Major colorectal resection is feasible using a new robotic surgical platform: the first report of a case series

Abstract

Background The number of abdominal procedures performed via a robotic-assisted approach is increasing as potential advantages of the modality are recognised. We report the first in human case series of major colorectal resection performed using a new system, Versius ® , and assess the feasibility of its use. Methods The initial cases performed using Versius ® at a single centre in the UK were included in the study. Anonymised data were prospectively collected including patient demographics, operative details and postoperative outcomes. Results Twenty-three operations were performed, including left (n = 14) and right (n = 9)-sided colonic resections. Rectal mobilisation was performed in 13. Fifty-seven percent of the patients were male, with a malignant indication for surgery in 70% of cases. Overall mean age was 59.1 ± 15.3 (range 23-89) years. Overall mean body mass index was 28.9 ± 5.2 with a mean of 31.3 ± 4.5 for left-sided resections. The median console operating time was 166 min (range 75-320 min). All malignant cases had negative resection margins and the mean lymph node yield was 18 (SD 9.4). Only one operation (4%) was converted from robotic to open approach. Postoperative length of stay was a median of 5 days (range 3-34 days) and there were no readmissions within 30 days. Conclusions These results compare favourably with the literature on existing robotic systems and also conventional laparoscopic surgery; hence, we believe that this series indicates the Versius ® system is feasible for use in major colorectal resection. These early results from a robot-naïve centre show exciting promise for an expanding robotic market and highlight the need for further evaluation.

Assessment of the Versius Robotic Surgical System in Minimal Access Surgery: A Systematic Review

“…The results of preclinical studies supported an assessment of the new robot-assisted MAS system in the clinical setting, in the fields of general, gynecologic, and urologic surgery [22,25,26]. This was followed by studies investigating the clinical safety and effectiveness of the Versius system in MAS [20,[29][30][31][32][33][34][35]. Investigations in live humans are summarized in Table 4.…”

“…The investigations had been conducted in Germany (n = 1), the United States (USA) (n = 3), the United Kingdom (UK) (n = 8), the USA and the UK (n = 1), and India (n = 4). The investigations had been performed on cardboard boxes (n = 1) (40); human cadavers (n = 5) [13,22,23,27,28]; human cadavers and live animals (n = 3) [24][25][26]; and live humans (n = 7) [20,[29][30][31][32][33][34][35]. Results were divided into the following two categories: (a) usability, safety, and effectiveness of the Versius system (9 studies); and (b) clinical safety and effectiveness of the Versius system for use in MAS (8 studies).…”

“…A year after the Versius surgical robotic system was introduced in the market, many surgeons started to use it in visceral, gynecological, and urological surgery despite a limited body of scientific data concerning its feasibility and safety [21]. In conjunction with the primary use of the system in MAS, scientists performed preliminary studies in human cadavers and live animals as well as preclinical investigations to evaluate the operational safety and feasibility of the system [13,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Given the novelty of the device and the small number of existing studies, scientists and surgeons have been unable to draw final conclusions about the safety and effectiveness of the robot.…”

Advances and Trends in Pediatric Minimally Invasive Surgery

“…CMR Surgical (Cambridge, UK) developed the Versius robotic system, which has already been clinically applied and evaluated in general surgical, urological and gynecological procedures [125][126][127][128][129][130]. With its 5 mm diameter fully wristed instruments its application in pediatric surgery appears promising.…”

Robotic Colorectal Surgery Using Senhance® Robotic Platform: Report of 81 Case

“…However, the analysis of true benefits of this surgery on an evidence based level is still ongoing. Furthermore, today, the Da Vinci ® is no longer the only existing robotic system: case series in colorectal cancer surgery, although small, are already published, using the FDA and European CE mark approved Senhance ® robotic system (2,3), the European CE mark approved Versius ® robotic system (4,5,6) and other systems having approval for clinical use on a single country level like Microhand S ® in China (7,8). In the near future, a number of new robotic systems are also to be introduced.…”