Re: da Vinci Xi and Si Platforms Have Equivalent Perioperative Outcomes during Robot-Assisted Partial Nephrectomy: Preliminary Experience

Background: The objective of this study was to evaluate our experience with robot-assisted partial nephrectomy (RAPN) in comparison with conventional open partial nephrectomy (OPN). Patients and Methods: This study included 37 and 50 patients undergoing OPN and RAPN for small renal masses, respectively. A single surgeon performed RAPN for all 50 cases using the da Vinci Xi. Trifecta was defined as satisfying all of the following 3 criteria: ischemic time of ≤ 25 minutes, negative surgical margin and no major postoperative complications. Results: After adjusting patient variables by 1:1 propensity-score matching, 37 patients were included in each group, and no significant differences in major clinicopathological characteristics were noted between these 2 groups. RAPN was significantly superior to OPN with respect to operative time, estimated blood loss and postoperative length of hospital stay. The rate of trifecta achievement was significantly higher in the RAPN group than in the OPN group (91.9 vs. 62.2%). Furthermore, the operative procedure and R.E.N.A.L. nephrometry score were found to be independently associated with trifecta outcome by multivariate analysis of the entire cohort. Conclusions: Although this is our early experience with 50 initial cases, RAPN using the da Vinci Xi resulted in more favorable perioperative outcomes than OPN.

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A comparison of the da Vinci Xi vs. da Vinci Si surgical systems for radical prostatectomy

BMC Surgery ◽

10.1186/s12893-021-01406-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kun-Yang Lei ◽

Wen-Jie Xie ◽

Sheng-Qiang Fu ◽

Ming Ma ◽

Ting Sun

Keyword(s):

Radical Prostatectomy ◽

Da Vinci ◽

Laparoscopic Radical Prostatectomy ◽

Perioperative Outcomes ◽

Da Vinci Xi ◽

Robot Assisted ◽

Short Term ◽

Term Efficacy ◽

Da Vinci Si ◽

The Cost

Abstract Background To compare the perioperative and short-term efficacy and cost of the da Vinci Xi and da Vinci Si surgical systems for radical prostatectomy. Methods We retrospectively analyzed the clinical data of 175 patients with prostate cancer who underwent radical prostatectomy with the da Vinci Si or Xi surgical systems in our hospital from June 2019 to June 2020. Of the 175 patients, 82 underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Xi surgery system, and 93 patients underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Si surgical system. The perioperative outcomes, short-term efficacy and costs were compared between the two groups. Results The anesthesia time, operation time, docking time, indwelling catheter time and postoperative bed rest time in the Xi group were shorter than those in the Si group (respectively, 268.8 min vs. 219.3 min, P = 0.001; 228.2 min vs. 259.6 min, P < 0.001; 7.4 min vs. 12.7 min, P < 0.001; 8.6 d vs. 9.7 d, P = 0.036; 2.2 d vs. 2.6 d, P = 0.002). However, the total cost of hospitalization and the cost of intraoperative consumables in the Xi group were higher than those in the Si group (84,740.7 vs. 76,739.1 ¥, P = 0.003; 13,199.4 vs. 10,823.0 ¥, P = 0.019). Conclusions Although the cost of robot-assisted radical prostatectomy is higher, compared with the Si system, the Xi system has better perioperative outcomes and can provide similar short-term efficacy and oncology outcomes.

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Robotic Partial Nephrectomy with the Da Vinci Xi

Advances in Urology ◽

10.1155/2016/9675095 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

George J. S. Kallingal ◽

Sanjaya Swain ◽

Fadi Darwiche ◽

Sanoj Punnen ◽

Murugesan Manoharan ◽

...

Keyword(s):

Partial Nephrectomy ◽

Da Vinci ◽

Intraoperative Complications ◽

Perioperative Outcomes ◽

Robotic Partial Nephrectomy ◽

Da Vinci Xi ◽

Port Placement ◽

Renal Masses ◽

Estimated Blood Loss ◽

Surgical Platform

Purpose.The surgical expertise to perform robotic partial nephrectomy is heavily dependent on technology. The Da Vinci Xi (XI) is the latest robotic surgical platform with significant advancements compared to its predecessor. We describe our operative technique and experience with the XI system for robotic partial nephrectomy (RPN).Materials and Methods.Patients with clinical T1 renal masses were offered RPN with the XI. We used laser targeting, autopositioning, and a novel “in-line” port placement to perform RPN.Results.15 patients underwent RPN with the XI. There were no intraoperative complications and no operative conversions. Mean console time was 101.3 minutes (range 44–176 minutes). Mean ischemia time was 17.5 minutes and estimated blood loss was 120 mLs. 12 of 15 patients had renal cell carcinoma. Two patients had oncocytoma and one had benign cystic disease. All patients had negative surgical margins and pathologic T1 disease. Two postoperative complications were encountered, including one patient who developed a pseudoaneurysm and one readmitted for presumed urinary tract infection.Conclusions.RPN with the XI system can be safely performed. Combining our surgical technique with the technological advancements on the XI offers patients acceptable pathologic and perioperative outcomes.

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da Vinci robot-assisted laparoscopic partial nephrectomy for renal tumors with PADUA score ≥10

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2014.00800 ◽

2014 ◽

Vol 35 (7) ◽

pp. 800

Author(s):

Hua-mao YE ◽

Rong WANG ◽

Zhen-jie WU ◽

Ming-min LI ◽

Chen CAI ◽

...

Keyword(s):

Partial Nephrectomy ◽

Da Vinci ◽

Laparoscopic Partial Nephrectomy ◽

Renal Tumors ◽

Robot Assisted ◽

Da Vinci Robot

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Single assistant vs dual assistant robotic surgery for robot‐assisted laparoscopic hysterectomy using da Vinci Xi or X

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.2315 ◽

2021 ◽

Author(s):

Hiroe Ito ◽

Satoshi Yanagida ◽

Yoichiro Tomonaga ◽

Hideyuki Yamashita ◽

Makoto Ohori ◽

...

Keyword(s):

Robotic Surgery ◽

Da Vinci ◽

Laparoscopic Hysterectomy ◽

Da Vinci Xi ◽

Robot Assisted

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

Surgical Innovation ◽

10.1177/1553350618816788 ◽

2018 ◽

Vol 26 (2) ◽

pp. 192-200 ◽

Cited By ~ 4

Author(s):

Yu-Min Huang ◽

Yan Jiun Huang ◽

Po-Li Wei

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Da Vinci ◽

Operation Time ◽

Robotic System ◽

Cancer Surgery ◽

Perioperative Outcomes ◽

Da Vinci Xi ◽

Colorectal Cancer Surgery ◽

Estimated Blood Loss

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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