title: Multiquadrant robotic colorectal surgery: the da Vinci Xi vs Si comparison.
abstract: The newly introduced da Vinci Xi Surgical System hopes to address the shortcomings of its predecessor, specifically robotic arm restrictions and difficulty working in multiple quadrants. We compare the two robot platforms in multiquadrant surgery at a major colorectal referral center. Forty-four patients in the da Vinci Si group and 26 patients in the Xi group underwent sigmoidectomy or low anterior resection between 2014 and 2016. Patient demographics, operative variables, and postoperative outcomes were compared using descriptive statistics. Both groups were similar in age, sex, BMI, pelvic surgeries, and ASA class. Splenic flexure was mobilized in more (p = 0.045) da Vinci Xi cases compared to da Vinci Si both for sigmoidectomy (50 vs 15.4%) and low anterior resection (60 vs 29%). There was no significant difference in operative time (219.9 vs 224.7 min; p = 0.640), blood loss (170.0 vs 188.1 mL; p = 0.289), length of stay (5.7 vs 6 days; p = 0.851), or overall complications (26.9 vs 22.7%; p = 0.692) between the da Vinci Xi and Si groups, respectively. Single-dock multiquadrant robotic surgery, measured by splenic flexure mobilization with concomitant pelvic dissection, was more frequently performed using the da Vinci Xi platform with no increase in operative time, bleeding, or postoperative complications. The new platform provides surgeons an easier alternative to the da Vinci Si dual docking or combined robotic/laparoscopic multiquadrant surgery.
authors.affiliation: General Surgery, Geisinger Health System, 1000 E. Mountain Blvd., Wilkes-Barre, PA, 18711, USA. protyniak@gmail.com.|Division of Colon and Rectal Surgery, University of Louisville, ACB2, Surgery Suite, 550 South Jackson Street, Louisville, KY, 40202, USA. protyniak@gmail.com.
authors.forename: Bogdan
authors.identifier: http://orcid.org/0000-0003-2873-7736
authors.initials: B
authors.lastname: Protyniak
authors.affiliation: Division of Colon and Rectal Surgery, University of Louisville, ACB2, Surgery Suite, 550 South Jackson Street, Louisville, KY, 40202, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Jorden
authors.affiliation: Division of Colon and Rectal Surgery, University of Louisville, ACB2, Surgery Suite, 550 South Jackson Street, Louisville, KY, 40202, USA.
authors.forename: Russell
authors.initials: R
authors.lastname: Farmer
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003110:Colonic Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012004:Rectal Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D013525:Surgical Instruments; D016896:Treatment Outcome
keywords: Colorectal surgery; Multiquadrant surgery; Robotic rectal resection; Splenic flexure mobilization