About

Sabino Zani is an Associate Professor of Surgery and also holds a position as Associate Professor in the Thomas Lord Department of Mechanical Engineering and Materials Science at Duke University. His educational background includes an M.D. from Albany Medical College, obtained in 2003. His research and professional contributions focus on surgical oncology, with a particular emphasis on minimally invasive surgical techniques, robotic-assisted surgeries, and the application of advanced imaging and genomic tools in cancer treatment. His work involves the development and assessment of innovative surgical procedures, such as robotic approaches to hepatic arterial infusion pump placement and laparoscopic and robotic lumbar interbody fusion, as well as the exploration of tumor genomics and immune profiling to improve cancer diagnosis, prognosis, and therapy. Dr. Zani has contributed to the scientific community through numerous publications in surgical and oncological research, advancing the understanding of complex surgical interventions and molecular cancer classification.

Research topics

• Medicine
• Internal medicine
• General surgery
• Surgery
• Statistics
• Radiology

Selected publications

• The OncoReach Stylet for Brachytherapy: Design Evaluation and Pilot Study

  Journal of Medical Robotics Research · 2026-05-14

  articleOpen access

  Cervical cancer accounts for a significant portion of the global cancer burden among women. Interstitial brachytherapy (ISBT) is a standard procedure for treating cervical cancer; it involves placing a radioactive source through a straight hollow needle within or in close proximity to the tumor and surrounding tissue. However, the use of straight needles limits surgical planning to a linear needle path. We present the OncoReach stylet, a handheld, tendon-driven steerable stylet designed for compatibility with standard ISBT 15- and 13-gauge needles. Building upon our prior work, we evaluated design parameters like needle gauge, spherical joint count and spherical joint placement, including an asymmetric disk design to identify a configuration that maximizes bending compliance while retaining axial stiffness. Free space experiments quantified tip deflection across configurations, and a two-tube Cosserat rod model accurately predicted the centerline shape of the needle for most trials. The best performing configuration was integrated into a reusable handheld prototype that enables manual actuation. A patient-derived, multi-composite phantom model of the uterus and pelvis was developed to conduct a pilot study of the OncoReach steerable stylet with one expert user. Results showed the ability to steer from less-invasive, medial entry points to reach the lateral-most targets, underscoring the significance of steerable stylets.

  PublisherOA PDFDOI

• Insufflatable Modular Abdominal Simulation Environment (MASE) for Surgical Training Simulation

  Surgical Innovation · 2026-05-08

  articleSenior author

  Background/NeedLaparoscopic abdominal surgery requires navigating unique technical challenges with precision, dexterity, and a thorough understanding of anatomy. There is a need for higher-fidelity training models to assist in improving trainee competence. This manuscript introduces a novel modular abdominal simulation environment (MASE) with the ability to insufflate under standard parameters to accommodate laparoscopic and robotic surgery training and assessment.Methodology and Device DescriptionCT scans of a deidentified patient pelvis and spine are processed, reconstructed, and modified into 3D printable files, then printed using a high-fidelity resin printer. Silicone skin is developed to cover the MASE and mechanically fixed to create an air-tight seal. Insufflation capability is tested by measuring the pre- and post-insufflation height of the model, as well as internal pressure.Preliminary ResultsMASE meets the following criteria: anatomical accuracy, scale-to-life, and re-usability. Its ability to be insufflated via a Veress needle at Palmer's point recreates a pneumoperitoneum (increasing in height by 108%), allowing for effective port placement and clear visualization with a laparoscope. The platform successfully supports fundamentals of laparoscopic surgery (FLS) tasks including intracorporeal knot tying and peg transfer both with laparoscopic tools and robotic system.Current StatusCurrent work includes a more efficient locking mechanism, incorporation of the retroperitoneal space, and addition of synthetic/explant organs for high-fidelity abdominal simulation. MASE combines high anatomical fidelity, realistic tissue simulation, and procedural versatility with reproducibility. Future testing includes stiffness characterization of the silicone skin and validation for surgical resident training.

  PublisherDOI

• Quantitative assessment of laparoscopic camera navigation skill: a retrospective cross-sectional study

  Surgical Endoscopy · 2025-12-23

  article
  PublisherDOI

• ASO Visual Abstract: Survival Outcomes and Genetic Characteristics of Resected Pancreatic Acinar Cell Carcinoma

  Annals of Surgical Oncology · 2025-06-18

  articleOpen access

  This multi-institutional series of resected pancreatic acinar cell carcinomas demonstrated a median overall survival longer than 70 months (https:// doi.org/ 10. 1245/ s10434-024-16331-4).Mutations within the Homologous Recombination Repair (HRR) pathway were identified in 45% of sequenced tumor specimen, with core HRR mutations in 26%, suggesting opportunities for informed targeted therapeutic options for pancreatic acinar cell carcinoma (pACC).

  PublisherOA PDFDOI

• Minimally invasive laparoscopic and robotic anterior lumbar interbody fusion: a systematic review and future directions

