor and teratoma. Perkmen 16 reported three cases of malignancy associated with PMDS (two was seminoma and the other showed mixture of both seminoma and teratoma). However the tumor related to mullerian duct structures are very rarely detected. As it is expected the rate of infertility is high, with azoospermia in semen analysis. 2 , 4

The mode of surgical treatment entitles, to try to preserve the testicular tissue, by fixing the testes to the scrotum (orchidopexy), this is usually combined with removal of mullerian duct structures, separating it from the vas difference. PMDS is only removed if it intervenes with the process of orchidopexy, as it is thought, that this may endanger the vessels of spermatic cord. In case of TTE, the other testes could be brought through crossing the root of the penis or through trans -septal approach. 17 This surgery should be attempted as early as possible to try to retrieve fertility. 2 , 4 The risk of malignant transformation of the testes increased in intra-abdominal location compared to inguinal position, as a result an undescended testes found in the inguinal canal could be safely brought to scrotum. In our case, the condition is unfortunately different, as both testes are found in one inguinal canal, and the tumor of one testes infiltrating the other, so the decision was made to remove both of them enblock.

4. Conclusion

The condition is usually diagnosed intra-operatively, with the subsequent risk of crypt orchid testes to become malignant is about 18 % (embryonal carcinoma, seminoma, yolk sac tumor, and teratoma). All effort should be done to preserve functional testes, with the ideal operation is bilateral orchidopexy. 18 The division of the PMD structures is not advised unless it prevents the orchidopexy. Again in case of TTE the ectopic testes could be placed in the contralateral scrotal sac by crossing the root of the penis, and if this is impossible, it could be placed in the retro peritoneum. 17 , 19

CRediT authorship contribution statement

Haytham Araibi: Writing – review & editing, Writing – original draft, Visualization, Validation, Supervision, Software, Resources, Project administration, Data curation, Conceptualization.

Declaration of competing interest

I hereby declare that I have no conflict of interest with the journal, publisher, or reviewer. This statement is directed to the chief editor in charge.

Abbreviations and acronyms

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A new case report of traboulsi syndrome: a literature review and insights into genotype–phenotype correlations.

1. Introduction

2. material and methods, case description, 4. discussion, phenotypic manifestations and ophthalmologic complications, 5. genetic insights and variability, 6. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

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Ibarra-Ramírez, M.; Campos-Acevedo, L.D.; Valenzuela-Lopez, A.; López-Villanueva, L.A.; Fernandez-de-Luna, M.; Mohamed-Noriega, J. A New Case Report of Traboulsi Syndrome: A Literature Review and Insights Into Genotype–Phenotype Correlations. Genes 2024 , 15 , 1120. https://doi.org/10.3390/genes15091120

Ibarra-Ramírez M, Campos-Acevedo LD, Valenzuela-Lopez A, López-Villanueva LA, Fernandez-de-Luna M, Mohamed-Noriega J. A New Case Report of Traboulsi Syndrome: A Literature Review and Insights Into Genotype–Phenotype Correlations. Genes . 2024; 15(9):1120. https://doi.org/10.3390/genes15091120

Ibarra-Ramírez, Marisol, Luis D. Campos-Acevedo, Aristides Valenzuela-Lopez, Luis Arturo López-Villanueva, Marissa Fernandez-de-Luna, and Jibran Mohamed-Noriega. 2024. "A New Case Report of Traboulsi Syndrome: A Literature Review and Insights Into Genotype–Phenotype Correlations" Genes 15, no. 9: 1120. https://doi.org/10.3390/genes15091120

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Robot-assisted vascular surgery: literature review, clinical applications, and future perspectives

• Open access
• Published: 23 August 2024
• Volume 18 , article number  328 , ( 2024 )

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• Balazs C. Lengyel 1 , 2 ,
• Ponraj Chinnadurai 1 ,
• Stuart J. Corr 1 ,
• Alan B. Lumsden 1 &
• Charudatta S. Bavare 1  

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Although robot-assisted surgical procedures using the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA) have been performed in more than 13 million procedures worldwide over the last two decades, the vascular surgical community has yet to fully embrace this approach (Intuitive Surgical Investor Presentation Q3 (2023) https://investor.intuitivesurgical.com/static-files/dd0f7e46-db67-4f10-90d9-d826df00554e . Accessed February 22, 2024). In the meantime, endovascular procedures revolutionized vascular care, serving as a minimally invasive alternative to traditional open surgery. In the pursuit of a percutaneous approach, shorter postoperative hospital stay, and fewer perioperative complications, the long-term durability of open surgical vascular reconstruction has been compromised (in Lancet 365:2179–2186, 2005; Patel in Lancet 388:2366–2374, 2016; Wanhainen in Eur J Vasc Endovasc Surg 57:8–93, 2019). The underlying question is whether the robotic-assisted laparoscopic vascular surgical approaches could deliver the robustness and longevity of open vascular surgical reconstruction, but with a minimally invasive delivery system. In the meantime, other surgical specialties have embraced robot-assisted laparoscopic technology and mastered the essential vascular skillsets along with minimally invasive robotic surgery. For example, surgical procedures such as renal transplantation, lung transplantation, and portal vein reconstruction are routinely being performed with robotic assistance that includes major vascular anastomoses (Emerson in J Heart Lung Transplant 43:158–161, 2024; Fei in J Vasc Surg Cases Innov Tech 9, 2023; Tzvetanov in Transplantation 106:479–488, 2022; Slagter in Int J Surg 99, 2022). Handling and dissection of major vascular structures come with the inherent risk of vascular injury, perhaps the most feared complication during such robotic procedures, possibly requiring emergent vascular surgical consultation. In this review article, we describe the impact of a minimally invasive, robotic approach covering the following topics: a brief history of robotic surgery, components and benefits of the robotic system as compared to laparoscopy, current literature on “vascular” applications of the robotic system, evolving training pathways and future perspectives.

