Robotic-assisted adrenalectomy using da Vinci Xi vs. Si: are there differences?

Area of Science:

• Minimally Invasive Surgery
• Robotic Surgery
• Surgical Technology

Background:

• The da Vinci Xi system, released in 2014, succeeded the Si platform for minimally invasive surgery.
• Robotic-assisted adrenalectomy has become a standard procedure for adrenal gland removal.

Purpose of the Study:

• To compare peri-operative outcomes of robotic-assisted adrenalectomy between the da Vinci Xi and Si platforms.
• To evaluate the effectiveness and efficiency of the da Vinci Xi system in adrenalectomy.

Main Methods:

• A retrospective review of 85 consecutive robotic-assisted adrenalectomies performed between June 2014 and the study's end.
• Patients were divided into two groups: Xi (n=25) and Si (n=60).
• Peri-operative outcomes including anesthesia time, procedure time, docking time, consumables fees, relative costs, and hospital stay were compared.

Main Results:

• The Xi group demonstrated significantly shorter average anesthesia time (145.8 min vs. 170.4 min) and procedure time (92.1 min vs. 122.5 min) compared to the Si group (p<0.001 for both).
• Average docking time was also reduced with the Xi system (18.2 min vs. 20.3 min, p=0.04).
• While average consumables fees were higher for Xi ($1246 vs. $1106, p=0.04), calculated relative costs were lower ($3375 vs. $3527, p=0.03). Post-operative hospital stay was similar between groups (1.6 days vs. 1.7 days, p=0.18).

Conclusions:

• Robotic-assisted adrenalectomy using the da Vinci Xi system is effective and efficient.
• The Xi system offers significant improvements in operative efficiency over the Si system.
• Outcomes were comparable between the Xi and Si groups, with the Xi system showing potential cost benefits.