Skip to main content
Erschienen in: Journal of Robotic Surgery 1/2017

24.06.2016 | Original Article

Da Vinci Xi and Si platforms have equivalent perioperative outcomes during robot-assisted partial nephrectomy: preliminary experience

verfasst von: Ali Abdel Raheem, Abulhasan Sheikh, Dae Keun Kim, Atalla Alatawi, Ibrahim Alabdulaali, Woong Kyu Han, Young Deuk Choi, Koon Ho Rha

Erschienen in: Journal of Robotic Surgery | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

The aims of this study were to compare the perioperative outcomes of da Vinci Xi to Si during robotic-assisted partial nephrectomy (RAPN) and to discuss the feasibility of our novel port placement scheme for the da Vinci Xi platform, to overcome the existing kinetic and technical difficulties we faced with the linear port placement in patients with a small body habitus. A retrospective data analysis of patients who underwent RPN using da Vinci Xi (n = 18) was carried out. The outcomes of the Xi group were compared with the Si group (n = 18) selected using a case-matched methodology. For da Vinci Xi, we applied the universal linear port placement in 12 patients and our modified port placement in the remaining 6 patients. The Xi group had a shorter mean docking time of 17.8 ± 2.6 min compared to the Si group of 20.5 ± 2.1 min (p = 0.002); otherwise, no significant difference was present with regard to the remaining perioperative variables (p > 0.05). The modified Xi port placement had a shorter mean console time of 70.8 ± 9.7 min compared to the universal linear port placement of 89.3 ± 17.2 min (p = 0.03). Moreover, it provided a broader field of vision with excellent robotic arms movement, minimizing collisions and allowing an easier and comfortable surgical assist. Da Vinci Xi appears to be feasible and safe during RPN with similar outcomes to Si. The novel Xi port placement makes surgery easier in patients with low BMI.
Literatur
1.
Zurück zum Zitat MacLennan S, Imamura M, Lapitan MC, Omar MI, Lam TB, Hilvano-Cabungcal AM, Royle P, Stewart F, MacLennan G, MacLennan SJ, Canfield SE, McClinton S, Griffiths TR, Ljungberg B, N’Dow J, UCAN Systematic Review Reference Group, EAU Renal Cancer Guideline Panel (2012) Systematic review of oncological outcomes following surgical management of localized renal cancer. Eur Urol 61(5):972–993CrossRefPubMed MacLennan S, Imamura M, Lapitan MC, Omar MI, Lam TB, Hilvano-Cabungcal AM, Royle P, Stewart F, MacLennan G, MacLennan SJ, Canfield SE, McClinton S, Griffiths TR, Ljungberg B, N’Dow J, UCAN Systematic Review Reference Group, EAU Renal Cancer Guideline Panel (2012) Systematic review of oncological outcomes following surgical management of localized renal cancer. Eur Urol 61(5):972–993CrossRefPubMed
2.
Zurück zum Zitat Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, Patard JJ, Mulders PF, Sinescu IC, European Association Of Urology Guideline Group (2010) EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 58(5):398–406CrossRefPubMed Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, Patard JJ, Mulders PF, Sinescu IC, European Association Of Urology Guideline Group (2010) EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 58(5):398–406CrossRefPubMed
3.
Zurück zum Zitat Choi JE, You JH, Kim DK, Rha KH, Lee SH (2015) Comparison of perioperative outcomes between robotic and laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol 67(5):891–901CrossRefPubMed Choi JE, You JH, Kim DK, Rha KH, Lee SH (2015) Comparison of perioperative outcomes between robotic and laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol 67(5):891–901CrossRefPubMed
4.
Zurück zum Zitat Zhenjie Wu, Li Mingmin, Liu Bing, Cai C, Ye H, Lv C, Yang Q, Sheng J, Song S, Qu L, Xiao L, Sun Y, Wang L (2014) Robotic versus open partial nephrectomy: a systematic review and meta-analysis. PLoS One 9(4):948–978 Zhenjie Wu, Li Mingmin, Liu Bing, Cai C, Ye H, Lv C, Yang Q, Sheng J, Song S, Qu L, Xiao L, Sun Y, Wang L (2014) Robotic versus open partial nephrectomy: a systematic review and meta-analysis. PLoS One 9(4):948–978
5.
Zurück zum Zitat Wilson TG (2014) Advancement of technology and its impact on urologists: release of the da Vinci Xi, a new surgical robot. Eur Urol 66(4):793–794CrossRefPubMed Wilson TG (2014) Advancement of technology and its impact on urologists: release of the da Vinci Xi, a new surgical robot. Eur Urol 66(4):793–794CrossRefPubMed
6.