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Introduction

The robotic-assisted laparoscopic approach has transformed many surgical subspecialties; however, it has yet to gain momentum and play a central role in vascular surgery [ 1 , 2 , 3 , 4 ]. Other surgical specialties such as thoracic surgery, general surgery, and urology have embraced robotic technology into clinical routine and now providing minimally invasive surgical options to patients while mastering the vascular skill sets imperative for these procedures. In the meantime, endovascular surgery has revolutionized the field of vascular surgery, delivering the promise of minimally invasive therapeutic options to our patients. However, one could argue that the durability of open surgical vascular reconstruction and repair has been compromised, in this pursuit of percutaneous endovascular technologies, as evidenced by the re-intervention rates for endovascular procedures [ 5 , 6 , 7 ]. The lack of early adoption of surgical robotics could be potentially due to the lack of surgical laparoscopic skills/training among vascular specialists, fear and risk of uncontrolled bleeding, and the inherent difficulties of creating laparoscopic vascular anastomosis.

A surgical procedure can be broadly divided into two parts: firstly, the core therapeutic part (i.e., the only portion which the patient benefits from) and secondly, the delivery system—the part that provides access/conduit to deliver the intended core therapeutic option. For example, to sew in a piece of Dacron into the aorta—as initially described by Dr. DeBakey—is easily the most durable repair described for aortic aneurysmal disease [ 8 ]. However, the delivery system—either a laparotomy thoracotomy or thoracoabdominal incision is very unappealing to most patients and associated with higher perioperative complication rates than endovascular alternatives [ 9 ]. Endovascular aortic repair has a very appealing delivery system namely a small incision or puncture site, however, the core therapeutic part of stent graft placement is fraught with long-term problems and is nowhere near the durability of the Dacron-based vascular reconstruction for abdominal aneurysmal disease [ 8 , 9 ]. These endovascular procedures also became an early target for steerable, robotic catheter technology; however, its routine adoption has been limited and also redirected recently toward image-guided, robotic endobronchial interventions, where it is transforming diagnosis and therapeutic care for patients with malignant lung nodules [ 10 , 11 , 12 ].

The concept that the robotic approach is an equivalent of an open operation delivered with a minimally invasive technique, due to the dynamic wristed instruments, which are essentially mimicking the hand movements of a surgeon, inside the body, makes it dramatically different from the traditional laparoscopic approach. An intriguing question is whether robotic surgery introduced in the vascular surgery world could retain the core therapeutic components that have been validated for decades while at the same time making the delivery of such repairs more acceptable and tolerable to patients. It is this intriguing concept that stimulated us to evaluate the role of robotics.

The outline of this review article is as follows: a brief history of robotic-assisted vascular surgery, components and benefits of the robotic system as compared to laparoscopy, current literature on vascular applications of the robotic system, evolving robotic training pathways of vascular surgeons and future perspectives of robotic vascular surgery with novel techniques/instrumentation.

Brief history of robotic surgical platforms

Early surgical robots were specialty focused, like the Robodoc, which was first developed in the late 1980s, for orthopedic surgery, or another urologic robot—developed for prostate surgery. Later advancements were propelled by the US military, which wanted to develop a telemedical unit that could provide surgical care in close proximity of the battlefield, operated by a surgeon in the safe zone. This led to the pioneering development of the Green Telepresence System, which consisted of a surgeon’s workstation and a remote surgical unit. This robot laid the basis for today’s surgical robotic appliances. Although it was first developed for open surgery, only after one of the developers, Colonel Satava, saw the presentation of Dr. Perrisat on one of the first videotaped laparoscopic cholecystectomy, the system was transitioned toward laparoscopic surgery. Interestingly, the first procedures that have been tested on robotic surgical systems were mostly vascular operations, such as running suture on bovine aorta, patch angioplasty, and PTFE graft anastomosis with the contribution of Jon Bowersox, a vascular surgeon from the Stanford Medical Center. They were all successful attempts, but were significantly slow, due to the lack of wristed instruments in early robots that were only introduced in the mid-1990s. Along with the above-mentioned efforts of the Stanford Research Institute and the Defense Advanced Research Projects Agency (DARPA), two private companies, Computer Motion and Intuitive Surgical, raced for the development of the ultimate surgical robotic system. Their competition ended with merging in 2003. Computer Motion’s Zeus system was discontinued for the sake of Intuitive Surgical’s more versatile robot, the da Vinci. The prototype of the da Vinci surgical system—called Lenny, was developed in 1995. It had to be attached to the surgical table and had fixed instrumentation. Later with the introduction of exchangeable instrumentation, Mona was developed, and was first used in human trials in 1997. It lacked a camera holding arm, so an assistant had to be present manipulating the camera on the instructions of the operating surgeon. Further improvements in visualization and the addition of a stand-alone cart—housing the patient-side components, were revealed one year later, forming the first surgical robot with the name da Vinci. After successful human trials, it received FDA approval in 2000 for general surgery indications in the USA [ 13 , 14 ]. Since then, the surgical robot has gone through significant upgrades and now represents state-of-the-art technology (Fig.  1 ).

Evolution of Intuitive Surgical’s da Vinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA, USA)

Intuitive Surgical reported that by September 2023, more than 13 million procedures were performed on the da Vinci system. More than 8200 da Vinci robots are available worldwide. The industry is exponentially growing and mostly led by general surgeons, urologists, and gynecologists, while other specialists, including vascular surgeons, only take part in a small fraction of procedures performed [ 1 ]. However, many of these procedures include essential vascular techniques, most vascular surgeons are yet to receive training on the robot. It is not only problematic in terms of practicing vascular operations, but also when it comes to treating rare, life-threatening vascular complications using the same robotic platform.

