Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jul 28:4:77-85.
doi: 10.2147/RSRR.S119317. eCollection 2017.

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

James Chi-Yong Ngu  1 , Charles Bih-Shiou Tsang  2   3 , Dean Chi-Siong Koh  2   3
Affiliations
Review

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

James Chi-Yong Ngu et al. Robot Surg. .

Abstract

The Xi is the latest da Vinci surgical system approved for use in colorectal surgery. With its novel overhead architecture, slimmer boom-mounted arms, extended instrument reach, guided targeting, and integrated auxiliary technology, the Xi manages to address several limitations of earlier models. The versatility of this new system allows it to be implemented in a wide range of colorectal procedures - from complex multiquadrant colectomies to challenging mesorectal dissections in the pelvis. While commonly criticized for its cost and prolonged operative time, robotic colorectal surgery holds the potential for enhanced ergonomics, superior precision, and a reduction in the learning curve involved in training an expert surgeon. This review appraises the existing literature on robotic colorectal surgery while elaborating how the improved capabilities of the Xi serve to usher in a new era of minimally invasive colorectal surgery.

Keywords: colorectal; minimally invasive; multiquadrant; review; surgery.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors have no financial relationships with any pharmaceutical or device company, and no conflict of interest to declare in this work.

Figures

Figure 1
Figure 1
Xi “linear” port configurations. Notes: (A) The oblique offset costofemoral, (B) vertical midline, and (C) transverse suprapubic port configurations with the respective port positions as numbered.
Figure 2
Figure 2
FLEX joints. Notes: (A) FLEX joints should be compacted, leaving one-fist-width spacing between each robotic arm (B) to allow the robotic arms to move in parallel. (C) The instrument carriage tends to clash with the adjacent arm (circle) when the FLEX joints are spaced apart. (D) The robotic arms also clash (circle) when the operative target (solid arrow) lies outside of the FLEX joint alignment (dotted arrows).
Figure 3
Figure 3
Movement of patient clearance joints during adjustment of patient clearance and instrument reach. Notes: As patient clearance is increased, the joints rotate axially clockwise away from the patient and the preceding arm.
See this image and copyright information in PMC

References

    1. Semm K. Endoscopic appendectomy. Endoscopy. 1983;15(2):59–64. - PubMed
    1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy) Surg Laparosc Endosc. 1991;1(3):144–150. - PubMed
    1. Clinical Outcomes of Surgical Therapy Study Group. Sargent DJ, Wieand HS, Fleshman J. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–2059. - PubMed
    1. Guillou PJ, Quirke P, Thorpe H, et al. MRC CLASICC trial group Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–1726. - PubMed
    1. Green BL, Marshall HC, Collinson F, et al. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg. 2013;100(1):75–82. - PubMed