RALP was performed using the daVinci Xi Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) using a 12 mm AirSeal® port and insufflator system (Conmed, Largo, FL, USA) with a standardized insufflation pressure of 12 mmHg. Changes in pressure were documented. After surgery, laparoscopic ports were removed, and manual compression of the abdomen was performed to subjectively release as much of the RPP as possible. All prostatectomies were radical in nature, and no drains were placed in any of the patients.
Da vinci xi surgical system
Manufactured by Intuitive Surgical
Sourced in United States
The da Vinci Xi Surgical System is a robotic surgical platform designed to assist surgeons in performing a variety of minimally invasive surgical procedures. The system consists of a surgeon's console, a patient-side cart with four robotic arms, and a vision system. The system enables the surgeon to operate with enhanced precision, flexibility, and control through smaller incisions than traditional open surgical procedures.
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Lab products found in correlation
26 protocols using da vinci xi surgical system
1
Robotic-Assisted Laparoscopic Prostatectomy
2
Implementing Robotic Pediatric Surgery
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The daVinci Xi surgical system (Intuitive Surgical Inc., Sunnyvale, CA, United States), together with instruments for 50 procedures and 1 year maintenance cost, were purchased and installed in our hospital with financing from an international benefit foundation. Our hospital is a dedicated pediatric center and therefore the robotic system is not shared with other surgical specialties. Two surgical teams consisting each of one console and one surgical chart surgeons successfully went through the training pathway. Scrub nurses and additional personnel were trained on site.
3
Robotic Esophageal Cancer Resection
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The institutional review board approved this retrospective study, and the study conformed to the Declaration of Helsinki and Strengthening the Reporting of Cohort Studies In Surgery 2019 (STROCSS 2019) (13 (link)), and all participants signed informed consent. Patients with esophageal cancer undertaking resection by RAME (da Vinci Xi Surgical System, Intuitive Surgical Inc., Sunnyvale, CA) were included from February 2019 to March 2022. The inclusion criteria were as follows: (1) aged 20 to 80 years; (2) first detected and endoscopically confirmed esophageal cancer; (3) preoperative evaluation showed no distant metastases and suitable for RAME; (4) preoperative clinical stage of I to III. Patients were excluded if (1) they had tumors located at the cervical esophagus or gastro-esophageal junction; (2) they had a history of thoracic or abdominal surgery; (3) they were IV to VI in the American Society of Anesthesiologists (ASA) physical status classification system; (4) they had other malignancies; (5) they had missing clinical data. To prevent surgeon bias, all participating surgeons had experienced more than 40 RAME cases per year and completed a learning curve before the study (14 (link)). Finally, all eligible patients were divided into the ERAS group (n=92) and the conventional group (n=119) based on different perioperative management strategies.
4
Comparative Surgical Approaches for Partial Nephrectomy
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PNs were performed with open, laparoscopic or robot-assisted approach by three dedicated surgeons with high experience in each surgical approach. The choice of surgical technique was left to the surgeon preference. Open PN was performed through a retroperitoneal flank incision between the XI and XII ribs, as previously described (24 (link)). Laparoscopic PN and robot-assisted PN were performed with transperitoneal approach as previously described (25 (link), 26 (link)). Laparoscopic PN was performed using three 12 mm trocars and one 5 mm trocar. Robot-assisted PN was performed using the DaVinci® Xi™ Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) in a four-arm configuration with the integrated Firefly™ fluorescence-imaging mode (6 (link)). In case of clamping approach to the renal hilum we adopted warm ischemia: a selective (first branch) or super-selective (secondary and tertiary branches) clamping approach was preferred over non selective clamping whenever feasible according to preoperative imaging and intraoperative patients-specific surgical anatomy.
5
Robotic Surgery for Radical Prostatectomy
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The surgical team comprised five surgeons who switched from open radical prostatectomy to laparoscopic radical prostatectomy (LRP) in 2014. After a period of proctoring, with the availability of the da Vinci Xi surgical system (Intuitive Surgical, Sunnyvale, CA, USA) in our hospital center from 2016, and a prior experience of 172 LRP procedures, the five surgeons performed RS-RARPs, as described by Galfano [17 (link)]. Surgeons exchanged roles in this study: the primary surgeon operated at the console assisted by an assistant surgeon at the patient table.
The surgical procedure as regards neurovascular bundle preservation, lymphadenectomy, blood loss, duration of hospital stay and complications according to the Clavien–Dindo classification were recorded as previously described [18 (link)]. An indwelling Foley catheter was kept for at least one week and all patients were considered incontinent in the immediate postoperative period.
The surgical procedure as regards neurovascular bundle preservation, lymphadenectomy, blood loss, duration of hospital stay and complications according to the Clavien–Dindo classification were recorded as previously described [18 (link)]. An indwelling Foley catheter was kept for at least one week and all patients were considered incontinent in the immediate postoperative period.
