title: SAGES TAVAC safety and effectiveness analysis: da Vinci ® Surgical System (Intuitive Surgical, Sunnyvale, CA).
abstract: BACKGROUND
  The da Vinci(®) Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) is a computer-assisted (robotic) surgical system designed to enable and enhance minimally invasive surgery. The Food and Drug Administration (FDA) has cleared computer-assisted surgical systems for use by trained physicians in an operating room environment for laparoscopic surgical procedures in general, cardiac, colorectal, gynecologic, head and neck, thoracic and urologic surgical procedures. There are substantial numbers of peer-reviewed papers regarding the da Vinci(®) Surgical System, and a thoughtful assessment of evidence framed by clinical opinion is warranted.
  
  
  METHODS
  The SAGES da Vinci(®) TAVAC sub-committee performed a literature review of the da Vinci(®) Surgical System regarding gastrointestinal surgery. Conclusions by the sub-committee were vetted by the SAGES TAVAC Committee and SAGES Executive Board. Following revisions, the document was evaluated by the TAVAC Committee and Executive Board again for final approval.
  
  
  RESULTS
  Several conclusions were drawn based on expert opinion organized by safety, efficacy, and cost for robotic foregut, bariatric, hepatobiliary/pancreatic, colorectal surgery, and single-incision cholecystectomy.
  
  
  CONCLUSIONS
  Gastrointestinal surgery with the da Vinci(®) Surgical System is safe and comparable, but not superior to standard laparoscopic approaches. Although clinically acceptable, its use may be costly for select gastrointestinal procedures. Current data are limited to the da Vinci(®) Surgical System; further analyses are needed.
authors.affiliation: Department of Surgery, University of Nevada School of Medicine, 1701 W. Charleston Blvd. Suite 400, Las Vegas, NV, 89102, USA. stsuda@medicine.nevada.edu.
authors.forename: Shawn
authors.initials: S
authors.lastname: Tsuda
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Oleynikov
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Gould
authors.affiliation: Department of Surgery, Stanford School of Medicine, Stanford, CA, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Azagury
authors.affiliation: Department of Surgery, University of California San Diego School of Medicine, La Jolla, CA, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Sandler
authors.affiliation: Department of Surgery, Harvard Medical School, Boston, MA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hutter
authors.affiliation: Department of Surgery, Florida Hospital, Orlando, FL, USA.
authors.forename: Sharona
authors.initials: S
authors.lastname: Ross
authors.affiliation: Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Haas
authors.affiliation: Department of Surgery, George Washington University, Washington, DC, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Brody
authors.affiliation: Department of Surgery, University of Washington, Seattle, WA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Satava
mesh_terms: D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D013505:Digestive System Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy; D061214:Patient Safety; D065287:Robotic Surgical Procedures / Q000295:instrumentation*
keywords: Abdominal surgery; Cost; Da Vinci® Surgical System; Effectiveness; Gastrointestinal surgery; Safety