USE OF THE NEW INTEGRATED TABLE MOTION FOR THE DA VINCI XI SURGICAL SYSTEM IN COLORECTAL SURGERY

PURPOSE Integrated Table Motion (ITM) for the da Vinci Xi Surgical System is a new feature comprising of a unique operating table by Trumpf medical that communicates wirelessly with the da Vinci Xi The feature allows the surgical staff to reposition the patient without undocking the robot and without removing instruments from inside the abdomen. ITM has been specifically developed to improve multiquadrant robotic surgery such as colorectal surgery. We herein present one of the first human use of this device in colorectal surgery in the EU. METHODS Between May and October 2015 one of the first human use of ITM was conducted in a post market study in the EU in which 40 cases across different specialties were prospectively enrolled. The colorectal study group comprised of 10 patients. Variables examined included patient characteristics, intraoperative data (patient position on the table, accessories used to secure patient, port placement measurements, cannula types, robot deployment, approach and targeting, operative time and robot dock/undock time. Primary end-points were: ITM efficacy, safety and efficiency. For these reasons we evaluated the targeting success, number of moves per case, duration of each table motion, table position attained, reasons for moving table and the state of instruments and scope during table motion (inserted or removed). We also evaluated the safety of ITM by recording occurrence of adverse events related to the use of ITM. RESULTS Seven patients underwent anterior rectal resection (ARR) with TME, while 3 patients underwent right hemicolectomy. The mean ITM moves during the ARR was 3 while it was 4 for right hemicolectomy resulting in 33 instances of table moves in 10 procedures. The ITM duration per move took less than 2 minutes in 25 of 33 of moves (75,8%). The reason for using ITM was to gain internal exposure for all moves. The endoscope was left inserted during 31 of the 33 table movements (94%), while the instruments were left inserted in 28 of the 33 moves (84.8%). No external collisions or other problems related to the operating table were noted. The mean robotic operative time was 230.4 min. There were no ITM related surgical complications or need for conversion to laparoscopy or laparotomy. There were no ITM safety-related observations and no adverse events. CONCLUSIONS This preliminary study demonstrated the efficiency of ITMfor the da Vinci Xi Surgical System, which enabled patient repositioning without disrupting surgical workflow by allowing the surgeon to leave instruments and the scope docked to the patient. ITM has been shown to be safe, and no adverse events related to its use were reported. Further studies can be useful to demonstrate if ITM could enable procedures or part of procedures to be done robotically that would otherwise be difficult and if ITM could improve operative efficiency by reducing surgical operative time.