Introduction to the da Vinci surgical robotic system

The most used laparoscopic robot, the da Vinci system can be subdivided into three subsystems, namely the surgeon console, the patient-side cart, and the vision cart. The surgeon who is performing the operation is physically disconnected from the patient, sitting in an ergonomic control unit, controlling a master–slave teleoperation architecture with an intermediary of a computerized control system. The patient-side manipulators are mounted on the transportable patient-side cart. The robot has four arms that work in the sterile field. Each of these can hold either an endoscopic camera or a surgical instrument. Since the input by the surgeon runs through a computer, it can filter out unwanted signals, such as the tremor of the surgeon’s hand, or it can scale motions to facilitate enhanced precision when it is required. But it could go both ways: the robot could inform the surgeon, based on visual or other imaging clues—aiding orientation, giving warning signs on critical steps, and ultimately enhancing patient safety. Certainly, it is the topic of the future, and innovation has limitless potential in this field [ 15 ].

Also contributing to better orientation, the state-of-the-art visualization system offers 3D vision by a stereo endoscopic camera that records in 4 K resolution [ 16 ].

Since the most widely available robotic systems do not support haptic feedback, one of the most important perceptions is lost. This forms huge limitations in vascular procedures, where tactile feedback is often paramount. However, in March 2024, Intuitive Surgical revealed the new, fifth-generation da Vinci robotic system, which will support haptic feedback, a long-awaited feature in robotic surgery. With this, tissue handling, and possibly suture handling, will improve. One of the hardships of today’s robotic instruments is that they can break monofilament sutures like Prolene (Ethicon, Raritan, NJ, USA) very easily, due to handling by the needle drivers, which is why most vascular robotic surgeons use PTFE sutures which are proven to be a bit more durable.

The biggest advantage of robotic surgery in contrast to laparoscopy is the utilization of wristed instruments that can be operated in an ergonomic and intuitive manner. These articulated instruments can allow up to seven degrees of freedom including grasping. These can essentially act as an extension of the surgeon`s arm, allowing a wide range of motion.

In the fourth-generation da Vinci system, visual clues help to overcome the lack of tactile feedback. As opposed to open vascular procedures, where one of the key techniques of locating blood vessels is palpation, on the robotic platform, localization mostly relies on visual clues. One of the existing imaging technologies that could help in the visualization of blood vessels is FireFly®—which is a near-infrared fluorescence imaging technology, where with the intravenous injection of indocyanine green, blood vessels can be highlighted [ 16 ].

The da Vinci Xi robot can be synchronized with the TRUMPF Medical TruSystem 7000dV operating table (TRUMPF Medezin Systeme, Saalfeld, Germany), which allows the surgical team to move the table without redocking the robot. The robot automatically adjusts the gantry and instruments to maintain position relative to the patient`s anatomy. This provides more efficiency and optimal exposure during multi-quadrant operations [ 16 ].

Currently, the most widely used robotic surgical system is represented by the da Vinci Xi robot, which was introduced in 2014. Compared to the previous model—the Si, it offers several advantages. It comes with an endoscopic camera that fits in an 8 mm port and supports 4 k resolution and 3D vision with magnification. A significant improvement over the previous generation is that the endoscope can be mounted on either of the robotic arms, which creates more freedom for port placement. If using the 30-degree optics, the surgeon can flip the camera 180 degrees with a simple touch of the touchscreen, without having the assistant do it manually. The touchscreen on the surgeon console can control the electrocautery and several other functions can be adjusted on the go. The patient-side cart’s top-mounted rotating boom enables multi-quadrant surgery without having to redock the robot. Laser guidance helps the faster docking process. The autotarget function optimizes the position of the robotic arms—which are significantly sleeker and can reach further, so they can move more freely without colliding. A synchronizeable table—as mentioned before, enables table movements during the operation without the need for redocking. All these advancements create a much more intuitive and user-friendly platform than laparoscopy. Along with the technical details, there is great emphasis on training, which in the case of the robotic system can be performed in computer simulation in a structured manner through Intuitive Surgical’s Learning platform.

Advantages and disadvantages of the robotic surgical platforms

The advantages of robot-assisted surgery include the capability of 3D visualization, seven degrees of freedom provided by the Endo-wrist technology, elimination of the fulcrum effect, and physiologic tremors. It also has the ability to scale motions and even to perform telesurgeries if needed. The system allows the surgeon to take up a more ergonomic posture than what traditional laparoscopy would require [ 17 , 18 ]. Although sitting in front of the surgeon console is considered more ergonomic, it has its challenges, like the possible development of upper body fatigue and neck pain; therefore, the correct use of the armrest and individual adjustment of the seating position is important [ 19 ].

One of the main drawbacks of the robotic approach is the lack of tactile or haptic feedback, which is present in laparoscopy. The system requires additionally trained staff to operate and a large enough space for the equipment [ 17 ]. Finally, its long-term outcome benefit is yet to be proven in vascular surgery. Today, only relatively small single-center studies and case series have been published.

A significant limitation of the widespread adoption of robotic surgery is its high cost. The price makes the equipment inaccessible to most hospitals, not to mention the high annual maintenance fees and additional cost of disposable instruments. Its use is generally limited to centers, although it’s sensible, considering the need for high expertise, which can be gained only through a high volume of cases. However, cost issues could be counterbalanced by reduced length of stay, lower morbidity, and better surgical outcomes as reported in urology and colorectal surgery compared to other techniques [ 20 , 21 ].

Besides the most widespread da Vinci robotic system, several other—possibly more cost-effective—robots are either under development or undergoing clinical trials to compete with the current generation. These could eventually create healthy competition in the market leading to lower costs and urging innovations [ 22 ].

In 2010, Stefanidis et al. highlighted the intuitive nature and steep learning curve of robotic procedures with their experiment involving 34 medical students with no prior laparoscopic or robotic experience. They performed suturing tasks using laparoscopy and the da Vinci robot on a live porcine model. Results showed faster suturing, higher assessment scores, and fewer errors per knot with the robot. Laparoscopic performance did not significantly improve over rounds, while robotic assistance led to significant improvement [ 23 ].

