Robotic Colorectal Resection With and Without the Use of the New Da Vinci Table Motion: A Case-Matched Study

Palmeri, Matteo; Gianardi, Desirée; Guadagni, Simone; Franco, Gregorio Di; Bastiani, Luca; Furbetta, Niccolò; Simoncini, Tommaso; Zirafa, Carmelina Cristina; Melfi, Franca; Buccianti, P; Moglia, Andrea; Cuschieri, Alfred; Mosca, Franco; Morelli, Luca

doi:10.1177/1553350618765540

Cited by 8 publications

(4 citation statements)

References 27 publications

(33 reference statements)

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“…The introduction of the new da Vinci Xi platform and its subsequent added use of the da Vinci Table Motion (dVTM) has overcome these limitations. Preliminary studies have indicated that the use of the new da Vinci Xi with the dVTM is associated with a shorter operative time, reduced docking time, and higher full robotic resection rates compared to the previous da Vinci Si [13][14][15][16][17][18][19][20][21]. The possible impact of these advantages of da Vinci Xi on costs is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Structured cost analysis of robotic TME resection for rectal cancer: a comparison between the da Vinci Si and Xi in a single surgeon’s experience

et al. 2018

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The authors declare that no funding support was received for this study. Background Robotic-assisted surgery by the da Vinci Si appears to benefit rectal cancer surgery in selected patients, but still has some limitations, one of which is its high costs. Preliminary studies have indicated that the use of the new da Vinci Xi provides some added advantages, but their impact on cost is unknown. The aim of the present study is to compare surgical outcomes and costs of rectal cancer resection by the two platforms, in a single surgeon's experience. Methods From April 2010 to April 2017, 90 robotic rectal resections were performed, with either the da Vinci Si (Si-RobTME) or the da Vinci Xi (Xi-RobTME). Based on CUSUM analysis, two comparable groups of 40 consecutive Si-RobTME and 40 consecutive Xi-RobTME were obtained from the prospectively collected database and used for the present retrospective comparative study. Data costs were analysed based on the level of experience on the proficiency-gain curve (p-g-curve) by the surgeon with each platform. Results In both groups, two homogeneous phases of the p-g-curve were identified: Si1 and Xi1: cases 1-19, Si2 and Xi2: cases 20-40. A significantly higher number of full RAS operations was achieved in the Xi-RobTME group (p<0.001). A statistically significant reduction in operating time (OT) during Si2 and Xi2 phase was observed (p<0.001), accompanied by reduced overall variable costs (OVC), personnel costs (PC) and consumable costs (CC) (p<0.001). All costs were lower in the Xi2 phase compared to Si2 phase: OT 265 vs. 290 min (p=0.052); OVC 7983 vs. 10231.9 (p=0.009); PC 1151.6 vs. 1260.2 (p=0.052), CC 3464.4 vs. 3869.7 (p<0.001). Conclusions Our experience confirms a significant reduction of costs with increasing surgeon's experience with both platforms. However, the economic gain was higher with the Xi with shorter OT, reduced PC and CC, in addition to a significantly larger number of cases performed by the fully robotic approach.

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Section: Introductionmentioning

confidence: 99%

“…The mean distal resection margin was 2.3 ± 1.4 cm in the Si-RobTME group versus 2.4 ± 1.2 cm in the Xi-RobTME group (p=0.73). A mean of 17 ± 7 lymph nodes per patient were removed in the Si-RobTME group versus 19 ± 8.0 in the Xi-RobTME group (p=0 20)…”

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confidence: 97%

Structured cost analysis of robotic TME resection for rectal cancer: a comparison between the da Vinci Si and Xi in a single surgeon’s experience

et al. 2018

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“…The preliminary results published in the literature agree in that the use of the table motion with the da Vinci X overcomes the limitations of the fixed positions of the patient 20 and resulted in improved exposure of the operative field. 19,21 Further studies are needed to confirm these findings.…”

Section: Table Motionmentioning

confidence: 93%

“…There are only 3 studies published regarding this topic, [19][20][21] with a small sample size. One of them reported shorter operative time in the table motion Xi group (P = .04).…”

Section: Table Motionmentioning

confidence: 99%

The Use of Enhanced Technologies in Robotic Surgery and Its Impact on Outcomes in Rectal Cancer: A Systematic Review

2020

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The main advantage of the robotic approach is the surgical precision that the technology offers. It is particularly useful in rectal cancer as this is a technically challenging procedure. The technological advantage of the robot leads to better postoperative outcomes. Apart from the 3D vision and endowrist instrumentation in comparison to laparoscopy, the options of using fluorescence imaging, endowrist stapler, and table motion have revolutionised the way of performing an anterior resection. Thus, the true benefit of these advances will be the quality of the surgery, which leads to better postoperative outcomes. This article focuses on the current status of applications of new modalities and technology development in robotic rectal surgery. A systematic literature search was performed using PubMed, MEDLINE, and cochrane database. The studies included were considered based on the following (1) articles written in English, (2) full text is available, (3) whether the topic is related to the use of novel technologies during robotic rectal surgery, and (4) sample: adult patients and malignant rectal disease. The primary end point was to analyse the current use of technological advances in robotic rectal surgery. Only a few studies are currently available on the use of these different technologies in robotic colorectal surgery. Many of these reports describe promising results, although with short-term outcomes. The use of technologies in robotic colorectal surgery is safe and feasible and can be used together to improve short-term outcomes. Intraoperative fluorescence angiography has demonstrated to reduce the rate of anastomotic leak, whereas the robotic stapler and the table motion simplify anatomic resection.

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Multiquadrant and Multiorgan Robotic Surgery with the da Vinci Xi

Morelli,

Guadagni,

Comandatore

et al. 2023

Updates in Surgery

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Robotic Colorectal Resection With and Without the Use of the New Da Vinci Table Motion: A Case-Matched Study

Cited by 8 publications

References 27 publications

Structured cost analysis of robotic TME resection for rectal cancer: a comparison between the da Vinci Si and Xi in a single surgeon’s experience

Structured cost analysis of robotic TME resection for rectal cancer: a comparison between the da Vinci Si and Xi in a single surgeon’s experience

The Use of Enhanced Technologies in Robotic Surgery and Its Impact on Outcomes in Rectal Cancer: A Systematic Review

Multiquadrant and Multiorgan Robotic Surgery with the da Vinci Xi

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