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Multiquadrant robotic colorectal surgery: the da Vinci Xi vs Si comparison

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Abstract

The newly introduced da Vinci Xi Surgical System hopes to address the shortcomings of its predecessor, specifically robotic arm restrictions and difficulty working in multiple quadrants. We compare the two robot platforms in multiquadrant surgery at a major colorectal referral center. Forty-four patients in the da Vinci Si group and 26 patients in the Xi group underwent sigmoidectomy or low anterior resection between 2014 and 2016. Patient demographics, operative variables, and postoperative outcomes were compared using descriptive statistics. Both groups were similar in age, sex, BMI, pelvic surgeries, and ASA class. Splenic flexure was mobilized in more (p = 0.045) da Vinci Xi cases compared to da Vinci Si both for sigmoidectomy (50 vs 15.4%) and low anterior resection (60 vs 29%). There was no significant difference in operative time (219.9 vs 224.7 min; p = 0.640), blood loss (170.0 vs 188.1 mL; p = 0.289), length of stay (5.7 vs 6 days; p = 0.851), or overall complications (26.9 vs 22.7%; p = 0.692) between the da Vinci Xi and Si groups, respectively. Single-dock multiquadrant robotic surgery, measured by splenic flexure mobilization with concomitant pelvic dissection, was more frequently performed using the da Vinci Xi platform with no increase in operative time, bleeding, or postoperative complications. The new platform provides surgeons an easier alternative to the da Vinci Si dual docking or combined robotic/laparoscopic multiquadrant surgery.

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References

  1. Wilson MZ, Hollenbeak CS, Stewart DB (2014) Laparoscopic colectomy is associated with a lower incidence of postoperative complications than open colectomy: a propensity score-matched cohort analysis. Colorectal Dis 16:382–389

    Article  CAS  PubMed  Google Scholar 

  2. Frangou C (2016) Robotic procedures continue to soar despite data, financial concerns. General Surgery News. http://www.generalsurgerynews.com/In-the-News/Article/08-16/Robotic-Procedures-Continue-To-Soar-Despite-Data-Financial-Concerns/37243. Accessed 1 Sept 2016

  3. Fleshman J, Branda M, Sargent DJ et al (2015) Effect of laparoscopic-assisted resection vs open resection of stage II or III rectal cancer on pathologic outcomes: the ACOSOG Z6051 randomized clinical trial. JAMA 314:1346–1355

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Speicher PJ, Englum BR, Ganapathi AM, Nussbaum DP, Mantyh CR, Migaly J (2015) Robotic low anterior resection for rectal cancer: a national perspective on short-term oncologic outcomes. Ann Surg 262:1040–1045

    Article  PubMed  Google Scholar 

  5. Zimmern A, Prasad L, Desouza A, Marecik S, Park J, Abcarian H (2010) Robotic colon and rectal surgery: a series of 131 cases. World J Surg 34:1954–1958

    Article  PubMed  Google Scholar 

  6. Allemann P, Duvoisin C, Di Mare L, Hubner M, Demartines N, Hahnloser D (2016) Robotic-assisted surgery improves the quality of total mesorectal excision for rectal cancer compared to laparoscopy: results of a case–controlled analysis. World J Surg 40:1010–1016

    Article  PubMed  Google Scholar 

  7. Tyler JA, Fox JP, Desai MM, Perry WB, Glasgow SC (2013) Outcomes and costs associated with robotic colectomy in the minimally invasive era. Dis Colon Rectum 56:458–466

    Article  PubMed  Google Scholar 

  8. Delaney CP, Lynch AC, Senagore AJ, Fazio VW (2003) Comparison of robotically performed and traditional laparoscopic colorectal surgery. Dis Colon Rectum 46:1633–1639

    Article  PubMed  Google Scholar 

  9. Bae SU, Baek SJ, Hur H, Baik SH, Kim NK, Min SB (2015) Robotic left colon cancer resection: a dual docking technique that maximizes splenic flexure mobilization. Surg Endosc 29:1303–1309

    Article  PubMed  Google Scholar 

  10. Sng KK, Hara M, Shin JW, Yoo BE, Yang KS, Kim SH (2013) The multiphasic learning curve for robot-assisted rectal surgery. Surg Endosc 27:3297–3307

    Article  PubMed  Google Scholar 

  11. Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196

    Article  PubMed  Google Scholar 

  12. Tamhankar AS, Jatal S, Saklani A (2016) Total robotic radical rectal resection with the da Vinci Xi system: single docking, single phase technique. Int J Med Robot. doi:10.1002/rcs.1734 (epub ahead of print)

    PubMed  Google Scholar 

  13. Morelli L, Guadagni S, Di Franco G, Palmeri M, Caprili G, D’Isidoro C et al (2016) Use of the new da Vinci Xi during robotic rectal resection for cancer: a pilot matched-case comparison with the da Vinci Si. Int J Med Robot 30:1281. doi:10.1002/rcs.1728 (epub ahead of print)

    Google Scholar 

  14. Yuh B, Yu X, Raytis J, Lew M, Fong Y, Lau C (2016) Use of a mobile tower-based robot—the initial Xi robot experience in surgical oncology. J Surg Oncol 113:5–7

    Article  PubMed  Google Scholar 

  15. Morelli L, Guadagni S, Di Franco G et al (2015) Use of the new Da Vinci Xi during robotic rectal resection for cancer: technical considerations and early experience. Int J Colorectal Dis 30:1281–1283

    Article  PubMed  Google Scholar 

  16. Trefis T (2016) FDA approval of key instruments could boost sales of Intuitive Surgical’s da Vinci Xi. http://www.forbes.com/sites/greatspeculations/2014/08/27/fda-approval-of-keyinstruments-could-boost-sales-of-intuitive-surgicals-da-vinci-xi/#3c1d08aa3485. Accessed 28 Febr 2016

  17. DeNoto G, Rubach E, Ravikumar TS (2006) A standardized technique for robotically performed sigmoid colectomy. J Laparoendosc Adv Surg Tech A 16:551–556

    Article  PubMed  Google Scholar 

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Correspondence to Bogdan Protyniak.

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Bogdan Protyniak, Jeffrey Jorden and Russell Farmer declare that they have no conflict of interest.

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Protyniak, B., Jorden, J. & Farmer, R. Multiquadrant robotic colorectal surgery: the da Vinci Xi vs Si comparison. J Robotic Surg 12, 67–74 (2018). https://doi.org/10.1007/s11701-017-0689-x

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  • DOI: https://doi.org/10.1007/s11701-017-0689-x

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