6
Robotic-Assisted Radical Prostatectomy Technique
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RARP was performed by a single-surgeon (PS) after completion of his initial learning curve (> 3000 prior open RP and 1500 RARPs) [5 (link)]. The techniques described by Patel et al. [14 (link)] were followed and the Da-Vinci Xi surgical system with 6 access ports was used (Intuitive Surgical Sunnyvale®, CA, USA). Specifically, after the bladder neck and seminal vesicles dissection, a combined antegrade/retrograde non-thermal nerve-sparing procedure was performed. Accessory pudendal arteries were preserved. The dorsal venous plexus was dissected using electro-cautery and sutured. A suspensory suture to the symphysis pubis was placed after removal of the prostate. A two-layer Rocco stitch was used to support the posterior bladder anastomosis [15 (link)]. An anterior bladder reconstruction was performed if needed. Extended lymph node dissection was performed in cases with > 5% chance of lymph node metastasis according to the Briganti nomogram [16 (link)].
7
Robotic Transabdominal Preperitoneal Hernia Repair
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Robotic surgery using the da Vinci® Xi surgical system (Intuitive Surgical Inc.) has been a standard treatment of choice for gastric and rectal cancer at Aichi Medical University (AMU) Hospital since July 2018. We evaluated this robot‐assisted system and recognized its reported operability and consistency.11 , 12 , 13 We therefore considered R‐TAPP as a potential alternative to laparoscopic TAPP (L‐TAPP) for patients with inguinal hernias. In December 2018, we introduced R‐TAPP as a treatment option after obtaining approval from AMU Hospital for this new and highly difficult medical technology. We nominated a surgeon who was board‐certified in L‐TAPP by the Japan Society for Endoscopic Surgery and who routinely performed robotic gastrectomy as the main operating surgeon for R‐TAPP in our department. This surgeon was also qualified as a specialist by the Japan Robotic Surgery Society.
8
Robot-Assisted Rectal Cancer Surgery Protocols
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The same robotic surgical system (da Vinci Xi Surgical System, Intuitive Surgical) was used for all robot-assisted rectal cancer surgeries at the LH and SH. All laparoscopic procedures were performed by surgical assistants skilled in laparoscopic surgical manipulations. Before introducing the dVSS, surgeons and operating room nurses at the SH observed robot-assisted rectal cancer surgeries at the LH 3 times to learn about the necessary equipment and instrumentation. In the LH, draping of the patient’s cart for the dVSS was performed by 1 or 2 operating room nurses, including a nurse with extensive experience in robotic surgery. In contrast, in the SH, draping was performed by 1 operating room nurse with little experience in robotic surgery. All time lapses and intraoperative events were recorded by the operating room nurse.
9
Offc-RAPN for Renal Tumor Resection
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Prospectively maintained and ethics commitment-approved renal tumor databases were analyzed. Out of the 127 RAPN patients, 50 consecutive patients who underwent purely Offc-RAPN at our center between January 2022 and April 2023 were included in this study. All procedures were performed by the same surgeon (C. Wang) using the da Vinci Xi Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). The surgeon had performed >100 robotic surgeries and >500 laparoscopic surgeries prior to this series.
Contrast-enhanced computed tomography with 1-mm slices was performed to adequately assess the degree of adherent perinephric fat (APF) and the anatomical characteristics of the tumor and renal vasculature. For completely intraparenchymal or located hilar tumors, additional three-dimensional reconstruction would be implemented (Figure 1 ). Important criteria for purely Offc-RAPN included (Figure 2 ): (1) exophytic rate ≥50% and cT1 renal tumors, the largest diameter within the renal parenchyma ≤4 cm; (2) exophytic rate <50% renal tumor, the largest diameter within the renal parenchyma ≤2 cm; (3) endophytic renal tumors, the largest diameter ≤2 cm (4) hilar tumors, the largest diameter ≤4 cm.
Contrast-enhanced computed tomography with 1-mm slices was performed to adequately assess the degree of adherent perinephric fat (APF) and the anatomical characteristics of the tumor and renal vasculature. For completely intraparenchymal or located hilar tumors, additional three-dimensional reconstruction would be implemented (
10
Robotic Ventral Mesh Rectopexies for Rectal Prolapse
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Since November 2020, the da Vinci Xi Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA, USA) was adopted in rectal prolapse surgery at Fondazione Policlinico Universitario “A. Gemelli” IRCCS, an academic tertiary referral center for colorectal surgery in Rome, Italy. A prospective single-center observational study on RVMR in the surgical treatment of rectal prolapse was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement for cohort studies [25 (link)]. The study protocol was approved by our local ethics committee, and informed written consent was obtained from the patients. Consecutive patients undergoing RVMR for external or internal rectal prolapse, rectocele, and enterocele, with at least 30 days of follow-up, were considered for this study. All surgical procedures were carried out by a single surgeon (C.R.), who has previously performed about 300 open ventral mesh rectopexies.
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