Introduction
Methods
Results of the literature search
Study | Surgical procedure and study population | Clinical outcomes | ||
---|---|---|---|---|
da Vinci robotic surgical procedures performed with ELS vs. EWSS (studies: n = 3) | ||||
Hagen et al. [7] | Robotic gastric bypass performed with Echelon ELS (49 patients) vs. EWSS (49 patients); January 2015 to July 2016; U.S. | ELS Operative time: 194 min, (p = 0.104) Intraoperative complications: 0, (p = 0.495) Recharges needed to complete gastric pouch: 4.1, (p = 0.005) Stapling costs: $1787, (p < 0.001) | EWSS Operative time: 216 min Stapler clamping unsuccessful: 19% Intraoperative complications: 2, with 1 being stapling related Recharges needed to complete gastric pouch: 4.9 Stapling costs: $2212 | |
Holzmacher et al. [8] | Colorectal robotic surgeries performed with ELS (58 patients) vs. EWSS (35 patients); 2012 to 2014; U.S. Note: The ELS used in robotic surgery were not further defined with the manufacturer | ELS Operative time: 264 min (p = 0.769) Hospital length of stay: 4.3 days (p = 0.895) All complications: 10 (p = 0.778) Bleeding: 1 (p = 0.554) Anastomotic leak: 6 (p = 0.705) Staple fires per patient: 2.7 (p = 0.001) Stapler cost: $631 per patient (p = 0.001) | EWSS Operative time median: 270 min Hospital length of stay: 4.4 days All complications: 5 Bleeding: 2 Anastomotic leak: 1 Staple fires per patient: 1.9 Stapler cost: $473 per patient | |
Atasoy et al. [9] | Rectal transection in robotic surgery for cancer with ELS (62 patients) vs. EWSS (45 patients); December 2014 to April 2017; Turkey; The ELS used in robotic surgery was either the Ethicon Echelon Endopath or Covidien Endo GIA Roticulator, but counts of each ELS utilization were not identified | ELS Staple fires per patient: 2 (p = 0.58) Overall complication rate: 24% (p = 0.32) Anastomotic leak rate: 3% (n = 2) (p = 1) | EWSS Staple fires per patient: 2 Overall complication rate: 31% Anastomotic leak rate: 5% (n = 2) | |
da Vinci robotic surgical procedures performed with echelon ELS (studies: n = 18) | ||||
Abdominal surgical procedures (study n = 8) | ||||
Smeenk et al. [10] | Robotic gastric bypass (RGB) with ELS (100 patients) vs. laparoscopic gastric bypass (LGB) with manual stapler device (100 patients); November 2011 to January 2015; Netherlands | RGB Operative room time: 117 min Median hospital stay: 2 days Staple defect: 1% Staple line bleeding: 2% Surgery-related morbidity: 5% Major morbidity: 3% No mortality | LGB Operative room time: 66 min Median hospital stay: 2 days Staple defect: 0% Staple line bleeding: 0% Surgery-related morbidity: 5% Major morbidity: 1% No mortality | |
Myers et al. [11] | Robotic gastric bypass (RGB, 100 patients) vs. laparoscopic (LGB, 100 patients); October 2009 to September 2011; U.S. | RGB Operative time: 144 min Hospital length of stay: 37 h Readmissions: 3 patients No conversions No mortality | LGB Operative time: 87 min Hospital length of stay: 52 h Readmissions: 8 patients No conversions No mortality | |
Kosanovic et al. [12] | Robotic sleeve gastrectomy (RSG, 134 patients) vs. robotic gastric bypass (RGB, 165 patients); 2009 to 2012; U.S. | RSG Operative time: 107.1 min Hospital length of stay: 2.3 days Bleeding: 0.7% No leaks Perioperative complications: 2.2% | RGB Operative time: 139.5 min Hospital length of stay: 2.7 days Bleeding: 1.2% No leaks Perioperative complications: 3.6% | |
Ijah et al. [13] | Robotic sleeve gastrectomy (RSG, 20 patients) vs. laparoscopic sleeve gastrectomy (LSG, 20 patients); October 2011 to October 2012; Nigeria & India | RSG Operative time: 153 min Hospital stay: 3.9 days Significant complications: 5% | LSG Operative time: 143 min Hospital stay: 4.6 days Significant complications: 15% | |
Vilallonga et al. [14] | Robotic sleeve gastrectomy (RSG, 100 patients) vs. laparoscopic sleeve gastrectomy (LSG, 100 patients); September 2006 to November 2012; Spain | RSG Operative time: 108 min Hospital length of stay: 4 days Bleeding: 2% Leak rate: 3% No perioperative complications No conversions No mortality | LSG Operative time: 96 min Hospital length of stay: 3 days Bleeding: 4% Leak rate: 4% No perioperative complications No conversions No mortality | |
Diamantis et al. [15] | Sleeve gastrectomy; case series of 19 patients; Greece | Single arm study Operative time: 95.5 min No hemorrhage or leakage from staple line No perioperative morbidity No mortality | ||
