The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Ngu, James Chi‐Yong; Tsang, Charles B.; Koh, Dean C.

doi:10.2147/rsrr.s119317

Cited by 53 publications

(89 citation statements)

References 81 publications

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“…The oncological outcomes are equivalent to that of conventional open surgery, whereas recovery and other short-term outcome measures are improved. [1][2][3][4][5][6][7][8] However, inherent features of the laparoscopic procedure such as limited range of motion of the rigid instruments, amplification of tremor from the fulcrum effect, and unstable image from the hand-held camera add to the difficulty and limit its widespread application. [5][6][7]9,10 Robotic surgery for colorectal cancer is an emerging technique.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] However, inherent features of the laparoscopic procedure such as limited range of motion of the rigid instruments, amplification of tremor from the fulcrum effect, and unstable image from the hand-held camera add to the difficulty and limit its widespread application. [5][6][7]9,10 Robotic surgery for colorectal cancer is an emerging technique. The incorporation of advantageous features such as dexterity from articulated instruments, intuitive ergonomics, fine motion scaling, tremor filtration, steady retraction for exposure provided by the extra robotic arm, and a stable surgeon-controlled camera with 3-dimensional high-definition imaging may help overcome the limitations of laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

“…The incorporation of advantageous features such as dexterity from articulated instruments, intuitive ergonomics, fine motion scaling, tremor filtration, steady retraction for exposure provided by the extra robotic arm, and a stable surgeon-controlled camera with 3-dimensional high-definition imaging may help overcome the limitations of laparoscopic surgery. [5][6][7][8]11 Studies have demonstrated potential benefits of the robotic approach such as a reduced conversion rate, a shorter learning curve, reduced surgeon fatigue, greater rates of negative resection margin, and better functional preservation when compared with conventional laparoscopic surgery. 5,10,[12][13][14][15] Other studies further specified that robotic surgery for rectal cancer resulted in more favorable outcomes in patients with unfavorable clinical characteristics, such as obesity, male sex, receiving neoadjuvant chemoradiation therapy (nCRT), and tumors in the lower two-thirds of the rectum.…”

Section: Introductionmentioning

confidence: 99%

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Colorectal Cancer Surgery Using the Da Vinci Xi and Si Systems: Comparison of Perioperative Outcomes

Huang

Wei

2018

Surg Innov

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Purpose. Robotic surgery for colorectal cancer is an emerging technique. Potential benefits as compared with the conventional laparoscopic surgery have been demonstrated. However, experience with the previous da Vinci Si robotic system revealed several unsolved problems. The novel features of the new da Vinci Xi increase operational flexibility and maneuverability and are expected to facilitate the performance of multiquadrant surgery. Methods. Between December 2011 and May 2015, 120 patients with colon or rectal cancer were operated on using the Si robotic system (the Si group). Between May 2015 and October 2017, 60 more patients with colon or rectal cancer were operated on using the Xi robotic system (the Xi group). The clinicopathological characteristics and perioperative outcomes of these 2 groups of patients were compared. Results. The 2 groups of patients were comparable with regard to baseline clinical characteristics, types of resection performed, and the proportion of patients undergoing neoadjuvant chemoradiation therapy. The statuses of resection margin, the numbers of lymph nodes harvested, and the rates of postoperative complications were also similar between the 2 groups. Nevertheless, a lower rate of diverting ileostomy, a shorter operation time, less estimated blood loss, and a faster postoperative recovery was observed in the Xi group. Conclusions. Colorectal cancer surgery using the Xi robotic system was associated with improved perioperative outcomes. These benefits may be attributed to its improved, more user-friendly design.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Colorectal Cancer Surgery Using the Da Vinci Xi and Si Systems: Comparison of Perioperative Outcomes

Huang

Wei

2018

Surg Innov

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“…In addition, since there is only one operating room for robotic surgery, it is necessary to move the patient cart several times to perform several operations in one day. The da Vinci Xi system overcame these di culties with its slimmer body and arms and the innovative progression, the rotatable boom [17]. The slimmer body allowed the patient cart of the robotic system to be more easily imported and mobile.…”

Section: Discussionmentioning

confidence: 99%

Detailed comparison of the da Vinci Xi and S surgical systems for transaxillary thyroidectomy

