Robot-Assisted Right Colectomy and Cholecystectomy with Robotic Endowrist Stapler and the Bluetooth Integrated Table Motion for the da Vinci Xi

Background: The new robotic Endowrist surgical staplers and the new Integrated Table Motion (ITM) for the Da Vinci Xi are new devices that allows to control directly from the console all steps of mechanical surgical suture and patient’re-positioning without undocking the robot and with instruments inside the abdomen. We present a case of robot assisted right colectomy and cholecystectomy with the Da Vinci Xi®and this new devices.Materials and Methods: An 81-years old woman with an adenocarcinoma of the right colon and gallstones was referred to our center. She was operated on with Da Vinci Xi platform with right quadrant trocar’disposition.Results: The procedure was successfully completed in 270 min. The patient position changed one time during the intervention with instruments left inside the abdomen and without undocking the robot. Both the resection of the transverse colon and of the last ileal loop, together with the ileocolic anastomoses were realized through the use of robotics linear stapler. The enterotomies were closed with a double layer of continuous sutures. Firstly the patient was arranged 15° tilted to the left and in Trendelemburg position for right colectomy. Then for the right colic flexure and ileo-colic anastomosis, the inclination was reduced. 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 she was discharged from hospital after 4 days.Conclusions:The linear robotic stapler could give some advantages allowing the operator directly control all the steps of the suture: "positioning, grip, clamp and fire". It also allows the full articulation of the stapler with a range of 108° and reduces the possibility of error related to the thickness of the tissue within the jaws of the stapler noting the suitable thickness. Moreover, with the use of specific table motion the patient can be moved without undocking the robotic platform. These advantages can also reduce the overall operating time and make the procedure more fluid