Anna R Spivak, DO, John Marks, MD. Lankenau Medical Center
Introduction: The Xi robot has been developed to facilitate multiquadrant abdominal surgery. This report presents initial experience to evaluate feasibility and safety of Xi robot in colorectal surgery.
Methods: All cases performed on Xi robot were prospectively entered into a robotic database that was queried for colorectal cases performed from July 2015-September 2017. 136 cases were identified. Demographics, perioperative, and postoperative data were analyzed.
Results: Patient population included 50.9% women, mean age 61.3 years(18-89), mean BMI 27.9 kg/m2(16-48). Preoperative diagnosis included cancer(47%), diverticulitis(34%), polyps(9%), rectal prolapse(5%), ulcerative colitis(2%), other(3%). 39.4% had at least one previous abdominal surgery. 65% of procedures were in the pelvis. Of 28 patients with rectal cancer, 75% underwent neoadjuvant radiation. Total mesorectal excision(TME) was done in 25 cases(24%). See table for procedure distribution.
Complete/near complete TME was achieved in 92% of cases. Incomplete TMEs had previous TEM surgery or radiation. Intraoperative complications were encountered in 2 cases(1.9%), requiring conversion to laparoscopy. None were converted to open. Mean length of largest incision 4.7cm. Median EBL 55ml. There was no mortality. There were 10(9.6%) immediate postoperative morbidities: postoperative abscess, bowel perforation, two postoperative bleeds, two hernias, two hematomas, SMV thrombosis, small bowel obstruction. Perioperative blood transfusions were required in 2.8% of cases. There was one anastomotic leak. Median time from surgery to low residue diet and discharge was 3 days.
Conclusion: Initial experience shows robotic colorectal resection with da Vinci Xi robot to be a reasonable and safe option in oncologic and benign diagnosis.
Table 1: Breakdown of Xi Procedures
| Procedure | Number of cases | Percentage |
|---|---|---|
| Deep Pelvic Dissection Cases | ||
| Abdominoperineal resection | 7 | 5% |
| Low Anterior Resection | 71 | 52% |
| Total Abdominal Colectomy | 2 | 2% |
| Rectopexy | 6 | 4% |
| Hartmann's Reversal | 2 | 2% |
| Total | 88 | 65% |
| Left Colectomy | 29 | 21% |
| Righ Colectomy | 17 | 12% |
| Exploratory Laparotomy | 1 | 1% |
| Colostomy | 1 | 1% |
| Total Cases | 136 | 100% |
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88232
Program Number: P805
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster