Robotic excision of parametrial endometriosis with the new Versius robotic system: a preliminary case series.

Abstract

Purpose: Endometriosis affects 10% of the female population in reproductive age. Although a greater awareness of the condition and constant progress in understanding its natural history, its treatment remain challenging. When it comes to surgical intervention, the minimally invasive, laparoscopic, or robotic approach is the gold standard. While offering better visualization and refinement of movements, the robotic system is burdened by often unaffordable costs. Since the Da Vinci patent expired, new platforms have entered this scene, trying to preserve the advantages of robotics, while cutting costs. To date, there are no deep infiltrating endometriosis cases reported in literature afforded with the new Versius surgical system. Materials and methods: We considered prospectively 3 patients undergoing robotic surgery for parametrial endometriosis with the versius system, in our tertiary referral multiplatform robotic center. The surgical technique was described step by step. Demographics, intra-operative robotic events and peri-operative outcomes were collected. Results: A total of 3 procedures were performed. The median BMI was 18.52 kg/m 2, [16.33-20.96]. The median age was 41 years [36-51]. Median docking time was 51 minutes [37-60], median console time 180 [136-223] minutes. Pneumoperitoneum was maintained at 9 mmHg. A single high priority collision occurred. Blood loss was negligible. There were no peri-operative complications nor conversions. Conclusions: Versius appeared to be a safe and feasible option for deep infiltrating endometriosis surgery. Our experience suggests operative room configuration and port placement to better perform these challenging procedures. These suggestions may enhance the mini-invasiveness while beating costs and making robotics worldwide approachable.