Pochhammer Julius, Franke Frederike, Martin Matthias, Beckmann Jan Henrik, Osmonov Daniar, Alkatout Ibrahim, Becker Thomas
Department of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
Life (Basel). 2025 Jul 17;15(7):1122. doi: 10.3390/life15071122.
(1) Minimally invasive techniques are standard in colorectal surgery, though complete mesocolic excision (CME) with central lymphadenectomy remains technically demanding. Robotic systems may address these challenges. While the DaVinci system is well established, the modular Dexter system allows rapid switching between laparoscopy and robotics. (2) This prospective single-surgeon study compared right hemicolectomy with CME and intracorporeal anastomosis using Dexter, DaVinci, and conventional laparoscopy in 75 patients (25 per group) at a German high-volume center. Outcomes assessed included operative time, complications, lymph node yield, and CME quality. (3) Mean operative time was longest with DaVinci (190.5 min) versus Dexter (164.8 min) and laparoscopy (152.6 min). Intracorporeal anastomosis was more frequent in robotic groups. No significant differences were found in lymph node yield, CME quality, postoperative complications, length of stay, or survival. (4) The ability to convert briefly to laparoscopy during Dexter procedures helped manage challenging steps, especially during the learning curve. The results suggest that Dexter is a safe, feasible alternative to established robotic and laparoscopic techniques, with the added benefits of flexibility and integration into existing workflows.
(1)微创技术是结直肠手术的标准术式,尽管完整系膜切除(CME)加中央淋巴结清扫在技术上仍具有挑战性。机器人系统或许可以应对这些挑战。虽然达芬奇系统已广泛应用,但模块化的德克斯特系统允许在腹腔镜手术和机器人手术之间快速切换。(2)这项前瞻性单术者研究在德国一家高容量中心对75例患者(每组25例)使用德克斯特系统、达芬奇系统和传统腹腔镜进行了右半结肠切除术加CME及体内吻合术的比较。评估的结果包括手术时间、并发症、淋巴结收获量和CME质量。(3)达芬奇系统的平均手术时间最长(190.5分钟),而德克斯特系统为(164.8分钟),腹腔镜手术为(152.6分钟)。机器人手术组的体内吻合术更为常见。在淋巴结收获量、CME质量、术后并发症、住院时间或生存率方面未发现显著差异。(4)在德克斯特手术过程中能够短暂转换为腹腔镜手术有助于处理具有挑战性的步骤,尤其是在学习曲线阶段。结果表明,德克斯特系统是现有机器人和腹腔镜技术的一种安全、可行的替代方案,具有灵活性以及能融入现有工作流程的额外优势。