Challenges in the adoption of surgical robotic technology in vascular surgery

The da Vinci Surgical System is approved for cardiac, thoracic, urologic, gynecologic, otorhinolaryngologic, colorectal, and general surgical uses. Despite numerous robotic procedures involving core vascular surgical techniques, the vascular application is still considered off-label [ 3 ]. The question is why did most vascular surgeons neglect this technology?

Every surgical specialty aspires to find less invasive ways to treat patients. Vascular surgery is no exception. We use vasculature as a pathway to reach and fix the disease with wires, catheters, balloons, and stents. Endovascular techniques have evolved in such a way, that in many areas of vascular surgery, it became the primary choice of care [ 24 , 25 , 26 , 27 ]. Most notably in cases of aortic aneurysmal disease or aortoiliac occlusive disease (AIOD), endovascular techniques offer less perioperative mortality, shorter hospital stay, comparable long-term durability, and survival. Despite these important factors, endovascular procedures often come with an increased re-intervention rate, and the need for lifelong surveillance, not to mention the elevated costs [ 5 , 6 , 28 ].

Recent studies have pointed out that the better long-term durability and need for less invasive surveillance methods and decreased exposure to radiation because of frequent CTA scans may outweigh the higher perioperative morbidity of open abdominal aortic aneurysm repair, also providing a better quality of life [ 6 ].

Not every patient is fit for open repair, even so in the case of most of the typical population requiring vascular surgery. These patients often have multi-systemic disease, limiting their ability to endure the surgical stress of an open reconstruction, subsequently suffering from high perioperative morbidity and mortality. Besides the possibility of endovascular interventions, robotic reconstruction could be the third operative option to choose from.

The failure of the adoption of laparoscopy in vascular surgery

Although laparoscopic aortic surgery has been available for more than 20 years, only a handful of centers have adopted the technique. The main reasons for it include the lack of interest, focus on endovascular treatment options, required steep learning curve, and most notably the difficulties of creating a vascular anastomosis, subsequently longer clamping times, and prolonged operation times [ 3 ]. Vascular surgical laparoscopy is extremely difficult to master.

Apart from technical difficulties, the laparoscopic approach could retain most of its attributed benefits when used for vascular reconstructions. A comparative study between open abdominal aortic repair and total laparoscopic repair found that there was no significant difference in short-term morbidity and mortality, but with laparoscopy, the operative times were significantly longer, mainly due to a longer anastomosis creation time. Interestingly, more bleeding was observed in laparoscopic cases [ 29 ]. This could be accounted for by several problems, such as the lack of effective tamponade, the negative effect of suction on the pneumoperitoneum, and consequently the loss of visual control. Possibly, the most feared complication of laparoscopy is major vascular injury, which can lead to severe complications, even death of the patient. Perhaps the lack of safe vascular control, mostly derived from the lack of appropriate laparoscopic clamps, was one of the main aversive factors against laparoscopy for the vascular community. This issue is still present in robotic surgery, which is why the development of reliable dedicated robotic vascular instruments is essential for the ability to perform more arterial cases with the robot.

The laparoscopic technique was associated with benefits including shorter hospitalization, reduced need for pain medication, and reduced time of postoperative bowel dysfunction [ 29 ]. Long-term results of laparoscopic aortic reconstruction yielded comparably good results to open repair in terms of survival and need for re-intervention, but with the additional benefit of the lack of laparotomy-related complications [ 30 ].

Despite the above-mentioned results, originating from only a handful of centers worldwide, laparoscopy was not appealing enough for vascular surgeons to invest in, due to inherent technical difficulties and the lack of laparoscopic training in vascular surgical education.

Although the robotic approach is based on the fundamentals of laparoscopy, it is a dramatically different technique. The main difference lies in the wristed robotic instruments and intuitive controls that facilitate surgical manipulation, resulting in shorter learning curves, allowing for faster vascular anastomosis and consequently shorter clamping times [ 31 ].

Current vascular procedures performed with robotic assistance

The following section describes vascular procedures currently performed using the da Vinci system. In terms of procedural volumes, most of these are performed by non-vascular specialists, who have mastered essential vascular surgical skills with the use of the robot. We believe that there are many techniques to be learned from these specialties, to adopt this technology in the vascular field. (Table  1 ).

Robot-assisted infrarenal aortic and aortoiliac aneurysm repair

Performing aortic reconstruction requires the ability to control high-pressure arteries, often heavily calcified. Choosing the right place for clamping heavily relies on preoperative imaging, as haptic feedback is unavailable (except the latest-generation da Vinci robot), although there are some visual clues like the color of the vessel wall or how it reacts to movement and palpation with the instruments, which might help the decision. Clamping can be done either by inserting a laparoscopic clamp through an assist port or by inserting a DeBakey clamp through a small incision. Balloon occlusion of the iliac arteries can be performed as well. However, we have to point out that no specialty-focused vascular robotic instruments, like dedicated aortic robotic clamps, are available so far.

Identification and control of lumbar arteries before opening the aneurysm sac is another key element in the safety of these operations, as uncontrolled bleeding from these can cause major issues. Preoperative imaging and image fusion could play a major role in this topic. There is an extensive need for further research in this regard.

Despite these concerns, Stadler and Lin have published case series with successful surgeries and acceptable operation times, when compared to laparoscopy, with improved clamping times and tolerable bleeding [ 32 , 33 , 34 , 35 , 36 ]. The latest report from Dr. Stadler included 61 patients operated on for aortoiliac aneurysms. The median operation time was 253 min (range, 185–360), the median clamping time was 93 min, and the anastomosis time was 31 min. Conversion to laparotomy was required in eight cases (13%), and median blood loss was 1210 ml. The median hospital stay was 7 days [ 36 ]. Although reported numbers prove that robot-assisted reconstruction is feasible and can be performed with good results, most of the studies come from a few centers and a relatively small number of cases. Further studies are needed to assess the place of robotic surgery in this field as well as to prove whether it has comparable results to open reconstruction and endovascular approaches.