Vilallonga et al. [16] | Anastomosis duodenoileal bypass; case series of 3 patients; Spain | Single arm study Operative times: 124 min, 174 min, 138 min Hospital length of stay: 2 days No perioperative complications in 30 days No conversions No mortality | ||
Dogra et al. [17] | Laparoscopic augmentation ileocystoplasty; case report of 1 male patient; India | Case report Operative time: 420 min Estimated blood loss: 200 mL Hospital length of stay: 6 days | ||
Liver surgical procedures (study n = 2) | ||||
Xu et al. [18] | Resection for hilar cholangiocarcinoma, case series that compared 10 patients with robotic surgery to 32 patients with open surgery; May 2009 to October 2012; China | Robotic surgery Operative time: 703 min Blood loss: 1360 mL Blood transfusion: 60% Complications: 90% Major morbidity: 30% Hospital stay: 16 days Mortality: 10% | Open surgery Operative time: 475 min Blood loss: 1014 mL Blood transfusion: 53% Complications: 50% Major morbidity: 16% Hospital stay: 14 days Mortality: 6% | |
Calin et al. [19] | Resection for liver metastasis; case report of 1 female patient; U.S. | Case report Operative time: 369 min Estimated blood loss: 100 mL Hospital stay: 4 days | ||
Colorectal surgical procedures (study n = 5) | ||||
Morelli et al. [20] | Intersphincteric resection with (15 patients) and without double-stapling (15 patients); April 2010 to December 2014; Italy | Single arm study Low postoperative complications for both procedures | ||
Bae et al. [21] | Anterior resection for colon cancer; case series of 11 patients; August 2014 to December 2014; Korea | Single arm study Operative time: 289 min Mean proximal and distal resection margins were 7.8 and 4.7 cm Hospital length of stay: 11.1 days Postoperative complications: 36.4% Surgical site infections: 2 patients No anastomotic leakage No conversions No mortality | ||
Morelli et al. [22] | Surgery for endometriosis with colorectal involvement; 10 patients; January 2011 to December 2013; Italy | Single arm study Operative time median: 280 min Hospital length of stay: 6 days Estimated blood loss: 200 mL No significant postoperative complications No conversions | ||
Leong et al. [23] | Low anterior resection; case report of 1 female patient; Korea | Case report Operative time: 215 min Blood loss: <50 mL Hospital length of stay: 6 days No complications (i.e., uneventful postoperative course) | ||
Trastulli et al. [24] | Surgery for colon cancer; case series of 20 patients; June 2011 to May 2012; Italy | Single arm study Operative time: 327.5 min Hospital length of stay: 4.5 days Blood loss: 55 mL No anastomotic leaks 1 infection complication No conversions No mortality | ||
Thoracic surgical procedures (study n = 1) | ||||
Rinieri et al. [25] | Robotic surgery with Echelon stapler or sutures (16 patients) vs. video-assisted thoracic surgery (VATS) with Endo GIA stapler (32 patients); April 2010 to June 2014; France | Robotic Operative time: 140 min Estimated blood loss: 50 mL Hospital stay: 4 days Major postoperative complications: 2 patients Conversions: 2 patients | VATS Operative time: 150 min Estimated blood loss: 100 mL Hospital stay: 5 days Major postoperative complications: 7 patients Conversions: 5 patients | |
Kidney surgical procedures (study n = 1) | ||||
Giacomoni et al. [26] | Nephrectomy; 20 patients; November 2009 to November 2012; Italy | Single arm study Operative time: 311 min Hospital length of stay: 5 days Median bleeding 174 mL Intraoperative hemorrhage: 5% Complications: 2 patients No severe postoperative complications No conversions | ||
Pancreas surgical procedures (study n = 1) | ||||
Liu et al. [27] | Distal pancreatectomy with robotic (102 patients) vs. laparoscopic (102 patients), January 2011 to December 2015, China Both approaches used ELS | Robotic Operative time: 207 min Hospital stay: 7.7 days Blood loss: 100 mL Transfusion rate: 2.9% Overall morbidity: 40.2% Pancreatic fistula: 30.4% Conversion rate: 2.9% | Laparoscopic Operative time: 200 min Hospital stay: 8.6 days Blood loss: 100 mL Transfusion rate: 3.9% Overall morbidity: 44.1% Pancreatic fistula: 35.3% Conversion rate: 9.8% | |
da Vinci robotic surgical procedures performed with endo GIA ELS (studies: n = 9) | ||||
Abdominal surgical procedures (study n = 2) | ||||
Reche et al. [28] | Reversal of gastric bypass, case report; 1 female patient; France | Case report Operative time: 232 min Hospital length of stay: 8 days No complications (i.e., uneventful postoperative course) | ||
Vasilescu et al. [29] | Surgery for gastric cancer; case series of 2 patients; Romania | No postoperative complications | ||
