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Versius 机器人胸腔手术系统的实施:可行性和性能的首次临床评估。

Implementation of the Versius robotic surgical system for thoracic surgery: first clinical evaluation of feasibility and performance.

机构信息

Department of Thoracic Surgery, Ramon y Cajal University Hospital, Madrid, Spain.

University of Alcalá, Madrid, Spain.

出版信息

Eur J Cardiothorac Surg. 2024 Aug 2;66(2). doi: 10.1093/ejcts/ezae286.

Abstract

OBJECTIVES

The aim of this study is to demonstrate the ability of the Versius surgical system to successfully and safely complete a range of thoracic procedures aligned with Stage 2a (Development) of the Idea, Development, Exploration, Assessment and Long-term follow-up framework for surgical innovation.

METHODS

This prospective study included the first 30 consecutive patients who underwent robotic surgery with Versius by 2 surgeons without prior robotic experience between 1 April 2023 and 30 December 2023 [25 lung resections (wedge, segmentectomy and lobectomy) and 5 thymectomies]. There were no specific predetermined selection criteria for each case. The primary outcome was safe completion of the procedure without unplanned conversion. Secondary outcomes included intraoperative and postoperative complications, intraoperative device-related outcomes and pathology results.

RESULTS

Twenty-eight (93.3%) cases were completed without conversion. Both conversions were to thoracoscopy, one due to a 'console alarm' and the other due to pulmonary artery bleeding. In lung resections, median console time was 103 (90-129) min. Five (20%) patients experienced postoperative complications, most frequent was persistent air leak (16%). Median length-of-stay was 3 (2-4) days. Neither readmissions nor mortality was observed. In thymectomies, no intraoperative or postoperative complications, readmissions, reinterventions or mortality were observed. Median console time was 77 (75-89) min and median length of stay was 1 (1-1) day.

CONCLUSIONS

This phase 2a IDEAL-D study confirms lung resections and thymectomies are feasible with the use of Versius system, laying the foundation for larger phase 2b and 3 clinical studies within the IDEAL-D framework.

摘要

目的

本研究旨在展示 Versius 手术系统成功完成一系列与手术创新的 Idea、Development、Exploration、Assessment 和 Long-term follow-up(IDEAL-D)框架第 2a 阶段一致的胸腔手术的能力。

方法

本前瞻性研究纳入了 2023 年 4 月 1 日至 2023 年 12 月 30 日期间,2 名没有机器人手术经验的外科医生对 30 例连续患者进行的机器人 Versius 手术[25 例肺切除术(楔形切除术、节段切除术和肺叶切除术)和 5 例胸腺切除术]。每个病例都没有特定的预定选择标准。主要结果是安全完成手术,无计划中转。次要结果包括术中及术后并发症、术中器械相关结果和病理结果。

结果

28 例(93.3%)手术无中转。两次中转均为胸腔镜,一次是因为“控制台报警”,另一次是因为肺动脉出血。肺切除术中,中位控制台时间为 103(90-129)分钟。5 例(20%)患者出现术后并发症,最常见的是持续性漏气(16%)。中位住院时间为 3(2-4)天。无再入院和死亡。在胸腺切除术中,无术中或术后并发症、再入院、再干预或死亡。中位控制台时间为 77(75-89)分钟,中位住院时间为 1(1-1)天。

结论

这项第 2a 期 IDEAL-D 研究证实,使用 Versius 系统可安全进行肺切除术和胸腺切除术,为 IDEAL-D 框架内更大规模的第 2b 期和 3 期临床研究奠定了基础。

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