Aortoiliac occlusive disease (AIOD)

There is extensive literature on the results of robotic aortic reconstruction with the indication of AIOD, but mostly from a few centers [ 36 ]. Wisselink and colleagues were the first to publish a successful aortobifemoral bypass with robotic assistance in 2002 [ 37 ]. Later, in 2009 Martinez et al. published the first totally robotic aortobifemoral bypass surgery [ 38 ].

Stadler reported the largest number of cases. During a nine-year period, 224 patients underwent robot-assisted reconstruction with the indication of AIOD. The median operation time was 194 (range, 127–315) min with a median clamping time of 37 min, of which the median anastomosis time was 24 min. Median bleeding was estimated to be 320 ml and the median length of stay was 5 days. According to pooled data including patients operated on aneurysmal disease, perioperative complications rate was 3% and 30-day mortality 0.3% [ 36 ].

In a recent study, early and midterm outcomes of robotic aortoiliac reconstruction were published. Out of 70 cases, conversion was required in three cases, two of which were because of bleeding complications. Early complications occurred in 14 cases, with 10 needing reoperation. Mortality was 1.4% (one out of 70 patients). Primary patency at 12 and 48 months was reported to be 94% and 92%, respectively, while secondary patency was 100% and 98.1% [ 39 ]. Although the above-mentioned results suggest that the operation is feasible and safe, and provides appropriate mid-term durability, it did not reach widespread acceptance; only a few centers made attempts with the technique due to partly technical problems such as missing dedicated vascular instrumentation or legal issues [ 39 ].

Furthermore, such as in the case of aortic aneurysms, in the case of AIOD, endovascular procedures have become more and more practiced with relatively low complication rates and acceptable durability, limiting the attention to other minimally invasive alternatives [ 40 , 41 , 42 ].

Robot-assisted thoracofemoral bypass

Thoracofemoral bypass has better patency rates than axillofemoral bypass, but requires a patient who can tolerate thoracic exposure and clamping of the descending aorta. By using robotic assistance, the time taken for the anastomosis can be shortened. However, this procedure is rarely done, due to the narrow group of ideal patients, and to the advances in endovascular therapy [ 43 ].

Robotic treatment of type II endoleak after endovascular aortic repair (EVAR)

Type II endoleak after EVAR can be a challenging diagnosis. Guidelines recommend re-intervention in the presence of sac enlargement during follow-up [ 24 ]. Most treatment options consist of endovascular techniques, but when these fail, open reconstruction may be required.

In a recent meta-analysis, results of eight studies, comprising 196 patients undergoing semiconversion (open conversion with endograft preservation), were analyzed. In 70% the indication was isolated type II endoleak. In 45.8%, previous endovascular attempts were made to close the endoleak. Aortic clamping was not necessary in 92% of the cases, but the sac was opened in 96%, and ligation or suture of the culprit arteries was performed. 30-Day pooled mortality was a non-negligible 5.3% with major systemic complications in 13.4% of the cases. Recurrence of endoleak was seen in 12.6%. Overall survival rate was 84.6% [ 44 ]. EVAR is generally considered a less durable, but minimally invasive procedure than traditional open repair, and thus offered to more frail patients or because of the intent to avoid high surgical risk. Where the reason for EVAR is to avoid complications associated with open repair, an open reoperation is a contradictory choice. When endovascular options fail, less invasive treatment can be provided by robot-assisted techniques.

There are a few small case series with robot-assisted surgery published on this topic. In 2009, Lin et al. presented a case, with successful robot-assisted ligation of the inferior mesenteric artery, which was the source of a type II endoleak, causing sac enlargement in an 84 old male. The total operation time was 249 min, of which 180 min was the time of robotic assistance. The estimated blood loss was only 50 ml. The patient tolerated the procedure well and was discharged home without complications on the 2nd postoperative day. The 3-month follow-up CT scan confirmed the occlusion of the IMA and the stabilization of the aneurysm sac size [ 45 ].

In 2019, Morelli shared their experience with their first two patients who underwent total robotic type II endoleak repair. They reported promising results. The average length of surgeries was 183 min, and average hospitalization was 2.5 days. The operation consisted of two phases: firstly, the ligation of the IMA and then the posterior mobilization of the aneurysm sac to make the selective clipping of lumbar arteries. Preoperative CTA imaging was used for the identification of feeding vessels in these cases. After target ligation was complete verification of the absence of backflow was carried out with a dedicated US probe, inserted through one of the assistant ports [ 46 ].

The above-mentioned literature shows that robot-assisted type II endoleak repair is feasible and safe, but more studies are required to evaluate its potential among other approaches. One of the biggest challenges lies in identifying the correct feeding vessels on preoperative imaging and translating this finding to the robotic platform. Creating an imaging-based navigation system, possibly with the help of augmented reality, could be an answer. Studies on how existing imaging can help intraoperative navigation and orientation are warranted.

Another challenge is finding an efficient method to expose both the left- and right-sided lumbar arteries, or the medial sacral artery, which often presents as a cause of endoleaks. The modified transperitoneal approach described by Stadler et al. is adequate for exposing the left-sided side branches, but going under an often heavily calcified aorta to reach feeding branches on the other side is a risky maneuver, which can easily result in bleeding complications requiring conversion [ 47 ]. Exposing the aorta from the right side is unlikely the answer to this dilemma due to the closeness of the inferior vena cava and the need for redocking and repositioning of ports, which would make the operation significantly longer and more complex. A hybrid approach mixing robotic exposure with endovascular techniques might present a solution, but this area is still in an experimental phase and needs further studies in terms of feasibility and safety.

Robot-assisted splenic aneurysm repair

Splenic artery aneurysm is the most common type of visceral aneurysm, with a prevalence of around 0.8% in the general population. Generally, diameters exceeding 30 mm are to be treated especially in pregnant women (regardless of the size) and symptomatic cases. The first treatment of choice if feasible is an endovascular procedure, but open reconstructions also provide viable options. Laparoscopic or robotic procedures could be proposed if the patient is not a candidate for endovascular treatment and open surgery predicts poor prognosis [ 48 , 49 ].

