Technical insights to multivisceral resections using the da Vinci Xi

Abstract

Background There have been few reports on the feasibility and safety of robotic multivisceral surgeries. The da Vinci Xi boasts significant upgrades that improve its applicability in combined resections. We report our early experience of multivisceral, multi‐quadrant resections with the Xi system. Methods Between May 2015 and August 2019, 13 multivisceral resections were performed. Patient demographics, procedural data, and perioperative outcomes were evaluated. Results The procedures were completed at a median operative time of 290 (range, 210–535) minutes. The median postoperative length of hospital stay was 3.5 (range, 2–7) days. There was one case of readmission for anastomotic leak, but no positioning injuries, external robot arm collisions or issues arising from trocar position. There were no cases of perioperative mortality. Conclusion Multivisceral resections can be safely accomplished using the Xi. Further studies are necessary to ascertain whether there are benefits of the robotic approach over conventional laparoscopy in these complex cases.

Dimensional optimisation and an inverse kinematic solution method of a safety‐enhanced remote centre of motion manipulator

“…40 (2) The da Vinci Xi needs to be repositioned during surgery to provide proper orientation and position for task execution. 41 Although preoperative positioning devices can achieve this goal, the procedure is time-consuming, and communication failure in emergencies may bring potential safety problems. 25,30 One of the possible reasons is the limited pitch movement, thus restricting the reachable workspace inside the abdominal cavity.…”

“…As a result, this increases the maintenance cost of the system and the complexity of the control system 40 . (2) The da Vinci Xi needs to be repositioned during surgery to provide proper orientation and position for task execution 41 . Although preoperative positioning devices can achieve this goal, the procedure is time‐consuming, and communication failure in emergencies may bring potential safety problems 25,30 .…”

Robotic colorectal surgery: evolution of its place

“…There are two interesting papers in this issue of the Journal that look at areas in colorectal surgery that are a challenge for all of us. The first, from Ngu et al 1 . examines the use of the da Vinci Xi in multi‐visceral surgery; and the second, from Wang et al 2 .…”

“…The Ngu et al . paper 1 is an initial case series of multi‐visceral resections using the Xi and provides detailed case descriptions and techniques used. The series highlights many important points regarding robotic surgery and its advantages in multivisceral surgery.…”

“…There are two interesting papers in this issue of the Journal that look at areas in colorectal surgery that are a challenge for all of us. The first, from Ngu et al 1 examines the use of the da Vinci Xi in multi-visceral surgery; and the second, from Wang et al 2 presents a review of robotic surgery in the obese. Both of these are complex areas that can be surgically challenging from multiple points of view-planning, access, patient positioning, prolonged operating times, managing comorbidity and achieving complete oncological resection.…”