Initial Experience of BABA Robotic Thyroidectomy Using the Da Vinci Xi System in Incheon, Korea

Background and Objectives: Robotic thyroidectomy via the bilateral axillo-breast approach (BABA), first introduced in Korea in 2008, has become a standard method of thyroid removal worldwide. The introduction of robotic surgical systems has enabled more patients to benefit from BABA robotic thyroidectomy, with good postoperative and excellent cosmetic results. To date, no studies have compared the benefits of the four currently available da Vinci robotic systems (S, Si, X, and Xi) for BABA robotic thyroidectomy. To determine the da Vinci model most suitable for BABA robotic thyroidectomy, the present study compared the perioperative outcomes in patients who underwent BABA robotic thyroidectomy using the four da Vinci models. Materials and Methods: This retrospective study evaluated outcomes in patients (n = 750) who underwent BABA robotic thyroidectomy using the four da Vinci systems from 2013 to 2019. The clinicopathologic data, including operation time, were compared. Substudy A compared the da Vinci models S and Si from 2013 to 2017, and substudy B compared models Si, X, and Xi from 2018 to 2019. Results: Substudy A, comparing the da Vinci S and Si systems, found no statistically significant differences between the two groups, whereas substudy B found that operation time was shorter in patients who underwent BABA robotic thyroidectomy with the da Vinci Xi system than with the Si and X systems. Conclusions: The da Vinci model Xi system can benefit patients undergoing BABA robotic thyroidectomy by shortening the operation time.

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

10.21203/rs.3.rs-25028/v1 ◽

2020 ◽

Author(s):

Da Young Yu ◽

Hye Yoon Lee ◽

Woo Young Kim ◽

Hoon Yub Kim ◽

Jae Bok Lee ◽

...

Keyword(s):

Complication Rate ◽

Da Vinci ◽

Operation Time ◽

Detailed Comparison ◽

Lymph Node Involvement ◽

Robotic Thyroidectomy ◽

Da Vinci Xi ◽

Node Involvement ◽

Central Lymph ◽

Transaxillary Thyroidectomy

Abstract 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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Radical Nephroureterectomy Without Patient or Port Repositioning Using the Da Vinci Xi Robotic System: Initial Experience

Urology ◽

10.1016/j.urology.2016.02.047 ◽

2016 ◽

Vol 92 ◽

pp. 136-139 ◽

Cited By ~ 9

Author(s):

Omer Burak Argun ◽

Panagiotis Mourmouris ◽

Ilter Tufek ◽

Mustafa Bilal Tuna ◽

Selcuk Keskin ◽

...

Keyword(s):

Da Vinci ◽

Robotic System ◽

Initial Experience ◽

Radical Nephroureterectomy ◽

Da Vinci Xi

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Initial Experience with Robotic Modified Radical Neck Dissection Using the da Vinci Xi System through the Bilateral Axillary Breast Approach

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2020.01585 ◽

2020 ◽

Author(s):

yunsuk choi ◽

Yong Tae Hong ◽

Jin Wook Yi

Keyword(s):

Neck Dissection ◽

Da Vinci ◽

Radical Neck Dissection ◽

Operation Time ◽

Central Neck Dissection ◽

Robotic Thyroidectomy ◽

Da Vinci Xi ◽

Modified Radical Neck Dissection ◽

Bilateral Axillary Breast Approach ◽

Endocrine Surgeon

Objectives: The bilateral axillo-breast approach (BABA) to robotic thyroidectomy has been extended to modified radical neck dissection (MRND). This study assessed outcomes in patients who underwent robotic MRND through BABA using the da Vinci Xi system. Methods: The medical records of 40 patients who underwent total thyroidectomy, bilateral central neck dissection and MRND from September 2018 to March 2020 were reviewed retrospectively, including 12 who underwent robotic surgery and 28 who underwent open surgery. All operations were performed by a single endocrine surgeon. Results: Operation time was significantly longer in the robotic than in the open group (277.08

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Robot-assisted laparoendoscopic single-site upper urinary tract surgery with da Vinci Xi surgical system: Initial experience

Investigative and Clinical Urology ◽

10.4111/icu.2020.61.3.323 ◽

2020 ◽

Vol 61 (3) ◽

pp. 323

Author(s):

Hyung Ho Lee ◽

Joon Chae Na ◽

Young Eun Yoon ◽

Koon Ho Rha ◽

Woong Kyu Han

Keyword(s):

Urinary Tract ◽

Da Vinci ◽

Upper Urinary Tract ◽

Single Site ◽

Initial Experience ◽

Da Vinci Xi ◽

Robot Assisted ◽

Laparoendoscopic Single Site ◽

Surgical System

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PS01.240: ROBOTIC ESOPHAGECTOMY USING THE DA VINCI XI: INITIAL EXPERIENCE FROM A TERTIARY CANCER CENTRE

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.240 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 118-118

Author(s):

Sabita Jiwnani ◽

Umasankar Tantravahi ◽

Parag Ingle ◽

Vijayraj Patil ◽

George Karimundackal ◽

...

Keyword(s):

Esophageal Cancer ◽

Blood Loss ◽

Da Vinci ◽

Neoadjuvant Chemoradiotherapy ◽

Preoperative Imaging ◽

Initial Experience ◽

Da Vinci Xi ◽

Robotic Approach ◽

Robotic Esophagectomy

Abstract Background Esophagectomy is a daunting procedure with a steep learning curve. Minimally invasive esophagectomy is associated with reduced perioperative complications. However, most studies so far have evaluated thoracoscopic or laparoscopic approaches. We describe our initial experience with robotic esophagectomy using the da Vinci Xi system. Methods We performed a retrospective analysis of a prospectively maintained database of patients operated with radical intent for esophageal cancer between November 2014 and November 2017. Results Thirty-four of the 483 curative esophagectomies were performed robotically. We performed the thoracic part in the semi-prone position and the abdominal part in a supine position. The thoracic component of the procedure was completed robotically in all 34 patients. For the abdominal approach, 19(55.9%) patients underwent gastric mobilization by the robotic approach, 9(26.5%) by the laparoscopic approach, and 6(17.6%) by laporotomy. The median age was 51 years and 76.5% of the patients were male. 73.5% of the patients had T3 tumours and 52.9% of the patients did not have significant nodes (N0) on preoperative imaging by PET-CT. 70.6% of the patients received neoadjuvant chemotherapy and 2.9% of the patients received neoadjuvant chemoradiotherapy. Standard two field (infracarinal and abdominal) lymphadenectomy was performed in 88.2% and three field lymphadenectomy in 11.8%. The median blood loss was 275 ml, with 85% of patients having blood loss below 400ml. The total surgical time (including docking and changing patient position) was 390 min. No patient needed intra or post-operative blood transfusion. Median ICU and hospital stay were 0.6 days and 10 days respectively. Major morbidity (Clavin-Dindo score > 3A) occurred in 17.6% with one post-operative mortality (2.9%). Pulmonary complications were seen in 8.8% and anastomotic leak in 11.8%. The median lymph nodes retrieved were 18. At a median of 24-months follow-up, the disease free survival was 58%, and the overall survival was 70%. Conclusion Transthoracic total esophagectomy is safe and feasible through the robotic approach. Larger studies with longer follow-up are needed to establish robotic esophagectomy as a standard surgical option for patients with esophageal cancer. Disclosure All authors have declared no conflicts of interest.

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