General Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
EndoCAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy.
Surg Endosc. 2018 Oct;32(10):4165-4172. doi: 10.1007/s00464-018-6161-9. Epub 2018 Mar 30.
The da Vinci® Table Motion (dVTM) comprises a combination of a unique operating table (Trumpf Medical™ TruSystem® 7000dV) capable of isocenter motion connected wirelessly with the da Vinci Xi® robotic platform, thereby enabling patients to be repositioned without removal of instruments and or undocking the robot.
Between May 2015 to October 2015, the first human use of dVTM was carried out in this prospective, single-arm, post-market study in the EU, for which 40 patients from general surgery (GS), urology (U), or gynecology (G) were enrolled prospectively. Primary endpoints of the study were dVTM feasibility, efficacy, and safety.
Surgeons from the three specialties obtained targeting success and the required table positioning in all cases. Table movement/repositioning was necessary to gain exposure of the operating field in 106/116 table moves (91.3%), change target in 2/116 table moves (1.7%), achieve hemodynamic relief in 4/116 table moves (3.5%), and improve external access for tumor removal in 4/116 table moves (3.5%). There was a significantly higher use of tilt and tilt plus Trendelenburg in GS group (GS vs. U p = 0.055 and GS vs. G p = 0.054). There were no dVTM safety-related or adverse events.
The dVTM with TruSystem 7000dV operating table in wireless communication with the da Vinci Xi is a perfectly safe and effective synergistic combination, which allows repositioning of the patient whenever needed without imposing any delay in the execution of the operation. Moreover, it is helpful in avoiding extreme positions and enables the anesthesiologist to provide immediate and effective hemodynamic relief to the patient when needed.
达芬奇® Table Motion(dVTM)由一台独特的手术台(Trumpf Medical™ TruSystem® 7000dV)组成,该手术台能够进行等中心点运动,与达芬奇 Xi®机器人平台无线连接,从而使患者在无需移除器械或断开机器人的情况下重新定位。
2015 年 5 月至 2015 年 10 月,在欧盟进行了这项前瞻性、单臂、上市后研究,首次将 dVTM 用于人体。研究前瞻性纳入了普外科(GS)、泌尿科(U)和妇科(G)的 40 名患者。该研究的主要终点是 dVTM 的可行性、疗效和安全性。
来自三个专业的外科医生在所有病例中都成功获得了目标,并完成了所需的手术台定位。为了获得手术视野的暴露,需要进行 106/116 次手术台移动/重新定位(91.3%);为了改变目标,需要进行 2/116 次手术台移动(1.7%);为了实现血液动力学缓解,需要进行 4/116 次手术台移动(3.5%);为了改善肿瘤切除的外部通道,需要进行 4/116 次手术台移动(3.5%)。GS 组中倾斜和倾斜加 Trendenlenburg 的使用明显更高(GS 与 U,p=0.055;GS 与 G,p=0.054)。无 dVTM 相关安全性或不良事件。
TruSystem 7000dV 手术台与达芬奇 Xi 无线通信的 dVTM 是一种非常安全有效的协同组合,可在需要时随时重新定位患者,而不会对手术执行造成任何延误。此外,它有助于避免极端体位,并使麻醉师能够在需要时立即为患者提供有效的血液动力学缓解。