Median arcuate ligament syndrome (MALS)

In median arcuate ligament syndrome compression of the celiac artery by the interweaving fibers of the two diaphragmatic pillars causes most typically postprandial epigastric abdominal pain, but can also be an incidentally found radiologic sign, often asymptomatic. Prevalence is 2/100,000 patients and it is more common in women, mainly affecting younger patients. Exclusion of other possible causes of abdominal discomfort is usually part of the evaluation [ 50 ]. Traditionally, the solution was carried out via open surgery, then laparoscopy emerged, offering a minimally invasive alternative. However, operating in tight spaces, the need for thorough clearance of the celiac plexus, controlling bleeding, or even performing vascular anastomosis made these surgeries challenging.

A few studies have presented small to medium amounts of cases of MALS release with robotic assistance. All reports show favorable outcomes and technical feasibility with minimal conversion rates and short in-hospital stays, providing good long-term results in terms of symptom relief and decrease of peak systolic velocity during ultrasound control. Re-interventions may be necessary in relatively small numbers [ 50 , 51 , 52 , 53 ].

In a recent case report, a patient who was not a candidate for open surgical reconstruction presented with pancreaticoduodenal and gastroduodenal artery aneurysm with celiac artery compressive occlusion. A three-step procedure was performed, where the robot-assisted release of the celiac artery was followed by stenting of the celiac artery and coil occlusion of the aneurysms [ 54 ].

Comparison of laparoscopic vs. robotic MAL release resulted in an equally effective decrease in measured PSV (peak systolic velocity) on duplex ultrasound postoperatively. Operative times were longer in the robotic group (mean of 86 min vs. 134 min). This could be attributed to the inherent mechanics of the robotic platform and the extended dissection performed in robotic cases. The latter could be associated with significant relief of postprandial symptoms and chronic nausea compared to laparoscopically operated patients. The authors also pointed out that robotic operations required significantly more junior first assistants and less frequently required second assistants, which can balance out the elevated costs of robotic equipment, while helping with the training of young residents [ 55 ] (Fig.  2 ).

A Intraoperative view of the median arcuate ligament (red arrow) causing a visible compression at the origin of the celiac artery. B 3D CTA reconstruction image of the same patient. The yellow arrow marks the compressed celiac artery

Left renal vein transposition for nutcracker syndrome

Renal nutcracker syndrome is a rare phenomenon characterized by the compression of the left renal vein, causing diverse symptoms, but most notably flank pain, hematuria, pelvic congestion syndrome in women, or left varicocele in men [ 56 ]. Consensus on the standard treatment of this phenomenon has not yet been reached. Several treatment options include open surgical or laparoscopic transposition of the left renal vein, kidney auto-transplantation, endovascular procedures, and recently robot-assisted techniques [ 57 ]. Several small case series were published, reporting favorable outcomes with low complication rates and good clinical outcomes in terms of symptom relief [ 57 , 58 , 59 ]. However renal auto-transplantation, even with robotic techniques is not a complication-free procedure and requires careful patient selection and high level of experience [ 56 ]. (Fig.  3 ).

Steps of a robotic renal vein transposition. A Rommel tourniquet on the supra- and infrarenal IVC, right renal vein, and laparoscopic bulldog clamp on the left renal vein and a lumbar vein. B Closing the defect of the IVC after the transection of the left renal vein. C Creation of the cavorenal anastomosis more distally. D Completed transposition of the left renal vein

Robot-assisted IVC filter removal

Whereas the FDA (US Food and Drug Administration) recommends IVC filter removal once the risk of embolization is gone, the retrieval rate is only around 25–30% in the USA [ 60 ]. Endovascular approach is considered the first choice when an IVC filter is to be removed; however, sometimes these attempts are unsuccessful or considered high risk because of possible extrusion of the filer. Robot-assisted surgery can be an alternative to an open approach, providing a minimally invasive solution. Few case series have been published on robot-assisted IVC filter removal, each of which presents good results, with high success rate, low number of postoperative complications, and short length of stay [ 59 , 61 , 62 ] (Fig.  4 ).

Robot-assisted IVC filter removal. In picture A and B protrusion of the filter’s struts can be appreciated on CT imaging, marked with a red arrow. C Intraoperative view of the infrarenal IVC with the protruding struts of the filter

Robot-assisted first rib resection

A case series of 83 patients undergoing robotic first rib resection with the indication of Paget–Schroetter syndrome was presented in 2018. The robot was used for the dissection of the first rib, disarticulation of the costosternal joint, and division of the scalene muscles. The operative time was 127 min (±20 min). Median hospitalization was 4 days, and no surgical or neurovascular complication was reported [ 63 ].

A systematic review comprising 12 studies of 379 patients with TOS suggested that the robotic technique is an effective method in the treatment of TOS. It offers improved exposure, reduced risk of neurovascular injury, and shorter hospitalization [ 64 ].

Robot-assisted nephrectomy and IVC thrombectomy

The gold standard technique of open radical nephrectomy with inferior vena cava (IVC) thrombectomy for renal cell carcinoma presenting with IVC thrombus is more and more challenged by a robot-assisted approach. Since the first published case series in 2011, a growing number of surgeons attempted to adopt the technique with a promise of an equally effective but less invasive approach [ 65 ]. While this procedure involves dissection and even opening of major vessels, it’s mainly performed by urologists, who have mastered specific vascular surgical skills with the robot. In 2022, a meta-analysis evaluating robotic IVC thrombectomies versus open surgeries concluded that the minimally invasive method is feasible, effective, and safe. It is associated with fever perioperative complications, lower postoperative transfusion rates, and shorter in-hospital stays, although it is still a relatively infrequent procedure apart from a few high-volume centers. Most possibly this is due to the considerable complexity of these cases, involving manipulation of major vessels with a significant risk of major bleeding complications [ 66 ].

