• Journal of Gastric Cancer
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• 제19권2호
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• pp.165-172
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• 2019

Purpose: The robotic system for surgery was introduced to gastric cancer surgery in the early 2000s to overcome the shortcomings of laparoscopic surgery. The more recently introduced da Vinci $Xi^{(R)}$ system offers benefits allowing four-quadrant access, greater range of motion, and easier docking through an overhead boom rotation with laser targeting. We aimed to identify whether the $Xi^{(R)}$ system provides actual advantages over the $Si^{(R)}$ system in gastrectomy for gastric cancer by comparing the operative outcomes. Materials and Methods: We retrospectively reviewed all patients who underwent robotic gastrectomy as treatment for gastric cancer from March 2016 to March 2017. Patients' demographic data, perioperative information, and operative and pathological outcomes were collected and analyzed. Results: A total of 109 patients were included in the $Xi^{(R)}$ group and 179 in the $Si^{(R)}$ group. Demographic characteristics were similar in both groups. The mean operative time was 229.9 minutes in the $Xi^{(R)}$ group and 223.7 minutes in the $Si^{(R)}$ group. The mean estimated blood loss was 72.7 mL in the $Xi^{(R)}$ group and 62.1 mL in the $Si^{(R)}$ group. No patient in the $Xi^{(R)}$ group was converted to open or laparoscopy, while 3 patients in the $Si^{(R)}$ group were converted, 2 to open surgery and 1 to laparoscopy, this difference was not statistically significant. Bowel function was resumed 3 days after surgery, while soft diet was initiated 4 days after surgery. Conclusions: We found no difference in surgical outcomes after robotic gastrectomy for gastric cancer between the da Vinci $Xi^{(R)}$ and da Vinci $Si^{(R)}$ procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.25.1-25.6
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• 2017

Background: The conventional transcervical resection for submandibular gland disease has some risks and an unsatisfactory cosmetic result. Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome. Case presentation: The authors performed robot-assisted sialadenectomy via modified facelift incision using the da Vinci Xi surgical system (Intuitive Surgical Inc., CA, USA) with two endowrist arms (monopolar curved scissors and Maryland bipolar forceps) successfully in a 44-year-old female patient who suffered from sialolith and severe atrophic submandibular gland. Conclusions: If similar studies are done in the future, this robot-assisted sialadenectomy may become established as an alternative to existing disadvantageous surgical methods.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.87.1-87.4
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• 2018

Objective: Upper paraaortic lymph node dissection (UPALD) to the infrarenal level is one of the most challenging robotic procedures. Because robotic system has the limitation in robotic arm mobility. This surgical video introduces a novel robotic approach, lower pelvic port placement (LP3), to perform optimally and simultaneously both UPALD and pelvic procedures in gynecologic cancer patients using da Vinci Xi system. Methods: The patient presented with high-grade endometrial cancer. She underwent robotic surgical staging operation. For the setup of the LP3, a line was drown between both anterior superior iliac spines. At 3 cm below this line, another line was drown and four robotic ports were placed on this line. Results: After paraaortic lymph node dissection (PALD) was completed, the boom of robotic system was rotated $180^{\circ}$ to retarget for the pelvic lateral displacement. Robotic ports were placed and docked again. The operation was completed robotically without any complication. Conclusion: The LP3 was feasible for performing simultaneously optimal PALD as well as procedures in pelvic cavity in gynecologic cancer patients. The advantage of LP3 technique is the robotic port placement that affords for multi-quadrant surgery, abdominal and pelvic dissection. The LP3 is facilitated by utilizing advanced technology of Xi system, including the patient clearance function, the rotating boom, and 'port hopping' that allows using every ports for a camera. The LP3 will enable surgeons to extend the surgical indication of robotic surgical system in the gynecologic oncologic field.