ROBOTIC COLORECTAL RESECTION WITH AND WITHOUT THE USE OF THE NEW DA VINCI TABLE MOTION: A CASE MATCHED STUDY

Background: The da Vinci Table Motion (dVTM) is a new device that enables patients to be repositioned with instruments in place within the abdomen and without undocking the robot. The present study was designed to compare operative and short-term outcomes of patients undergoing colorectal cancer surgery with the da Vinci Xi system with or without use of the dVTM. Materials and Methods: Ten patients underwent robotic colorectal resection for cancer with the use of dVTM (Xi-dVTM group) between May 2015 and October 2015 at our center. The intraoperative and short-term clinical outcome were compared, using case-control methodology (propensity scores approach to create 1:2 matched pairs), with a similar group of patients who underwent robotic colorectal surgery for cancer without the use of the dVTM device (Xi only group). Results: There was a significant difference between the two groups in mean overall robotic operative time (227 min in Xi-dVTM group versus 297 min in Xi only group, p= 0.04). Operations were executed fully robotic in all Xi-dVTM cases, while two cases of Xi only group required conversion to open surgery because of bulky tumors and difficult exposure. Postoperative medical complications, were higher in Xi only group (11 vs 1, p= 0.024). Conclusions: This preliminary experience, with the use of new dVTM in colorectal surgery, by enhancing the workflow during use of the da Vinci Xi, resulted in improved exposure of operative field and enables change in the patient’s position, without the need for removing instruments. These added benefits result in a reduced overall robotic operative time, possibly a lower conversion rates and lower postoperative medical morbidity probably due more favourable patient positioning during surgery needed for optimal exposure of operative field.