Skip to main content
Log in

A comparison of the da Vinci Xi vs. the da Vinci Si Surgical System for Roux-En-Y gastric bypass

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

The da Vinci Surgical System family remains the most widely used surgical robotic system for laparoscopy. Data about gastric bypass surgery with the Xi Surgical System are not available yet. We compared Roux-en-Y gastric bypass surgery performed at our institution with the da Vinci Xi and the da Vinci Si Surgical System.

Methods

All robotic gastric bypass procedures performed between January 2013 and September 2016 were analyzed retrospectively. Patient demographics and operative and postoperative outcomes up to 30 days were compared for the da Vinci Xi and Si Surgical System. Robotic costs per procedure were modeled including posts for a standard set of robotic instruments, capital investment, and yearly maintenance.

Results

One-hundred forty-four Xi Surgical System and 195 Si Surgical System procedures were identified. Mean age (p = 0.9), gender distribution (p = 0.8), BMI (p = 0.6), and ASA scores (p > 0.5) were similar in both cohorts. Operating room times were similar in both groups (219.4 ± 58.8 vs. 227.4 ± 60.5 min for Xi vs. Si, p = 0.22). Docking times were significantly longer with the Xi compared with the Si Surgical System (9 ± 4.8 vs. 5.8 ± 4 min, p < 0.0001). There was no difference in incidence of minor (13.9 vs. 10.3%, p = 0.3) and major complications (5.6 vs. 5.1%, p = 1 for Xi vs. Si). Costs were higher for the Xi Surgical System caused by higher capital investment and yearly maintenance.

Conclusions

Roux-en-Y gastric bypass surgery can be safely performed with the Xi Surgical System, while drawbacks include longer docking times and higher costs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Jung MK, Hagen ME, Buchs NC, Bühler LH, Morel P (2017) Robotic bariatric surgery: a general review of the current status. Int J Med Robot 13:e1834–e1840

    Article  Google Scholar 

  2. Snyder BE, Wilson T, Leong BY, Klein C, Wilson EB (2010) Robotic-assisted Roux-en-Y gastric bypass: minimizing morbidity and mortality. Obes Surg 20:265–270

    Article  PubMed  Google Scholar 

  3. Markar SR, Karthikesalingam AP, Venkat-Ramen V, Kinross J, Ziprin P (2011) Robotic vs. laparoscopic Roux-en-Y gastric bypass in morbidly obese patients: systematic review and pooled analysis. Int J Med Robot 7:393–400

    Article  CAS  PubMed  Google Scholar 

  4. Wang L, Yao L, Yan P, Xie D, Han C, Liu R, Yang K, Guo T, Tian L (2018) Robotic versus laparoscopic Roux-en-Y gastric bypass for morbid obesity: a systematic review and meta-analysis. Obes Surg 28:3691–3700

    Article  PubMed  Google Scholar 

  5. Khorgami Z, Aminian A, Shoar S, Andalib A, Saber AA, Schauer PR, Brethauer SA, Sclabas GM (2017) Cost of bariatric surgery and factors associated with increased cost: an analysis of national inpatient sample. Surg Obes Relat Dis 13:1284–1289

    Article  PubMed  Google Scholar 

  6. Sharma G, Strong AT, Tu C, Brethauer SA, Schauer PR, Aminian A (2018) Robotic platform for gastric bypass is associated with more resource utilization: an analysis of MBSAQIP dataset. Surg Obes Relat Dis 14:304–310

    Article  PubMed  Google Scholar 

  7. Lundberg PW, Wolfe S, Seaone J, Stoltzfus J, Claros L, El Chaar M (2018) Robotic gastric bypass is getting better: first results from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Surg Obes Relat Dis 14:1240–1245

    Article  PubMed  Google Scholar 

  8. Celio AC, Kasten KR, Schwoerer A, Pories WJ, Spaniolas K (2017) Perioperative safety of laparoscopic versus robotic gastric bypass: a propensity matched analysis of early experience. Surg Obes Relat Dis 13:1847–1852

