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Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases

There has been little enthusiasm for performing robotic colectomy for colon cancer in recent years due to multiple factors, one being that the previous robotic systems such as the da Vinci Si(®) (dVSi) were poorly designed for multi-quadrant surgery. The new da Vinci Xi(®) (dVXi) system enables cole...

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Autores principales: Yeo, Shen Ann, Noh, Gyoung Tae, Han, Jeong Hee, Cheong, Chinock, Stein, Hubert, Kerdok, Amy, Min, Byung Soh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686285/
https://www.ncbi.nlm.nih.gov/pubmed/28150094
http://dx.doi.org/10.1007/s11701-016-0664-y
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author Yeo, Shen Ann
Noh, Gyoung Tae
Han, Jeong Hee
Cheong, Chinock
Stein, Hubert
Kerdok, Amy
Min, Byung Soh
author_facet Yeo, Shen Ann
Noh, Gyoung Tae
Han, Jeong Hee
Cheong, Chinock
Stein, Hubert
Kerdok, Amy
Min, Byung Soh
author_sort Yeo, Shen Ann
collection PubMed
description There has been little enthusiasm for performing robotic colectomy for colon cancer in recent years due to multiple factors, one being that the previous robotic systems such as the da Vinci Si(®) (dVSi) were poorly designed for multi-quadrant surgery. The new da Vinci Xi(®) (dVXi) system enables colectomy with central mesocolic excision to be performed easily in a single docking procedure. We developed a universal port placement strategy to allow right and left hemicolectomies to be performed via a suprapubic approach and a Pfannensteil extraction site. This proof of concept paper describes the development and subsequent clinical application of this setup. After extensive training on the dVXi system concepts in collaboration with clinical development engineers, we developed a port placement strategy which was tested and adapted after performing experimental surgery in three cadaveric models. Subsequently our port placement was used for two clinical cases of suprapubic right and left hemicolectomy. With some modifications of port placements after the initial cadaveric colectomies, we have developed a potentially universal suprapubic port placement strategy for robotic colectomy with complete mesocolic excision and central vascular ligation using the dVXi robotic system. This port placement strategy was applied successfully in our first two clinical cases. Based on our cadaveric laboratory as well as our initial clinical application, the suprapubic port placement strategy for the dVXi system with its improved features over the dVSi can feasibly perform right and left hemicolectomy with complete mesocolic excision and central vascular ligation. Further studies will be required to establish efficacy as well as safety profile of these procedures.
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spelling pubmed-56862852017-11-28 Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases Yeo, Shen Ann Noh, Gyoung Tae Han, Jeong Hee Cheong, Chinock Stein, Hubert Kerdok, Amy Min, Byung Soh J Robot Surg Original Article There has been little enthusiasm for performing robotic colectomy for colon cancer in recent years due to multiple factors, one being that the previous robotic systems such as the da Vinci Si(®) (dVSi) were poorly designed for multi-quadrant surgery. The new da Vinci Xi(®) (dVXi) system enables colectomy with central mesocolic excision to be performed easily in a single docking procedure. We developed a universal port placement strategy to allow right and left hemicolectomies to be performed via a suprapubic approach and a Pfannensteil extraction site. This proof of concept paper describes the development and subsequent clinical application of this setup. After extensive training on the dVXi system concepts in collaboration with clinical development engineers, we developed a port placement strategy which was tested and adapted after performing experimental surgery in three cadaveric models. Subsequently our port placement was used for two clinical cases of suprapubic right and left hemicolectomy. With some modifications of port placements after the initial cadaveric colectomies, we have developed a potentially universal suprapubic port placement strategy for robotic colectomy with complete mesocolic excision and central vascular ligation using the dVXi robotic system. This port placement strategy was applied successfully in our first two clinical cases. Based on our cadaveric laboratory as well as our initial clinical application, the suprapubic port placement strategy for the dVXi system with its improved features over the dVSi can feasibly perform right and left hemicolectomy with complete mesocolic excision and central vascular ligation. Further studies will be required to establish efficacy as well as safety profile of these procedures. Springer London 2017-02-01 2017 /pmc/articles/PMC5686285/ /pubmed/28150094 http://dx.doi.org/10.1007/s11701-016-0664-y Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Yeo, Shen Ann
Noh, Gyoung Tae
Han, Jeong Hee
Cheong, Chinock
Stein, Hubert
Kerdok, Amy
Min, Byung Soh
Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases
title Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases
title_full Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases
title_fullStr Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases
title_full_unstemmed Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases
title_short Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi(®) system: from cadaveric models to clinical cases
title_sort universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da vinci xi(®) system: from cadaveric models to clinical cases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686285/
https://www.ncbi.nlm.nih.gov/pubmed/28150094
http://dx.doi.org/10.1007/s11701-016-0664-y
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