Lee

Kim

et al. 2020

Preprint

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Background Robotic surgical systems have evolved over time. The da Vinci Xi system was developed in 2014 and was expected to solve the shortcomings of the previous S system. Therefore, we conducted this study to compare these two systems and identify if the Xi system truly improves surgical outcomes. Methods In this retrospective study, a total of 86 patients with unilateral papillary thyroid carcinoma without central lymph node involvement underwent gasless transaxillary hemithyroidectomy using two robotic systems, the da Vinci S and Xi. Forty patients were in the da Vinci S group and 46 patients were in the da Vinci Xi group. All surgeries were performed by one surgeon (YWC). All surgery video files were analyzed to compare the duration of each surgical step. Results The total operation time was significantly shorter in the Xi group than in the S group (153.0 min vs. 105.7 min, p < 0.01). Time for robot docking was shorter in the Xi group (19.8 min vs. 10.6 min, p < 0.01), and all procedures performed in the console also required a shorter time in this group. The overall complication rate did not differ significantly (p = 0.464). Conclusions The da Vinci Xi system made robotic thyroidectomy easier and faster without increasing the complication rate. It is a safe and valuable system for robotic thyroidectomy.

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“…In the end, uptake in the United States is likely driven by ongoing and increasing surgeon use. So whether it is the shorter learning curve (11e13), improved economics [36][37][38] or the joy and novelty of using advanced technology (no available studies), unless regulatory forces slow the march, the use of robotic surgery will likely continue to expand.…”

Section: Discussionmentioning

confidence: 99%

Sigmoidectomy for Diverticulitis—A Propensity-Matched Comparison of Minimally Invasive Approaches

Ogilvie

Saunders

Parker

et al. 2019

Journal of Surgical Research

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a b s t r a c tBackground: As the availability and use of robotic surgery increases, current data suggest comparable outcomes to laparoscopic surgery but at an increased cost. Elective sigmoid resection for diverticular disease is the most common colorectal application of robotic surgery and there is limited comparative data specifically for this indication. Methods:We identified all elective cases of laparoscopic-and robot-assisted surgery for diverticular disease among a practice of 7 colorectal surgeons within an established enhanced recovery protocol. We performed propensity matching based on surgical indications (recurrent disease, ongoing symptoms, or fistula), stoma creation, and body mass index to create a matched cohort. Our primary outcomes were return of bowel function, length of stay, opioid use, and pain scores during the first 72 h postoperatively. Secondary outcomes were operative room and hospital charges.Results: From 2011 to 2016, 69 robotic cases were propensity matched from a group of 222 laparoscopic cases to create a 1:1 case ratio that was equivalent in terms of patient demographics and operative indications. Time to first bowel movement was slightly quicker in the robotic group (1 [1] versus 2 [1.5], P ¼ 0.09), while length of stay (3.5 [1.6] versus 3.6 [1.4] d, P ¼ 0.64) was equivalent. Pain scores were lower in the robotic group on day 0 (4.6 versus 6.1, P ¼ 0.0001), but similar on day 1 and day 2 (4.3 versus 4.1, P ¼ 0.62 and 3.8 versus 3.3, P ¼ 0.19). There was no difference in postoperative 72-h opioid use between groups (110.8 MME [144.5] versus 97.4 MME [101.5], P ¼ 0.70). In the robotic arm operating room charges were slightly more ($2835 AE $394 versus $2196 AE $359, P < 0.0001), but total hospital charges were over significantly increased ($41,159 [$7840] versus $25,761 [$11,689], P < 0.0001).Conclusions: Via a carefully matched cohort of elective sigmoid resection for diverticular disease at a single community institution, we have demonstrated that laparoscopic-and robotic-assisted surgery result in clinically equivalent return of bowel function, length of stay, postoperative pain, and opioid use. ª

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The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Cited by 53 publications

References 81 publications

Colorectal Cancer Surgery Using the Da Vinci Xi and Si Systems: Comparison of Perioperative Outcomes

Colorectal Cancer Surgery Using the Da Vinci Xi and Si Systems: Comparison of Perioperative Outcomes

Detailed comparison of the da Vinci Xi and S surgical systems for transaxillary thyroidectomy

Sigmoidectomy for Diverticulitis—A Propensity-Matched Comparison of Minimally Invasive Approaches

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