G T Sung1, I S Gill. 1. Section of Laparoscopic and Minimally Invasive Surgery, Urological Institute, and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Abstract
OBJECTIVES: To evaluate two currently available robotic surgical systems in performing various urologic laparoscopic procedures in an acute porcine model. METHODS: Robotic laparoscopic surgery was performed in 14 swine. Data were compared between the da Vinci Robotic System and the Zeus Robotic System. RESULTS: During laparoscopic nephrectomy, the da Vinci System (n = 6) had a significantly shorter total operating room time (51.3 versus 71.6 minutes; P = 0.02) and actual surgical time (42.1 versus 61.4 minutes; P = 0.03) compared with the Zeus System (n = 5). However, the blood loss and adequacy of surgical dissection were comparable between the two groups. For laparoscopic adrenalectomy, the da Vinci System (n = 5) had a shorter actual surgical time (12.2 versus 26.0 minutes; P = 0.006) than did the Zeus System (n = 5). For laparoscopic pyeloplasty, the da Vinci System had a shorter total operating room time (61.4 versus 83.4 minutes; P = 0.10) and anastomotic time (44.7 versus 66.4 minutes; P = 0.11). During pyeloplasty anastomosis, the total number of suture bites per ureter was 13.0 for the da Vinci System (n = 6) and 10.8 for the Zeus System (n = 6). The complications included an adrenal parenchymal tear each during a da Vinci System-based left adrenalectomy and a Zeus System-based right adrenalectomy. An inferior vena caval tear during a Zeus System-based right adrenalectomy occurred in 1 case, which was suture-repaired telerobotically. CONCLUSIONS: Robotic laparoscopic procedures can be performed effectively using either the da Vinci or Zeus System. In this limited study, the learning curve and operative times were shorter and the intraoperative technical movements appeared inherently more intuitive with the da Vinci System. Additional clinical experience is necessary.
OBJECTIVES: To evaluate two currently available robotic surgical systems in performing various urologic laparoscopic procedures in an acute porcine model. METHODS: Robotic laparoscopic surgery was performed in 14 swine. Data were compared between the da Vinci Robotic System and the Zeus Robotic System. RESULTS: During laparoscopic nephrectomy, the da Vinci System (n = 6) had a significantly shorter total operating room time (51.3 versus 71.6 minutes; P = 0.02) and actual surgical time (42.1 versus 61.4 minutes; P = 0.03) compared with the Zeus System (n = 5). However, the blood loss and adequacy of surgical dissection were comparable between the two groups. For laparoscopic adrenalectomy, the da Vinci System (n = 5) had a shorter actual surgical time (12.2 versus 26.0 minutes; P = 0.006) than did the Zeus System (n = 5). For laparoscopic pyeloplasty, the da Vinci System had a shorter total operating room time (61.4 versus 83.4 minutes; P = 0.10) and anastomotic time (44.7 versus 66.4 minutes; P = 0.11). During pyeloplasty anastomosis, the total number of suture bites per ureter was 13.0 for the da Vinci System (n = 6) and 10.8 for the Zeus System (n = 6). The complications included an adrenal parenchymal tear each during a da Vinci System-based left adrenalectomy and a Zeus System-based right adrenalectomy. An inferior vena caval tear during a Zeus System-based right adrenalectomy occurred in 1 case, which was suture-repaired telerobotically. CONCLUSIONS: Robotic laparoscopic procedures can be performed effectively using either the da Vinci or Zeus System. In this limited study, the learning curve and operative times were shorter and the intraoperative technical movements appeared inherently more intuitive with the da Vinci System. Additional clinical experience is necessary.