  BMC Surgery · 2025-05-21 · 4 citations

  reviewOpen access

  INTRODUCTION: Anterior Lumbar Interbody Fusion (ALIF) is a commonly performed spine surgery procedure used to treat lumbar conditions such as degenerative disc disease, spondylolisthesis, and spinal deformities. Traditionally, it has been performed using open and mini-open surgical techniques. Recently, however, laparoscopic and robotic-assisted ALIF have gained attention for their potential benefits, including shorter recovery times, fewer complications, and improved patient outcomes. However, the safety, effectiveness, and long-term outcomes of these newer techniques remain to be fully compared to conventional methods. METHODS: The systematic review was conducted in accordance with the PRISMA 2020 guidelines. MEDLINE and Cochrane databases were searched for studies on laparoscopic and robotic approaches to the anterior spine, with a focus on ALIF. Article selection and data extraction were independently conducted by two reviewers. Studies involving animal models, non-ALIF robotic techniques, or non-English publications were excluded. RESULTS: A total of 650 articles were initially identified. After screening, a full-text review was conducted on 80 articles, of which 48 studies met the inclusion criteria: 42 focused on laparoscopic ALIF (L-ALIF) and 6 on robotic-assisted ALIF (R-ALIF). Laparoscopic ALIF achieved similar outcomes to mini-open methods, offering limited consistent benefits while presenting challenges such as a steep learning curve and a higher risk of retrograde ejaculation. Data on robotic-assisted ALIF, though limited, indicated improved precision and a reduced rate of intraoperative complications. However, high costs, logistical challenges, and the lack of substantial long-term outcome data remain significant barriers to the broader adoption of this technique in spine surgery. CONCLUSION: L-ALIF and R-ALIF present promising minimally invasive alternatives to mini-open ALIF approaches. L-ALIF yields outcomes similar to mini-open techniques, though its technical demands warrant careful consideration. R-ALIF shows potential for improved precision and reduced complications, but logistical and financial constraints limit its wider adoption. Future studies should focus on multicenter prospective trials, alongside efforts to reduce costs and enhance training, to refine the role of these techniques in optimizing patient outcomes.

  PublisherOA PDFDOI

• A platform for multisite immune profiling of premetastatic pancreatic cancer at single-cell resolution

  Cancer Immunology Immunotherapy · 2025-08-23 · 1 citations

  articleOpen access

  BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is characterized by exceedingly high rates of metastatic progression, with the liver representing the most common site of distant spread. Here, we established a platform for multisite immune profiling of human PDAC encompassing the tumor, peripheral circulation, and premetastatic liver, to more comprehensively study how various immune subsets might contribute to patient outcomes. METHODS: Tumor, liver, and blood samples were obtained from patients undergoing resection for non-metastatic PDAC. Derived immune cells underwent paired single-cell RNA and TCR sequencing. Immune composition, cell-type functional profiles, and T cell clonal expansion patterns were evaluated across tissue sites. RESULTS: In total, 106,539 immune cells were sequenced, of which 85,748 met criteria for analysis. We identified 32 cell populations, of which seven demonstrated significant enrichment within a particular tissue, highlighting that this workflow possesses the granularity needed for identifying potential future biomarkers. Functional profiling revealed tissue-specific differences in cell phenotypes. This included terminally differentiated exhausted CD8 T cells within the tumor, highly active Tregs within the premetastatic liver and tumor, and M1 versus M2 polarization of liver and tumor macrophage populations, respectively. Within the tumor, expanded Treg clones were uniquely abundant, and while expanded clones could be tracked to the blood and premetastatic liver, many of these mapped back to known viral antigens. Leveraging previously validated gene sets, we show how these can be applied to predict the tumor reactivity of intratumoral T cells using transcriptional signatures. We demonstrated a high degree of concordance between multiple independent signatures and tracked high-priority TCRs within the blood and liver. CONCLUSION: This study demonstrates the feasibility of a platform, which has already been implemented into ongoing clinical protocols, for immune profiling of human PDAC across the sites most relevant to metastatic progression. Future applications of this work can monitor immune populations throughout metastatic progression to build a temporal database of immune phenotypes and track association with clinical outcomes.

  PublisherOA PDFDOI

• Prognostic factors for patients with T2/T3 gallbladder cancer: Does extent of resection matter?

  Surgical Oncology Insight · 2025-01-28

  articleOpen access
  PublisherOA PDFDOI

• Robotic assisted anterior lumbar interbody fusion with the use of indocyanine green and posterior spinal fusion

  Neurosurgical Focus Video · 2025-07-01 · 2 citations

  articleOpen access

  A 50-year-old male with grade I spondylolisthesis at L5-S1 was treated surgically with a robotic anterior lumbar interbody fusion (R-ALIF). A general surgeon used the da Vinci robotic system to access the disc space and indocyanine green to visualize the vessels including the aortic bifurcation and middle sacral artery. A neurosurgeon completed the discectomy and fusion through a suprapubic GelPOINT Mini. R-ALIF combined with robotic percutaneous pedicle screw fixation resulted in no significant complications, minimal blood loss, a 4-hour surgical time, reduced patient-reported pain, and adequate cage placement. The video can be found here: https://stream.cadmore.media/r10.3171/2025.4.FOCVID2521.

  PublisherDOI

• ASO Visual Abstract: ctDNA as a Novel Prognostic Biomarker of Therapeutic Efficacy in Patients with Unresectable Colorectal Liver Metastases Treated with Hepatic Arterial Infusion

  Annals of Surgical Oncology · 2025-07-22

  article
  PublisherDOI

• ASO Visual Abstract: Perioperative and Oncologic Outcomes of Hepatic Arterial Infusion Pump Chemotherapy for Patients with Unresectable Colorectal Liver Metastases at an Expanding Hai Program

  Annals of Surgical Oncology · 2025-01-02

  article
  PublisherDOI

Frequent coauthors

• Dan G. Blazer

  Duke Medical Center

  90 shared

• Peter J. Allen

  Duke University

  70 shared

• Michael E. Lidsky

  Duke Medical Center

  63 shared

• Kevin N. Shah

  Duke University

  45 shared

• Donna Niedzwiecki

  Duke University

  44 shared

• Daniel P. Nussbaum

  Duke University

  32 shared

• Demetrios Moris

  Duke University Hospital

  27 shared

• Melissa Lowe

  University of South Florida

  26 shared