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Da Vinci SP robotic approach to colorectal surgery: two specific indications and short-term results

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Abstract

Background

Da Vinci® Single Port (dvSP) was recently developed. Its application in colorectal surgery is under investigation. The aim of this study was to explore the safety and feasibility of dvSP for intersphincteric (dvSP-ISR), right colectomy (dvSP-RC), and transverse colectomy (dvSP-TC). Surgical indication and short-term results were analyzed.

Methods

All consecutive patients from a prospective database of patients who underwent dvSP-ISR, dvSP-RC, and dvSP-TC at Korea University Anam Hospital from November 2020 to December 2021, were analyzed. Perioperative, pathological, and oncological short-term outcomes were analyzed.

Results

A total of 7 dvSP-ISR, 5 dvSP-RC, and 1 dvSP-TC were performed. Median age was 56.0 (55.0–61.0) years for the dvSP-ISR and 54.0 (44.7–63.5) years for the dvSP-RC/TC. Median body mass index was 22.8 (17.1–24.8) kg/m2 for the dvSP-ISR and 23.6 (20.8–26.9) kg/m2 for the dvSP-RC/TC. All dvSP-ISR patients received neoadjuvant long-course chemoradiotherapy, including one patient with squamocellular carcinoma who was treated with 5-fluorouracil (5-FU)/mitomycin. All other patients, excluding one dvSP-RC patient with Crohn’s disease, had an adenocarcinoma. Median operation time was 280 (240–370) minutes for the dvSP-ISR and 220 (201–270) minutes for the dvSP-RC/TC. Estimated blood loss was insignificant. No intraoperative complications or conversions to multiport/open surgery was reported. Median post-operative stay was 7.0 (6.0–10.0) days for the dvSP-ISR and 5.0 (4.0–6.7) days for the dvSP-RC/TC. Quality of mesorectum was complete for six patients, and nearly complete for one. Median number of retrieved lymph nodes were 21 (17–25) for the dvSP-ISR and 28 (24–49) for the dvSP-RC/TC. Proximal and distal resection margins were tumor free. Four patients experienced post-operative complications not related to the platform which were: ileus, voiding dysfunction, infected pelvic hematoma, and wound infection. Median follow-up was 9 (6–11) months and 11 (7–17) months for the dvSP-ISR and dvSP-RC/TC, respectively. Two patients had systemic recurrence; all others were tumor free.

Conclusions

The dvSP platform is safe and feasible for intersphincteric resection with right lower quadrant access, and right/transverse colectomy with suprapubic access. Further studies are needed to evaluate benefit differences compared to multiport robotic platform.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Goryodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea

    G. N. Piozzi, J.-S. Kim, J. M. Choo, S. H. Shin, J. S. Kim, T.-H. Lee, S.-J. Baek, J.-M. Kwak, J. Kim & S. H. Kim

Authors
  1. G. N. Piozzi
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  2. J.-S. Kim
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  3. J. M. Choo
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  4. S. H. Shin
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  5. J. S. Kim
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  6. T.-H. Lee
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  7. S.-J. Baek
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  8. J.-M. Kwak
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  9. J. Kim
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  10. S. H. Kim
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Contributions

Conceptualization: GNP, SHK; methodology: GNP, J-SK, JMC, SHS, JSK, T-HL; formal analysis and investigation: GNP, SHS; writing—original draft preparation: GNP; writing—review and editing: S-JB, J-MK, JK, SHK; supervision: SHK.

Corresponding author

Correspondence to S. H. Kim.

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Conflict of interest

The authors declare no conflict of interest do disclose.

Ethical approval

This study was approved by the Institutional Review Board.

Informed consent

As this study was a retrospective analysis of routine clinical data, participants’ informed consent was waived by the institutional review board.

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Piozzi, G.N., Kim, JS., Choo, J.M. et al. Da Vinci SP robotic approach to colorectal surgery: two specific indications and short-term results. Tech Coloproctol 26, 461–470 (2022). https://doi.org/10.1007/s10151-022-02597-x

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  • DOI: https://doi.org/10.1007/s10151-022-02597-x

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