Department of Surgery, Ewha Womans University College of Medicine, 260, Gonghang-Daero, Gangseo-Gu, Seoul, 07804, South Korea.
Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea.
Tech Coloproctol. 2023 Jul;27(7):589-599. doi: 10.1007/s10151-023-02791-5. Epub 2023 Mar 27.
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.
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.
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.
This study demonstrated the surgical and oncological safety and feasibility of dVSP, which may be a novel surgical platform for colorectal surgery.
达芬奇 SP®（dVSP）手术系统（直觉外科公司，美国加利福尼亚州森尼韦尔）是一种专为单切口手术设计的机器人平台，克服了传统机器人手术中多个端口的需要以及单切口腹腔镜手术中的三角测量和牵引等问题。然而，之前的研究仅包括病例报告或小样本量的系列研究。本研究旨在评估 dVSP 手术系统及其器械和附件用于结直肠手术的安全性和性能。
对 2019 年 3 月至 2021 年 9 月在梨花女子大学首尔医院接受 dVSP 手术的患者的病历进行了调查。对患有恶性肿瘤的患者的病理和随访数据进行了单独分析，以评估肿瘤安全性。
共纳入 50 例患者（26 例男性，24 例女性），中位年龄为 59 岁（四分位间距 52.5-63.0 岁）。手术包括低位前切除术伴全直肠系膜切除术（n=16）、乙状结肠切除术伴完整结肠系膜切除术和中央血管结扎术（CME+CVL）（n=14）、右半结肠切除术伴 CME+CVL（n=9）、左半结肠切除术伴 CME+CVL（n=4）、右半结肠切除术（n=6）和乙状结肠切除术（n=1）。25 例手术后手术时间显著缩短（早期 vs. 晚期；手术时间 295.0 分钟 vs. 250.0 分钟，p=0.015；对接时间 16.0 分钟 vs. 12.0 分钟，p=0.001；控制台时间 212.0 分钟 vs. 190.0 分钟，p=0.019）。所有患者均成功完成了计划的手术。通过 3 个月的随访，仅 6 例出现轻度不良事件，术后结果可接受。术后 1 年内无局部复发，仅 1 例发生全身复发。
本研究表明 dVSP 的手术和肿瘤学安全性和可行性，可能是一种新的结直肠手术机器人平台。
