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You are here: Home / Abstracts / Initial Experience Using da Vinci Xi Robot in Colorectal Surgery

Initial Experience Using da Vinci Xi Robot in Colorectal Surgery

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

86

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