Impact of robotic platform transition on short term outcomes in colorectal cancer surgeries

Robotic colorectal surgery is increasingly complex, expanding from pelvic to multiquadrant procedures. Reports on the impact of institutional robotic platform transition remain limited. This study evaluated the challenges and effects of transitioning from the da Vinci Si (dV Si) to the da Vinci X/Xi (dV X/Xi) platform. A prospective observational cohort with historical comparison describing an institutional experience that included consecutive elective robotic colorectal cancer resections performed in 2023 (dV Si) and 2024 (dV X/Xi). The primary endpoint was the learning curve for console time. Secondary outcomes included total operative time, port placement time, length of stay (LOS), ileus, anastomotic leakage, severe complications (Clavien-Dindo ≥ 3), reoperation, and 30-day mortality. An institutional learning curve for the surgical team was constructed and evaluated using the cumulative sum (CUSUM) test. A total of 121 procedures were analyzed (dV Si: n = 49; dV X/Xi: n = 72). Procedural profile shifted significantly (p = 0.002), with increased multiquadrant resections in the dV X/Xi group. Console time was longer in dV X/Xi group (p = 0.05), while total operative time and LOS were similar in the two groups. Postoperative outcomes were comparable. Parenteral nutrition was less frequently required in the dV X/Xi group (p = 0.02). CUSUM analysis showed a console learning plateau at 48 cases.We describe a real-world experience of robotic platform transition, demonstrating that it enabled an expanded range of procedures without compromising short-term outcomes.