Proposal of set-up standardization for general surgery procedures with the CMR Versius system, a new robotic platform: our initial experience.

Minimally invasive surgery New frontiers in surgery Robotic surgical system Versius

Journal

Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285

Informations de publication

Date de publication:
03 Apr 2024
Historique:
received: 20 09 2023
accepted: 20 03 2024
medline: 3 4 2024
pubmed: 3 4 2024
entrez: 2 4 2024
Statut: epublish

Résumé

The article describes our initial experience using CMR Versius platform for several procedures in general surgery. Between September 2022 and April 2023, seventy patients underwent robotic surgery in a multi-robotic referral center (San Paolo University Hospital, Milan, Italy). Three surgeons with only laparoscopic experience performed 24 cholecystectomies, 13 inguinal hernia repairs, 9 ventral hernia repairs, 7 right hemicolectomies, 11 left hemicolectomies, 1 sigmoidectomy, 1 ileocecal resection, 1 ventral rectopexy, 1 Nissen fundoplication, 1 total splenectomy, and 1 exploration with multiple biopsies. All surgeries were full-robotic, with only one conversion to laparoscopy. The short length of stay and low rate of severe morbidity are promising findings. Although operative time was lengthened, clinical outcomes were not affected. Our experience demonstrates that the adoption of Versius system is safe and feasible in general surgery. The standardization of port placement and BSU set-up can certainly reduce the operative time.

Sections du résumé

BACKGROUND BACKGROUND
The article describes our initial experience using CMR Versius platform for several procedures in general surgery.
METHODS METHODS
Between September 2022 and April 2023, seventy patients underwent robotic surgery in a multi-robotic referral center (San Paolo University Hospital, Milan, Italy). Three surgeons with only laparoscopic experience performed 24 cholecystectomies, 13 inguinal hernia repairs, 9 ventral hernia repairs, 7 right hemicolectomies, 11 left hemicolectomies, 1 sigmoidectomy, 1 ileocecal resection, 1 ventral rectopexy, 1 Nissen fundoplication, 1 total splenectomy, and 1 exploration with multiple biopsies.
RESULTS RESULTS
All surgeries were full-robotic, with only one conversion to laparoscopy. The short length of stay and low rate of severe morbidity are promising findings. Although operative time was lengthened, clinical outcomes were not affected.
CONCLUSIONS CONCLUSIONS
Our experience demonstrates that the adoption of Versius system is safe and feasible in general surgery. The standardization of port placement and BSU set-up can certainly reduce the operative time.

Identifiants

pubmed: 38565787
doi: 10.1007/s00423-024-03291-2
pii: 10.1007/s00423-024-03291-2
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

