Use of a new integrated table motion for the da Vinci Xi in colorectal surgery

Background: Integrated table motion (ITM) is a new feature comprising a unique operating table by Trumpf Medical that communicates wirelessly with the da Vinci Xi surgical system. ITM has been specifically developed to improve multiquadrant robotic surgery such as that conducted in colorectal surgery. Herein we present one of the first case series using this device in human colorectal surgery in the European Union. Methods: Between May and October 2015, a prospective post-market study was conducted on ITM in the EU in 40 cases from different specialties. The colorectal study group comprised 10 patients. Primary end-points were ITM feasibility, safety and efficacy. Results: Seven patients underwent anterior rectal resection with total mesorectal excision, while two patients underwent right colectomy and one patient underwent sigmoidectomy. Mean number of ITM moves was three during anterior rectal resection, and four during right colectomy; there were 33 instances of table moves in the 10 procedures. All ITM moves were made to gain internal exposure. The endoscope remained inserted during 31 of the 33 table movements (94%), while the instruments remained inserted during 28 of the 33 moves (84.8%). No external instrument collisions or other problems related to the operating table were noted. There were no ITM safety-related observations and no adverse events. Conclusions: This preliminary study demonstrated the feasibility, safety and efficacy of ITM for the da Vinci Xi surgical system. ITM enabled patient repositioning without disrupting surgical workflow by allowing the surgeon to leave instruments and the endoscope docked to the patient. ITM was safe, with no adverse events related to its use. Further studies will be useful to define the real role and potential benefit of ITM.