One of the main challenges of this operation is to acquire control over the main vessels. Temporary occlusion of the IVC can be done by clamps introduced to the abdomen through an assist port or simple stab incision. Another technique is to apply vessel loops circumferentially and then create a modified Rummel tourniquet using a small rubber tube. This can be later reinforced by the application of laparoscopic bulldog clamps.

Kundavaram et al. described a technique when the temporary occlusion of the IVC is obtained by an intracaval 9 Fr Fogarty catheter inserted through a 5 mm assist port into the abdomen. The IVC is punctured, the catheter is introduced, then inflated. The position of the balloon is either confirmed by laparoscopic ultrasonography or transesophageal echocardiography [ 67 ]. Later, this approach was modified by the insertion of a Reliant compliant balloon (Medtronic, Minneapolis, MN, USA) into the IVC through the right internal jugular vein under fluoroscopic and intraoperative ultrasonographic guidance [ 68 ].

Robot-assisted kidney transplantation

Open kidney transplantation is the gold standard of care in end-stage renal disease. Since first performed in 1954 by Doctor Joseph E. Murray, the technique has not changed much.

In the 1990s, advances in minimally invasive surgery warranted the adoption of these techniques in the field of transplant surgery. The first laparoscopic donor nephrectomy was reported by Ratner et al. in 1995, and not much later it gained widespread acceptance and has become the standard technique for kidney donation. Laparoscopy’s adoption into renal implantation on the other hand was challenging. Since the first laparoscopic kidney transplant in 2009, it was rarely performed, because of the challenge of completing intracorporeal vascular anastomosis with instrumentation lacking articulation, limited movement range, and fulcrum effect. This highly demanding task, requiring high levels of expertise in laparoscopy, was difficult to master and this ultimately led to longer warm ischemia times and poor graft function [ 2 , 69 ].

Robotic assistance, however, has helped overcome the difficulties of laparoscopic renal transplantation. Since its first description, it is now becoming more and more accepted and performed. In a meta-analysis published in 2022, it was demonstrated that robot-assisted kidney transplant is safe and feasible, compared to the open approach it is associated with a lower risk of surgical site infection, less postoperative pain, and shorter length of hospital stay, while there is no difference in renal function, graft, and patient survival. It can be especially beneficial for obese patients due to the assessed lower risk of surgical site infections [ 70 ]. A notable limitation of the procedure for now is that most centers exclude all patients with calcified iliac arteries from the robotic approach, while chronic renal insufficiency is notoriously associated with atherosclerosis. This limits the use of this technique in more frail patients who would possibly benefit most from a minimally invasive approach.

Calcification of the arteries creates a change for robotic surgery because of the potential disastrous complications of vascular injury or inefficient clamping. In an experiment conducted by Le et al. in 2013, it was proven that robotic bulldog clamps exerted significantly less clamp force compared to laparoscopic clamps [ 71 ]. This issue could be potentially overcome by developing more robust robotic vascular clamps.

Robot-assisted lung transplantation

In 2023, as reported by Emerson et al., the first robot-assisted lung transplantation was performed successfully. The robot was used for the removal of the recipient’s diseased right lung and after the donor’s lung was inserted into the chest, the bronchial and the left atrial anastomosis were created with robotic assistance. The pulmonary artery anastomosis was then performed under direct vision due to the longer ischemic time at that point. The patient recovered without any major adverse events and was discharged on the 11th postoperative day. Since then, several more robot-assisted lung transplants have been performed by the team [ 72 ].

Portal vein reconstruction in robot-assisted pancreaticoduodenectomy

Pancreatic cancer is widely recognized as one of the most vicious tumors, with only 5% combined 5-year survival rate. Although surgical therapy is the most effective treatment, a minority of the patients are candidates for it, due to locally invasive disease or the presence of distant metastasis. Pancreaticoduodenectomy (PD) as described by Whipple in 1935 is the gold standard procedure for pancreatic head tumors to this day. It is considered one of the most complex surgeries of the alimentary tract due to the challenge of careful dissection along critical vascular structures and then the restoration of the enteric continuity, requiring three anastomoses (pancreaticojejunostomy, hepaticojejunostomy, and gastrojejunostomy). This demanding operation has high morbidity and mortality rates even at high-volume centers [ 73 ]. Like in the case of many previously described areas, laparoscopy could not gain widespread popularity, although it was first described more than 20 years ago [ 74 ]. The technically challenging requirement of retroperitoneal dissection in close proximity to major vascular structures and the need to perform the reconstruction with laparoscopic instruments made it difficult to master this procedure. Robot-assisted surgery promises to overcome many boundaries of the traditional minimally invasive approach.

When the tumor involves the superior mesenteric or portal vein, portomesenteric resection is now considered the standard of care. A patient is considered a candidate for robotic PD in case of venous involvement is less than 180° circumferentially and the vein is patent [ 75 , 76 ]. After resection is complete, reconstruction is required, which is an essentially vascular surgical procedure, performed with robotic assistance. According to the International Study Group of Pancreatic Surgery (ISGP) classification, types of vein resection can be divided into four categories. Type 1 resection means a small side wall resection, which can be closed with direct suture. In case of type 2 resection, patch closure is required. In the case of type 3 and 4 resections, a complete segmental resection is required, which can be reconstructed with direct repair in the former, and only with interposition in the latter. If the resection involves the splenomesenteric junction, the surgeon has to sew in a mini-Y graft with three robot-assisted anastomoses to preserve the flow [ 76 ]. This requires high-level vascular surgical skills and can be easily considered a “vascular” operation.