Biondi A, Grosso G, Mistretta A, Marventano S, Toscano C, Gruttadauria S, Basile F (2013) Laparoscopic-assisted versus open surgery for colorectal cancer: short- and long-term outcomes comparison. J Laparoendosc Adv Surg Tech A 23(1):1–7
doi: 10.1089/lap.2012.0276 pubmed: 23004676 pmcid: 3698686
Alkatout I, Salehiniya H, Allahqoli L (2022) Assessment of the Versius robotic rurgical system in minimal access surgery: a systematic review. J Clin Med 11:3754
doi: 10.3390/jcm11133754 pubmed: 35807035 pmcid: 9267445
Ballantyne GH (2002) The pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery. Surg Laparosc Endosc Percutaneous Tech 12:1–5
doi: 10.1097/00129689-200202000-00001
Maeso S, Reza M, Mayol JA, Guerra M, Andradas E, Plana MN (2010) Efficacy of the da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systematic review and meta-analysis. Ann Surg 252:254–262
doi: 10.1097/SLA.0b013e3181e6239e pubmed: 20622659
Ishikawa N, Watanabe G, Inaki N, Moriyama H, Shimada M, Kawaguchi M (2012) The da Vinci surgical system versus the radius surgical system. Surg Sci 3:21150
doi: 10.4236/ss.2012.37070
Alip SL, Kim J, Rha KH, Han WK (2022) Future platform of robotic surgery. Urol Clin N Am 49:23–38
doi: 10.1016/j.ucl.2021.07.008
Haig F, Medeiros ACB, Chitty K, Slack M (2020) Usability assessment of Versius, a new robot-assisted surgical device for use in minimal access surgery. BMJ Surg Interv Health Technol 2:e000028
doi: 10.1136/bmjsit-2019-000028 pubmed: 35047788 pmcid: 8749256
El Dahdah J, Halabi M, Kamal J, Zenilman ME, Moussa H (2022) Initial experience with a novel robotic surgical system in abdominal surgery. J Robot Surg
Wehrmann S, Tischendorf Mehlhorn T, Lorenz A, Gundekl M, Rudolph H, Mirow L (2023) Clinical implementation of the Versius robotic surgical system in visceral surgery- a single centre experience and review of the first 175 patients. Surg Endosc 37(1):528–534
doi: 10.1007/s00464-022-09526-x pubmed: 36002682
Hares L, Roberts P, Marshall K, Slack M (2019) Using end-user feedback to optimize the design of the Versius surgical system, a new robot-assisted device for use in minimal access surgery. BMJ Surg Interv Health Technol 1:e000019
doi: 10.1136/bmjsit-2019-000019 pubmed: 35047780 pmcid: 8749308
Puntambekar SP, Goel A, Chandak S, Chitale M, Hivre M, Chahal H, Rajesh KN, Manerikar K (2021) Feasibility of robotic radical hysterectomy (RRH) with a new robotic system. Experience at Galaxy Care Laparoscopy Institute. J Robot Surg 15:451–456
doi: 10.1007/s11701-020-01127-x pubmed: 32710253
Collins D, Paterson HM, Skipworth RJE, Speake D (2021) Implementation of the Versius robotic surgical system for colorectal cancer surgery: first clinical experience. Colorectal Dis 23:1233–1238
doi: 10.1111/codi.15568 pubmed: 33544433
Butterworth J, Sadry M, Danielle Julian, Fiona Haig (2021) Assessment of training program for Versius, a new innovative robotic system for use in minimal access surgery. BMJ Surg Interv Health Technol 3:e000057
doi: 10.1136/bmjsit-2020-000057 pubmed: 35051252 pmcid: 8647592
Kelkar D, Borse MA, Godbole GP, Kurlekar U, Slack M (2021) Interim safety analysis of the first-in-human clinical trial of the Versius surgical system, a new robot-assisted device for use in minimal access surgery. Surg Endosc 35:5193–5202
doi: 10.1007/s00464-020-08014-4 pubmed: 32989548
Tejedor P, Sagias F, Khan JS (2020) The use of enhanced technologies in robotic surgery and its impact on outcomes in rectal cancer: a systematic review. Surg Innov 27:384–391
doi: 10.1177/1553350620928277 pubmed: 32484427
Prete FP, Pezzolla A, Prete F, Testini M, Marzaioli R, Patriti A et al (2018) Robotic versus laparoscopic minimally invasive surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials. Ann Surg 267(6):1034–1046
doi: 10.1097/SLA.0000000000002523 pubmed: 28984644
Kelkar DS, Kurlekar U, Stevens L, Wagholikar GD, Slack M (2023) An early prospective clinical study to evaluate the safety and performance of the Versius surgical system in robot-assisted cholecystectomy. Ann Surg 277(1):9–17
doi: 10.1097/SLA.0000000000005410 pubmed: 35170538
Dixon F, Qureshi A, Vitish-Sharma P, Khanna A, Keeler BD (2022) Implementation of robotic hernia surgery using the Versius system. J Robot Surg
Dixon F, O’Hara R, Ghuman N, Strachan J, Khanna A, Keeler BD (2021) Major colorectal resection is feasible using a new robotic surgical platform: the first report of a case series. Tech Coloproctol 25:285–289
doi: 10.1007/s10151-020-02366-8 pubmed: 33156413
Baur J, Ramser M, Keller N, Muysoms F, Dorfer J, Wiegering A, Eisner L, Dietz UA (2021) Robotic hernia repair II. English version: robotic primary ventral and incisional hernia (rv-TAPP and r-Rives or r-TARUP). Video report and results of a series of 118 patients. Chirurg 92(suppl 1):S15–S26
doi: 10.1007/s00104-021-01479-6
Bhattacharya P, Phelan L, Fisher S, Hajibandeh S, Hajjbandeh S (2022) Robotic vs laparoscopic splenectomy in management of non-traumatic splenic pathologies: a systematic review and meta-analysis. Am Surg 88(I):38–47
doi: 10.1177/0003134821995057 pubmed: 33596106
Husher C, Marchegiani F, Cobellis F, Tejedor P, Pastor C, Lazzarin G, Wheeler J, Di Saverio S (2022) Robotic oncologic colorectal surgery with a new robotic platform (CMR Versius): hope or hipe? A preliminary experience from a full-robotic case-series. Tech Coloproctol 26:745–753
doi: 10.1007/s10151-022-02626-9
Hussein AA, Mohsin R, Qureshi H, Leghari R, Jling Z, Ramahi YO, Rizvi I, Guru KA, Rizvi A (2023) Transition from da Vinci to Versius robotic surgical system: initial experience and outcomes of over 100 consecutive procedures. J Robot Surg 17(2):419–426
doi: 10.1007/s11701-022-01422-9 pubmed: 35752748
Dalager T, Jensen PT, Eriksen JR et al (2020) Surgeons’ posture and muscle strain during laparoscopic and robotic surgery. Br J Surg 107:756–766
doi: 10.1002/bjs.11394 pubmed: 31922258
Raimondi P, Marchegiani F, Cieri M et al (2018) Is right colectomy a complete learning procedure for a robotic surgical program? J Robot Surg 12:147–155
doi: 10.1007/s11701-017-0711-3 pubmed: 28500580
Dixon F, Khanna A, Vitish-Sharma P, Singh NS, Nakade K, Singh A, Qureshi A, O’Hara R, Keeler BD (2021) Initiation and feasibility of a multi-specialty minimally invasive surgical programme using a novel robotic system: a case series. Int J Surg 96:106182
doi: 10.1016/j.ijsu.2021.106182 pubmed: 34848372
Soumpasis I, Nashef S, Dunning J et al (2023) Safe implementation of a next-generation surgical robot: first analysis of 2,083 cases in the Versius surgical registry. Ann Surg 278(4):e903–e910
doi: 10.1097/SLA.0000000000005871 pubmed: 37036097

Auteurs

Andrea Pisani Ceretti (A)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy. andreapisaniceretti@yahoo.it.

Nicolò Maria Mariani (NM)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy. nicolo.mariani@unimi.it.

Marta Perego (M)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Marco Giovenzana (M)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Adelona Salaj (A)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Giampaolo Formisano (G)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Federico Gheza (F)

Division of General Surgery, Department of Clinical and Experimental Sciences, University of Brescia and Civili Hospital, Brescia, Italy.

Gaia Gloria (G)

Division of Gynecology, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Rocco Bernardo (R)

Division of Urology, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Paolo Pietro Bianchi (PP)

Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.

Classifications MeSH