Mohamed R Ali1, Jason J Rasmussen. 1. Department of Surgery, University of California, Davis, Sacramento, California, USA. mohamed.ali@ucdmc.ucdavis.edu
Abstract
BACKGROUND: Robotic surgery is heavily dependent on the availability of, and innovation in, technology. As new robotic systems become available, it will be important to identify the impact of emerging technology on clinical outcomes in robotic surgery. MATERIALS AND METHODS: A total of 140 laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures have been performed with robotic assistance (80 with Zeus and 60 with da Vinci). Data were collected regarding the robotic operative tasks performed, the robotic setup time, the robotic operative time, and the total operative time for all cases. RESULTS: The 60 patients who had a da Vinci LRYGB had a statistically lower body mass index, when compared to patients who underwent Zeus LRYGB (n = 80; P < 0.05). The groups were otherwise statistically similar. The set-up time required for the Zeus cases decreased quickly but increased significantly once the switch was made to da Vinci. The da Vinci set-up time then decreased significantly after the first 10 cases (P < 0.05). There was no demonstrable regression in the robotic operative time when the robotic system was changed to da Vinci. Total operative time temporarily increased during the first 10 da Vinci cases but then decreased significantly (P < 0.05). There were two intraoperative gastrojejunostomy (GJ) leaks in this series (one with each system). There were no anastomotic strictures at the robotic GJ or mortalities throughout this series. CONCLUSIONS: Our data suggest that the impact of robotic platform change should be minimal in an established program. Any regression in clinical efficacy should be short-lived and only minimally impact clinical performance and outcomes.
BACKGROUND: Robotic surgery is heavily dependent on the availability of, and innovation in, technology. As new robotic systems become available, it will be important to identify the impact of emerging technology on clinical outcomes in robotic surgery. MATERIALS AND METHODS: A total of 140 laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures have been performed with robotic assistance (80 with Zeus and 60 with da Vinci). Data were collected regarding the robotic operative tasks performed, the robotic setup time, the robotic operative time, and the total operative time for all cases. RESULTS: The 60 patients who had a da Vinci LRYGB had a statistically lower body mass index, when compared to patients who underwent Zeus LRYGB (n = 80; P < 0.05). The groups were otherwise statistically similar. The set-up time required for the Zeus cases decreased quickly but increased significantly once the switch was made to da Vinci. The da Vinci set-up time then decreased significantly after the first 10 cases (P < 0.05). There was no demonstrable regression in the robotic operative time when the robotic system was changed to da Vinci. Total operative time temporarily increased during the first 10 da Vinci cases but then decreased significantly (P < 0.05). There were two intraoperative gastrojejunostomy (GJ) leaks in this series (one with each system). There were no anastomotic strictures at the robotic GJ or mortalities throughout this series. CONCLUSIONS: Our data suggest that the impact of robotic platform change should be minimal in an established program. Any regression in clinical efficacy should be short-lived and only minimally impact clinical performance and outcomes.