Gaia Giorgia, Sighinolfi Maria Chiara, Afonina Margarita, Terzoni Stefano, Iannuzzi Veronica, Felline Mauro, Morandi Alessandro, Alboni Carlo, Marca Antonio La, Ceretti Andrea Pisani, Bianchi Paolo Pietro, Rocco Bernardo, Marconi Anna Maria
Division of Obstetrics and Gynecology, San Paolo Hospital Medical School, ASST Santi Paolo E Carlo, Milan, Italy.
Department of Urology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy.
Langenbecks Arch Surg. 2025 Aug 28;410(1):252. doi: 10.1007/s00423-025-03812-7.
The Versius surgical system (CMR Surgical, Cambridge, UK) is a new robotic platform introduced after the original patent of the DaVinci system expired; it has already been applied in different fields, including gynaecology. Unlike DaVinci, Versius has four independent bedside units (BSU), which must be individually positioned with adequate angles and distance to avoid collisions. Given this peculiarity and the shorter arm (30 cm) compared to the Da Vinci, investigating BSU positioning and port placement is mandatory. We aim to report technical tips and tricks for OR setup and port placement by analyzing our initial series with the Versius system for benign gynaecological conditions, thereby making the procedure easily reproducible.
We considered prospectively 19 patients undergoing robotic surgery for gynaecological diseases. Demographics, pre-surgical variables, intraoperative robotic events (number and characteristics of collisions, need for detaching instruments, and moving trays during surgery), and perioperative outcomes were collected. Factors impacting the occurrence of high-impact collisions (requiring the disconnection of instruments and restarting of the port training) were analyzed.
All surgeries were carried out uneventfully and without conversion. Collisions of any type occurred in 16 out of 19 operations, including 11 high impact collisions. The distance between the trocars and the target organ is a factor that impacts the necessity to restart the system.
Versius appeared to be a safe option for benign gynaecological surgery. Our experience suggests that a minimum distance of 19 cm from the bipolar operative trocar and the target organ, as well as a minimum distance of 15 cm between the scissors operative trocar and the target organ, is recommendable to avoid any collisions, or 11 and 9 cm to avoid high impact collisions.
Versius appeared to be a safe option for benign gynaecological surgery. Our experience suggests that a minimum distance of 19 cm from the bipolar operative trocar and the target organ, as well as a minimum distance of 15 cm between the scissors operative trocar and the target organ, is recommendable to avoid any collisions, or 11 and 9 cm to avoid high impact collisions.
Versius手术系统（英国剑桥CMR外科公司）是在达芬奇系统的原始专利到期后推出的一种新型机器人平台；它已被应用于包括妇科在内的不同领域。与达芬奇系统不同，Versius有四个独立的床边单元（BSU），必须以适当的角度和距离单独定位，以避免碰撞。鉴于这一特点以及与达芬奇系统相比其臂长较短（30厘米），研究BSU的定位和端口放置是必不可少的。我们旨在通过分析我们使用Versius系统治疗良性妇科疾病的初始系列病例，报告手术室设置和端口放置的技术技巧，从而使该手术易于重复进行。
我们前瞻性地纳入了19例接受机器人妇科手术的患者。收集了人口统计学资料、术前变量、术中机器人事件（碰撞的数量和特征、手术过程中拆卸器械的必要性以及移动托盘的情况）以及围手术期结果。分析了影响高影响碰撞发生的因素（需要断开器械连接并重新进行端口训练）。
所有手术均顺利完成，无中转开腹。19例手术中有16例发生了任何类型的碰撞，其中包括11例高影响碰撞。套管针与目标器官之间的距离是影响重新启动系统必要性的一个因素。
Versius似乎是良性妇科手术的一个安全选择。我们的经验表明，双极手术套管针与目标器官之间的最小距离为19厘米，剪刀手术套管针与目标器官之间的最小距离为15厘米，可避免任何碰撞；若要避免高影响碰撞，这两个距离分别为11厘米和9厘米。
Versius似乎是良性妇科手术的一个安全选择。我们的经验表明，双极手术套管针与目标器官之间的最小距离为19厘米，剪刀手术套管针与目标器官之间的最小距离为15厘米，可避免任何碰撞；若要避免高影响碰撞，这两个距离分别为11厘米和9厘米。
