Fujii Yoshiaki, Asai Hiroyuki, Uehara Shuhei, Kato Akira, Watanabe Kaori, Suzuki Takuya, Ushigome Hajime, Yamakawa Yushi, Takahashi Hiroki, Takiguchi Shuji
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Surg Endosc. 2025 May 12. doi: 10.1007/s00464-025-11771-9.
Robotic surgery, represented by the da Vinci™ system (hereafter da Vinci), has been adopted worldwide owing to its high precision and improved surgical outcomes. After key patents for da Vinci expired, the hinotori™ system (hereafter hinotori), Japan's first domestically developed surgical robot system, was introduced and received clinical approval in November 2022. Although hinotori is introduced as an alternative to da Vinci, its clinical performance in gastrointestinal surgery, particularly in colectomy, remains unclear. This study provided an overview of the surgical techniques for right colectomy using hinotori and retrospectively compared its short-term clinical outcomes with those of da Vinci, post-adjusting for background factors using propensity score matching (PSM).
Data from 88 consecutive patients who underwent robotic right colectomy at our institute between 2020 and 2024 were retrospectively reviewed. Patients were classified into the hinotori (n = 28) and da Vinci (n = 60) groups. PSM resulted in 26 patients being assigned to each group. Patient demographics, perioperative outcomes, pathological findings, and complication rates were analyzed and compared between the groups. Patients in both groups underwent standardized surgical procedures performed by the same surgeons using intracorporeal anastomosis. Role switching between the assistant and primary surgeon was required for some procedural steps owing to instrumentation limitations of hinotori.
No significant differences were observed in patient demographics between the propensity score-matched groups. Operative (277.5 vs. 242.5 min, p = 0.044) and console (210 vs. 184.5 min, p = 0.047) times were significantly longer in the hinotori group than in the da Vinci group. No significant differences in blood loss, Clavien-Dindo grade III or higher complications, or postoperative hospital stay were found between the groups. Both groups had comparable histopathological outcomes, including lymph node yield and resection margins.
Our findings suggest that perioperative outcomes in robotic right colectomy using hinotori are comparable to those of da Vinci.
以达芬奇™系统（以下简称达芬奇）为代表的机器人手术，因其高精度和改善的手术效果而在全球范围内得到应用。达芬奇的关键专利到期后，日本首个国产手术机器人系统hinotori™系统（以下简称hinotori）于2022年11月推出并获得临床批准。尽管hinotori被作为达芬奇的替代品引入，但其在胃肠手术尤其是结肠切除术中的临床性能仍不清楚。本研究概述了使用hinotori进行右半结肠切除术的手术技术，并通过倾向评分匹配（PSM）对背景因素进行调整后，回顾性比较了其与达芬奇的短期临床结果。
回顾性分析了2020年至2024年间在我院连续接受机器人辅助右半结肠切除术的88例患者的数据。患者分为hinotori组（n = 28）和达芬奇组（n = 60）。PSM后每组分配26例患者。分析并比较两组患者的人口统计学、围手术期结果、病理结果和并发症发生率。两组患者均由同一组外科医生采用体内吻合术进行标准化手术操作。由于hinotori的器械限制，在某些手术步骤中需要助手和主刀医生进行角色切换。
倾向评分匹配组之间的患者人口统计学特征无显著差异。hinotori组的手术时间（277.5 vs. 242.5分钟，p = 0.044）和控制台操作时间（210 vs. 184.5分钟，p = 0.047）显著长于达芬奇组。两组之间在失血量、Clavien-Dindo III级或更高等级并发症或术后住院时间方面无显著差异。两组的组织病理学结果相当，包括淋巴结收获量和切缘情况。
我们的研究结果表明，使用hinotori进行机器人辅助右半结肠切除术的围手术期结果与达芬奇相当。
