Comparison of perioperative outcomes and technical features using da Vinci Si and Xi robotic platforms for early stages
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ORIGINAL ARTICLE
Comparison of perioperative outcomes and technical features using da Vinci Si and Xi robotic platforms for early stages of endometrial cancer Andrea Giannini1 · Elisa Malacarne1 · Claudia Sergiampietri1 · Paolo Mannella1 · Alessandra Perutelli1 · Vito Cela1 · Massimo Stomati3 · Franca Melfi2 · Tommaso Simoncini1 Received: 11 November 2019 / Accepted: 12 May 2020 © Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract We directly compared perioperative outcomes and technical features between previous da Vinci Si and the newer Xi robotic platform during total hysterectomy plus salpingo-oophorectomy with or without lymphadenectomy for early-stage endometrial cancer. We retrospectively analyzed147 patients with histological confirmation of endometrial carcinoma stage IA: grade 1–2, 3 and stage IB: grade 1–2 who underwent surgery with da Vinci Si or Xi system between January 2016 and December 2018. Perioperative data, technical features and postoperative complications were considered. 91 patients underwent surgery with the Si system and 56 with the Xi system. Docking time using the Xi system was significantly shorter (p 200 procedures) techniques in gynecologic oncology (n > 50 procedures for endometrial cancer). All patients were assessed with a complete physical examination and full laboratory investigations. Preoperative imaging was obtained and included pelvic ultrasonography and computed tomography of the abdomen and pelvis. The decision to plan robotic surgery was given by the gynecologic oncologist. The use of da Vinci Si or da Vinci Xi was decided without specific selection criteria, but only according to the theater and platform availability during the planning of all the operation rooms of the hospital since the arrival of the innovative da Vinci Xi surgical system in December 2014. All the surgical procedures were performed in the Multidisciplinary Center of Robotic Surgery of the University Hospital of Cisanello in Pisa. The data were reviewed for patient’s information, including age and body mass index (BMI). Surgical history was assessed for the American Society of Anesthesiologist (ASA) physical status classification and prior pelvic operations were investigated. Perioperative data, including overall operative time
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Journal of Robotic Surgery
(OT defined as the time from the creation of pneumoperitoneum to skin closure), docking time (defined as the time from the skin incision to be ready to start the console), number of harvested lymph nodes, estimated blood loss (EBL), intraoperative complications, use of full robotic technique, number of robotic arms and technical drawbacks related to robotic systems during surgery, were assessed. Postoperative data were also analyzed and included the need for transfusion, need of reoperation, length of hospital stay, morbidity/mortality, and readmission rate. Postoperative complications were scored according to the Clavien–Dindo classification [19]. Those not requiring surgical, endoscopic or radiological re-intervention were con
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