Zurück zum Zitat Darwiche F, Swain S, Kallingal G, Punnen S, Manoharan M, Parekh DJ, Gonzalgo ML (2015) Operative technique and early experience for robotic-assisted laparoscopic nephroureterectomy (RALNU) using da Vinci Xi. Springer Plus 4:298–303CrossRefPubMedPubMedCentral Darwiche F, Swain S, Kallingal G, Punnen S, Manoharan M, Parekh DJ, Gonzalgo ML (2015) Operative technique and early experience for robotic-assisted laparoscopic nephroureterectomy (RALNU) using da Vinci Xi. Springer Plus 4:298–303CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat WHO expert consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–163CrossRef WHO expert consultation (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–163CrossRef
9.
Zurück zum Zitat Goh VH, Tain CF, Tong TY, Mok HP, Wong MT (2004) Are BMI and other anthropometric measures appropriate as indices for obesity? A study in an Asian population. J Lipid Res 45(10):1892–1898CrossRefPubMed Goh VH, Tain CF, Tong TY, Mok HP, Wong MT (2004) Are BMI and other anthropometric measures appropriate as indices for obesity? A study in an Asian population. J Lipid Res 45(10):1892–1898CrossRefPubMed
10.
Zurück zum Zitat Patel MN, Aboumohamed A, Hemal Ashok (2015) Does transition from the da Vinci Si to Xi robotic platform impact single-docking technique for robot-assisted laparoscopic nephroureterectomy? BJU Int 116(6):990–994CrossRefPubMed Patel MN, Aboumohamed A, Hemal Ashok (2015) Does transition from the da Vinci Si to Xi robotic platform impact single-docking technique for robot-assisted laparoscopic nephroureterectomy? BJU Int 116(6):990–994CrossRefPubMed
11.
Zurück zum Zitat Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R, Artibani W (2009) Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol 56(5):786–793CrossRefPubMed Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R, Artibani W (2009) Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol 56(5):786–793CrossRefPubMed
12.
Zurück zum Zitat Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med 130(6):461–470CrossRefPubMed Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med 130(6):461–470CrossRefPubMed
13.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Khalifeh A, Autorino R, Hillyer SP, Laydner H, Eyraud R, Panumatrassamee K, Long JA, Kaouk JH (2013) Comparative outcomes and assessment of trifecta in 500 robotic and laparoscopic partial nephrectomy cases: a single surgeon experience. J Urol 189(4):1236–1242CrossRefPubMed Khalifeh A, Autorino R, Hillyer SP, Laydner H, Eyraud R, Panumatrassamee K, Long JA, Kaouk JH (2013) Comparative outcomes and assessment of trifecta in 500 robotic and laparoscopic partial nephrectomy cases: a single surgeon experience. J Urol 189(4):1236–1242CrossRefPubMed
15.
Zurück zum Zitat Lorenzo El, Jeong W, Oh CK, Chung BH, Choi YD, Rha KH (2011) Robotics applied in laparoscopic kidney surgery: the Yonsei University experience of 127 cases. Urology 77(1):114–118CrossRefPubMed Lorenzo El, Jeong W, Oh CK, Chung BH, Choi YD, Rha KH (2011) Robotics applied in laparoscopic kidney surgery: the Yonsei University experience of 127 cases. Urology 77(1):114–118CrossRefPubMed
16.
Zurück zum Zitat Komninos C, Shin TY, Tuliao P, Kim DK, Han WK, Chung BH, Choi YD, Rha KH (2014) Robotic partial nephrectomy for completely endophytic renal tumors: complications and functional and oncologic outcomes during a 4-year median period of follow-up. Urology 84(6):1367–1373CrossRefPubMed Komninos C, Shin TY, Tuliao P, Kim DK, Han WK, Chung BH, Choi YD, Rha KH (2014) Robotic partial nephrectomy for completely endophytic renal tumors: complications and functional and oncologic outcomes during a 4-year median period of follow-up. Urology 84(6):1367–1373CrossRefPubMed
17.
Zurück zum Zitat Hung AJ, Cai J, Simmons MN, Gill IS (2013) ‘‘Trifecta’’ in partial nephrectomy. J Urol 189(1):36–42CrossRefPubMed Hung AJ, Cai J, Simmons MN, Gill IS (2013) ‘‘Trifecta’’ in partial nephrectomy. J Urol 189(1):36–42CrossRefPubMed
Metadaten
Titel
Da Vinci Xi and Si platforms have equivalent perioperative outcomes during robot-assisted partial nephrectomy: preliminary experience
verfasst von
Ali Abdel Raheem
Abulhasan Sheikh
Dae Keun Kim
Atalla Alatawi
Ibrahim Alabdulaali
Woong Kyu Han
Young Deuk Choi
Koon Ho Rha
Publikationsdatum
24.06.2016
Verlag
Springer London
Erschienen in
Journal of Robotic Surgery / Ausgabe 1/2017
Print ISSN: 1863-2483
Elektronische ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-016-0612-x

Weitere Artikel der Ausgabe 1/2017

Journal of Robotic Surgery 1/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.