    Article  PubMed  Google Scholar 

  9. Sebastian R, Howell MH, Chang KH, Adrales G, Magnuson T, Schweitzer M, Nguyen H (2019) Robot-assisted versus laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a propensity score-matched comparative analysis using the 2015-2016 MBSAQIP database. Surg Endosc 33:1600–1612

    Article  PubMed  Google Scholar 

  10. Hagen ME, Jung MK, Ris F, Fakhro J, Buchs NC, Buehler L, Morel P (2017) Early clinical experience with the da Vinci Xi Surgical System in general surgery. J Robotic Surg 11:347–353

    Article  Google Scholar 

  11. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  12. Worni M, Guller U, Shah A, Gandhi M, Shah J, Rajgor D, Pietrobon R, Jacobs DO, Ostbye T (2012) Cholecystectomy concomitant with laparoscopic gastric bypass: a trend analysis of the nationwide inpatient sample from 2001 to 2008. Obes Surg 22:220–229

    Article  PubMed  Google Scholar 

  13. Warschkow R, Tarantino I, Ukegjini K, Beutner U, Güller U, Schmied BM, Müller SA, Schultes B, Thurnheer M (2013) Concomitant cholecystectomy during laparoscopic Roux-en-Y gastric bypass in obese patients is not justified: a meta-analysis. Obes Surg 23:397–407

    Article  PubMed  Google Scholar 

  14. Mohr CJ, Nadzam GS, Alami RS, Sanchez BR, Curet MJ (2006) Totally robotic laparoscopic Roux-en-Y gastric bypass: results from 75 patients. Obes Surg 16:690–696

    Article  PubMed  Google Scholar 

  15. Buchs NC, Pugin F, Bucher P, Hagen ME, Chassot G, Koutny-Fong P, Morel P (2012) Learning curve for robot-assisted Roux-en-Y gastric bypass. Surg Endosc 26:1116–1121

    Article  PubMed  Google Scholar 

  16. Ngu JC, Tsang CB, Koh DC (2017) The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery. Robot Surg 4:77–85

    Article  PubMed  PubMed Central  Google Scholar 

  17. Buchs NC, Pugin F, Volonté F, Morel P (2014) Reliability of robotic system during general surgical procedures in a university hospital. Am J Surg 207:84–88

    Article  PubMed  Google Scholar 

  18. Protyniak B, Jorden J, Farmer R (2018) Multiquadrant robotic colorectal surgery: the da Vinci Xi vs. Si comparison. J Robotic Surg 12:67–74

    Article  Google Scholar 

  19. Hagen ME, Jung MK, Fakhro J, Buchs NC, Buehler L, Mendoza JM, Morel P (2018) Robotic versus laparoscopic stapling during robotic Roux-en-Y gastric bypass surgery: a case-matched analysis of costs and clinical outcomes. Surg Endosc 32:472–477

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Francoise Bernardi and Bénédicte Nicaise Saridas (University Hospital Geneva) for data collection.

Author information

Authors and Affiliations

Authors

Contributions

Nadja Niclauss, Philippe Morel, and Monika E. Hagen were implicated in study conception and design. All authors realized acquisition of data. Nadja Niclauss and Monika E. Hagen performed analysis and interpretation of data. Nadja Niclauss and Monika E. Hagen wrote the manuscript draft. All authors revised the manuscript.

Corresponding author

Correspondence to Nadja Niclauss.

Ethics declarations

Conflict of interest

Nadja Niclauss and Philippe Morel have no conflicts of interest to declare. Minoa K. Jung received fellowship grants non-related to the research from Ethicon Inc. and Intuitive Surgical Inc. Monika E. Hagen received personal fees and non-financial support from Intuitive Surgical Inc. and Ethicon Inc., outside this project.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards with the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Niclauss, N., Morel, P., Jung, M.K. et al. A comparison of the da Vinci Xi vs. the da Vinci Si Surgical System for Roux-En-Y gastric bypass. Langenbecks Arch Surg 404, 615–620 (2019). https://doi.org/10.1007/s00423-019-01803-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-019-01803-z

Keywords

Navigation