Department of Colorectal Surgery, Western General Hospital, NHS Lothian, Edinburgh, UK.
Department of Surgery, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
Colorectal Dis. 2021 May;23(5):1233-1238. doi: 10.1111/codi.15568. Epub 2021 Mar 6.
The Versius surgical system, from CMR Surgical, is the first UK-based robotic platform to become commercially available. This is a prospective series in accordance with the IDEAL development framework for surgical innovation reporting the clinical implementation and initial experience using this robotic platform.
Patients with colorectal cancer were included. Exclusion criteria included T4 tumours, ultra-low rectal cancer and severe comorbidity (American Society of Anesthesiologists grade ≥ 3). Institutional ethical approval was obtained, and patients were counselled preoperatively with informed consent. Patients underwent colorectal resection using the Versius surgical system. Procedures were anticipated as hybrid operations (laparoscopic/robotic) consistent with a proof of concept/technical feasibility study.
Main outcome measures included operative time, complication rates and pathological results. Thirty-two patients (15 men) underwent colorectal cancer resections. The mean age was 68 years (27-85 years). Estimated blood loss was 150 ml; range <100 to <500 ml. For right hemicolectomy, the average operative time was 221 min (183-323 min). The average console time was 111 min (64-213 min). For robotic anterior resection, the total operative time was on average 319 min (222-408 min) with an average console time of 204 min (85-242 min). Eight patients experienced Grade II morbidities (22%) with no serious morbidities and no mortalities. Mean return to bowel function was 2.9 days (1-6 days). The average length of stay was 5.3 days with a median of 4 days (2-20 days). All resections were R0 with an average lymph node yield of 20 nodes (8-46 nodes).
Our initial experience with Versius demonstrates its safe adoption and implementation for colorectal resections.
Versius 手术系统由 CMR Surgical 公司研发，是首个在英国获得商业许可的机器人平台。本研究为前瞻性系列研究，根据外科创新 IDEAL 发展框架报告了该机器人平台的临床应用和初步经验。
纳入结直肠癌患者。排除标准包括 T4 肿瘤、超低位直肠癌和严重合并症（美国麻醉医师协会分级≥3 级）。获得机构伦理批准，并在术前对患者进行咨询和知情同意。患者接受 Versius 手术系统的结直肠切除术。手术预计为混合操作（腹腔镜/机器人），符合概念验证/技术可行性研究。
主要观察指标包括手术时间、并发症发生率和病理结果。32 例患者（男 15 例）接受了结直肠癌切除术。平均年龄为 68 岁（27-85 岁）。估计失血量为 150ml；范围为 100-500ml。右半结肠切除术的平均手术时间为 221 分钟（183-323 分钟）。控制台平均使用时间为 111 分钟（64-213 分钟）。对于机器人前切除术，总手术时间平均为 319 分钟（222-408 分钟），控制台平均使用时间为 204 分钟（85-242 分钟）。8 例患者发生 II 级并发症（22%），无严重并发症和死亡病例。平均恢复肠道功能时间为 2.9 天（1-6 天）。平均住院时间为 5.3 天，中位数为 4 天（2-20 天）。所有切除均为 R0 级，平均淋巴结检出数为 20 枚（8-46 枚）。
我们使用 Versius 的初步经验表明其安全可行，可用于结直肠切除术。