Robotic coronary artery bypass grafting

Although the first reported endoscopic bypass grafting was performed in 1998, by a French group, this approach faced similar criticism as other vascular surgical procedures [ 77 ]. These were the lack of haptic feedback, steep learning curve, high costs, lack of standardized training, concerns regarding the conversion rates, difficulties of creating multi-vessel revascularization, and long-term durability [ 78 ]. Recently, Balkhy et al. published their experience with totally endoscopic coronary artery bypass (TECAB) in 544 patients. 56% had multi-vessel revascularization and 242 patients underwent hybrid revascularization. Only one patient required conversion with sternotomy due to bleeding and there were six reoperations (1.1%) with four requiring sternotomies. Early mortality was 0.9% and at a median follow-up of 36 months, cardiac-related mortality was 2.4%, with freedom from MACE being 93% [ 79 ].

One of the critical points of TECAB is the creation of vascular anastomosis. There have been proprietary devices developed to ease this procedure, including the C-Port Flex A distal anastomosis device, and the PAS-port proximal anastomosis device (Cardica, Redwood, CA, USA). Utilization of such an anastomotic device significantly shortened operation times, but did not significantly affect patency compared to the sutured approach in a large single-center retrospective analysis [ 80 ].

Transitioning skills learned and devices developed for cardiac procedures have the potential to advance the adoption of vascular surgical procedures in the realm of robotics.

Training pathway to becoming a vascular robotic surgeon

As previously demonstrated, many “vascular” procedures are constantly being performed, many by other specialties; however, vascular surgery performed with robotic assistance is still considered barred by many. Although these procedures have core vascular surgical elements, the current generation of vascular surgeons receive no training in robotics, which also means they lack the skills to solve occasional vascular complications, without the need for a conversion when called into the OR emergently. That is why setting a training pathway for fellows and vascular surgical residents is of paramount importance. Fellows coming to vascular surgery may have basic training in laparoscopy or even robotic surgery; therefore, their expertise in this field can be built upon.

Our current strategy is to focus on individuals having experience with laparoscopy to train them in robotic surgery through a complex pathway. This includes basic robotic training, simulation on the manufacturer’s platform, wet lab practice, and case observations. This is followed by five robotic cases with the supervision of an external proctor. We determined a graduated increase in case complexity, starting from low complexity high-volume cases, such as peritoneal dialysis catheter insertion with lysis of intraabdominal adhesions through gradually more complex cases like venous repairs to highly complex and more demanding operations, like median arcuate ligament release, visceral aneurysm repair, and type 2 endoleak repair after stentgraft placement. This graduality in case complexity along with the increasing volume of cases allows appropriate experience to be gained to handle the more complex procedures. However, neither vascular robotic surgery nor this method has been accepted by the vascular community. We need further discussion and a concurrent position statement on this topic.

Future perspectives of robotic vascular surgery

Future robotic surgical systems could include the following improvements to the current generation of robotic systems. The concept of “master–slave” controls in robotic systems can be reimagined to reflect the levels of surgical autonomy and provide real-time assistance to surgeons with a smart robotic setup and positioning, including a certain level of automation of repetitive surgical tasks [ 81 ]. The current concept of streaming a set of imagery (laparoscopic camera, patient hemodynamics, preoperative imaging) and letting the surgeon integrate the relevant procedural stage-specific information could be adapted to a surgical-state intelligence system that provides integrated imaging, sensing, and feedback to the surgeon in the console. This could include better visualization of preoperative and intraoperative 3D imagery using novel image visualization systems [ 82 ]. Integration of intraoperative imaging systems for real-time visualization of robotic devices and changes in vascular anatomy can be adopted to improve imaging, visualization, and ‘integrated navigation” of future robotic systems [ 83 ]. Real-time image processing systems can impact how intraoperative imagery is generated and visualized during surgical procedures. This could include automatic tissue/target organ recognition and delineation of surgical tools/steps and complications using machine-learning algorithms. The major difference between conventional open surgery and robotic-assisted laparoscopic surgery is the lack of tactile sensation. Latest-generation robotic systems have been exploring the added clinical value of providing tactile feedback to the user using sensors and trackers built into the robotic instrument [ 84 ]. Automated recognition of surgical gestures, including quantification of surgical performance could be an insightful way of understanding surgical skills, and potentially optimize surgical performance and predict patient outcomes for robotic surgical procedures [ 85 ].

In the field of robotic surgery, there has been a dramatic improvement in technology, technique, and adoption of a wide array of specialties. In vascular surgery, the robotic approach is still in its infancy, despite many “vascular procedures” being performed by non-vascular specialists. Although this technique holds the promise of delivering the core therapeutic elements of an open approach through a keyhole incision, it is still to be determined whether the same durability can be achieved. Promising data originating from only a handful of centers worldwide. There is still a huge need for dedicated robotic vascular instruments, namely forceps and aortic clamps to be developed. In addition, dedicated robotic surgery training pathways for vascular surgeons have to be developed and embraced by the vascular community.

Data availability

No datasets were generated or analyzed during the current study.

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Balazs C. Lengyel, Ponraj Chinnadurai, Stuart J. Corr, Alan B. Lumsden & Charudatta S. Bavare

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BCL: conceptualization, methodology, data curation, writing—original draft, and visualization; PC: data curation, writing—original draft, review, and editing; SJC: writing—review and editing; ABL: conceptualization, writing—original draft, review and editing, and supervision; CSB: writing—review and editing, supervision.

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BCL, SC, and CSB have no competing interests. PC is a consultant senior scientist at Occam Labs LLC, Santa Cruz, CA, and interventional consultant at Siemens Medical Solutions, USA Inc., Malvern, PA. ABL received research support from W. L. Gore & Associates, he also consults with Boston Scientific, W. L. Gore & Associates, Siemens, and is a shareholder in Hatch Medical.

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Lengyel, B.C., Chinnadurai, P., Corr, S.J. et al. Robot-assisted vascular surgery: literature review, clinical applications, and future perspectives. J Robotic Surg 18 , 328 (2024). https://doi.org/10.1007/s11701-024-02087-2

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DOI : https://doi.org/10.1007/s11701-024-02087-2

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