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. 2020 Jul;12(7):3561-3572.
doi: 10.21037/jtd-20-720.

Impact of da Vinci Xi robot in pulmonary resection

Basem G Soliman  1 , Duc T Nguyen  2 , Edward Y Chan  1   3 , Ray K Chihara  1   3 , Leonora M Meisenbach  1 , Edward A Graviss  2   4 , Min P Kim  1   3
Affiliations

Impact of da Vinci Xi robot in pulmonary resection

Basem G Soliman et al. J Thorac Dis. 2020 Jul.

Abstract

Background: This study sought to evaluate the impact of a da Vinci Xi surgical robot on perioperative outcomes after pulmonary resections.

Methods: A retrospective analysis of prospectively collected STS data was performed at a single institution for patients who underwent elective lung resections from 2012 to 2019. Patient outcomes were compared at three different time periods: before the adoption of the robot technology (predominately VATS), during the initial robot experience (the first 18 months), and after the mature robot experience (the second 18 months). Univariate and multivariate logistic regression modeling was performed to determine the factors associated with perioperative complications.

Results: Five hundred and four patients underwent pulmonary resection between the three time periods: 220 patients (43.7%) had surgery prior to the first use of the robot (predominately VATS), 126 patients (25%) had surgery during the initial experience with robot, and 158 patients (31.1%) had surgery during the mature robot experience. There were significantly less post-operative complications (15.2% vs. 34.9% vs. 39.1%, P<0.001), shorter median length of stay (2 vs. 3 vs. 4 days, P<0.001), and lower hospital readmission rates (1.9% vs. 4% vs. 11.8%, P<0.001) in the mature robot period compared to the initial robot period and the predominately VATS period, respectively. Multivariate analysis showed that the robot was associated with a decrease in post-operative complications (OR 0.36; 95% CI, 0.23-0.57, P<0.001).

Conclusions: The adoption of a da Vinci Xi robot in our institution was associated with improved outcomes in patients having pulmonary resections.

Keywords: Robot assisted lung resection; VATS lung resection; da Vinci Xi robot; lobectomy; minimally invasive surgery; surgical outcome.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-720). EY Chan reports personal fees from Veran, outside the submitted work; MP Kim reports personal fees from Veran, personal fees from Intuitive Surgical, personal fees from Medtronic, outside the submitted work; MP Kim also serves as an unpaid editorial board member of Journal of Thoracic Disease from Sep 2018 to Aug 2020. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Surgical outcomes during different time periods prior to adoption of da Vinci Xi robot (predominately VATS), first 18 months after adoption of the robot (initial Xi robot) and last 18 months after adoption of the robot (mature Xi robot). There was a significant decrease in postoperative events (A), length of stay (B) and readmission rate (C) during the mature Xi robot time period compared to predominately VATS time period.
Figure 2
Figure 2
Surgical outcomes in propensity matched groups of patients who had VATS anatomic lung resection (VATS) compared to da Vinci Xi robot assisted anatomic lung resection (Xi robot). There was a significant decrease in postoperative events (A), length of stay (B) and readmission rate (C) for patients who had anatomic resection with Xi robot compared to VATS technique.
See this image and copyright information in PMC

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