Liver surgical procedures (study n = 2) | ||||
Montalti et al. [30] | Robotic (36 patients) vs. laparoscopic (72 patients) liver resections; June 2008 to February 2014; Italy | Robotic Hospital length of stay: 6 days Complications: 19.4% Blood loss: 415 mL Bleeding: 5.5% Conversions: 13.9% Mortality: 2.8% | Laparoscopic Hospital length of stay: 4.9 days Complications: 19.4% Blood loss: 437 mL Bleeding: 2.8% Conversions: 9.7% Mortality: 0% | |
Salloum et al. [31] | Laparoscopic hepatectomy; case series of 24 patients; March 2011 to June 2013 | Single arm study Operative time: 164 min Hospital length of stay: 6 days Blood loss: 170 mL Postoperative complications: 8% 1 open conversion All patients had R0 resection with a mean margin of 13 mm No mortality | ||
Colorectal surgical procedures (study n = 3) | ||||
Ahmed et al. [32] | Rectal surgery; case series of 100 patients; May 2013 to April 2015; U.K. | Single arm study Operative time median: 240 min Blood loss median: 10 mL Hospital length of stay median: 7 days No intraoperative complications Anastomotic leakage: 2% No anastomotic bleeding No conversions Readmission rate: 12% No mortality | ||
Rovielli et al. [33] | Colectomy; case series of 4 patients; Italy | Single arm study Operative time: 235 min Blood loss: 100 cc Hospital length of stay median: 6 days Morbidity: 75% Major complications: 25% No mortality | ||
Liu et al. [34] | Surgery for urostomy and colostomy; case report of 1 female patient | Case report Operative time: 6 h Blood loss: < 50 mL No complications (i.e., uneventful postoperative course) | ||
Kidney surgical procedures (study n = 1) | ||||
Patel et al. [35] | Laparoscopic nephroureterectomy; case series of transition from da Vinci Si to Xi of 55 patients; U.S. | Single arm study Operative time: 154 min Estimated blood loss: 120 mL Hospital length of stay: 2 days Positive surgical margin: 7.3% 1 patient with intraoperative complication 3 patients with postoperative complications | ||
Prostate surgical procedures (study n = 1) | ||||
Wit et al. [36] | Radical prostatectomy with stapling (55 patients) vs. another method (i.e. clips, electrocautery, 100 patients); July 2011 to December 2012; Netherlands | Robotic Operative time median: 58 min Estimated blood loss: 162 ml Hospital length of stay median: 1 day Positive surgical margins: 33% Intraoperative complications: 11.7% | Other method Operative time median: 74 min Estimated blood loss: 134 ml Hospital length of stay median: 1 day Positive surgical margins: 42% Intraoperative complications: 11% | |
da Vinci robotic surgical procedures performed with EWSS (studies: n = 6) | ||||
Abdominal surgical procedures (study n = 1) | ||||
Alper et al. [37] | Bariatric surgery with robotic (40 patients) vs. laparoscopic (57 patients) staplers; 2015 to 2016; U.S. | Robotic stapler In primary group: 0/218 staple loads misfired In revision group: 2/60 staple (3.3%) loads misfired, both patients developed staple line leak complications Misfire rate: 0.72% | Laparoscopic stapler No report of outcomes in abstract | |
Colorectal surgical procedures (study n = 2) | ||||
Bae et al. [38] | Mesocolic excision and intracorporeal anastomosis; case report of 1 female patient; Korea | Case report Operative time: 280 min Proximal and distal resection margins were 31 and 50 cm, respectively Surgery was uneventful with no conversion | ||
Guadagni et al. [39] | 1 male patient with adenocarcinoma of rectum, Italy | Case report Operative time: 245 min Hospital stay: 8 days No surgical complications No conversion | ||
Bladder surgical procedures (study n = 2) | ||||
Mass et al. [40] | Radical cystectomy with ileal conduit; number of patients not provided; U.S. | Single arm study Use of the robotic staplers can facilitate performance of intracorporeal diversions by allowing for safe division and anastomosis of bowel with minimal bedside assistance | ||
Simone et al. [41] | Radical cystectomy, 22 patients; March 2016 to October 2016; Italy | Single arm study Operative time median: 270 min Hospital stay median: 9 days 1 patient had wound infection 3 patients had grade 2 complications Overall complication rate: 40% Overall severe complication rate: 18% All surgeries successfully completed No conversions | ||
Gynecologic surgical procedures (study n = 1) | ||||
Benton et al. [42] | Coincidental appendectomy; 10 patients; November 2013 to December 2013; U.S. | Single arm study Intraoperative and postoperative complications: none No conversions |