The new integrated table motion for Da Vinci Xi in multi-quadrant combined surgery: a case of right colectomy and sigmoidectomy

Background/Hypothesis: The Integrated Table Motion (ITM) is a new operating table that works wireless with the Da Vinci Xi surgical cart, so that it allows patient’s to be-repositioned without undocking the robot and with instruments inside the abdomen. We present a case of right colectomy and sigmoidectomy using Da Vinci Xi and the specific operating table. Materials and Methods:. An 80-years old woman with an adenocarcinoma of the right colon and a polyp of the sigma resulted a tubulo-villous adenoma containing adenocarcinoma was referred to our center. She was operated on with Da Vinci Xi® platform with left lower quadrant trocar’ disposition shift to the left for both operations. Results: The procedure was successfully completed in 300 min. The patient position changed three times during the intervention with instruments left inside the abdomen and without undocking the robot. Firstly the patient was arranged 15° tilted to the left for right colectomy. Then for the ileocolic anastomosis, the right inclination was reduced to 5°. For the sigma resection, the robot was undocked and the boom rotated of 180° and the patient was arranged a in 20° Trendelenburg position and 15° then tilted to the right. No external collision or other problems related to the operating bed was noted. There were no surgical complications or a need for conversion to laparoscopy or laparotomy. The patient had an uneventful recovery and he was discharged from hospital after 8 days. Conclusions: The Da Vinci Xi® with ITM is safe and feasible and seems to give some advantages in multi-quadrant combined surgery. These new versatile devices offer potential advantages by increasing the ability to perform surgeries with totally robotic technique and making the operations more fluid, even in cases in which involve multiple procedures.