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Single-incision robotic colorectal surgery with the da Vinci SP® surgical system: initial results of 50 cases

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Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Purpose

The da Vinci SP® (dVSP) surgical system (Intuitive Surgical, Sunnyvale, CA, USA), a robotic platform designed for single-incision surgery, overcame the need for multiple ports in traditional robotic surgery and issues including triangulation and retraction in single-incision laparoscopic surgery. However, previous studies only included case reports or series with small sample sizes. The aim of this study was to assess the safety and performance of the dVSP surgical system and its instruments and accessories for colorectal procedures.

Methods

The medical records of patients who had surgery with the dVSP from March 2019 to September 2021 at Ewha Womans University Seoul Hospital were investigated. The pathologic and follow-up data of patients who had malignant tumors were analyzed separately to evaluate oncological safety.

Results

Fifty patients (26 male and 24 female) with a median age of 59 years (interquartile range 52.5–63.0 years) were enrolled. The procedures included low anterior resection with total mesorectal excision (n = 16), sigmoid colectomy with complete mesocolic excision and central vessel ligation (CME + CVL) (n = 14), right colectomy with CME + CVL (n = 9), left colectomy with CME + CVL (n = 4), right colectomy (n = 6), and sigmoid colectomy (n = 1). Operative time significantly decreased after 25 cases (early phase vs. late phase; operative time 295.0 min vs. 250.0 min, p = 0.015; docking time 16.0 min vs. 12.0 min, p = 0.001; console time 212.0 min vs. 190.0 min, p = 0.019). Planned procedures were successfully completed in all patients. Postoperative outcomes were acceptable with only six cases of mild adverse events through a 3-month follow-up. No local recurrence and only one case of systemic recurrence occurred within 1 year postoperatively.

Conclusions

This study demonstrated the surgical and oncological safety and feasibility of dVSP, which may be a novel surgical platform for colorectal surgery.

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Data availability

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by research funding from Intuitive Surgical, Inc.

Author information

Authors and Affiliations

  1. Department of Surgery, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804, South Korea

    H. S. Kim, S. S. Chung, R.-A. Lee, K. H. Kim & G. T. Noh

  2. Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea

    B.-Y. Oh

  3. Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea

    C. Cheong

  4. Ewha Womans University Seoul Hospital, Seoul, South Korea

    M. H. Park

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  1. H. S. Kim
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  2. B.-Y. Oh
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  5. S. S. Chung
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  7. K. H. Kim
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Corresponding author

Correspondence to G. T. Noh.

Ethics declarations

Conflict of interest

Gyoung Tae Noh received research funding from Intuitive Surgical, Inc. For the remaining authors none were declared.

Ethical approval

This is an observational study. This study was reviewed and approved by the institutional review board of Ewha Womans University Seoul hospital.

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Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Fig. 1 CONSORT flow diagram. Supplementary file1 (TIF 597 KB)

Supplementary file2 (DOCX 18 KB)

Supplementary file3 (DOCX 21 KB)

Supplementary file4 (DOCX 33 KB)

Supplementary Information 1 Video that demonstrates the robotic phase of right colectomy. mp4. Supplementary file5 (MP4 48738 KB)

Supplementary Information 2 Video that demonstrates the robotic phase of left colectomy. mp4. Supplementary file6 (MP4 48573 KB)

Supplementary Information 3 Video that demonstrates the robotic phase of low anterior resection. mp4. Supplementary file7 (MP4 47566 KB)

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Kim, H.S., Oh, BY., Cheong, C. et al. Single-incision robotic colorectal surgery with the da Vinci SP® surgical system: initial results of 50 cases. Tech Coloproctol 27, 589–599 (2023). https://doi.org/10.1007/s10151-023-02791-5

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  • DOI: https://doi.org/10.1007/s10151-023-02791-5

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