A comparison of the da Vinci Xi vs. the da Vinci Si Surgical System for Roux-En-Y gastric bypass
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The da Vinci Surgical System family remains the most widely used surgical robotic system for laparoscopy. Data about gastric bypass surgery with the Xi Surgical System are not available yet. We compared Roux-en-Y gastric bypass surgery performed at our institution with the da Vinci Xi and the da Vinci Si Surgical System.
All robotic gastric bypass procedures performed between January 2013 and September 2016 were analyzed retrospectively. Patient demographics and operative and postoperative outcomes up to 30 days were compared for the da Vinci Xi and Si Surgical System. Robotic costs per procedure were modeled including posts for a standard set of robotic instruments, capital investment, and yearly maintenance.
One-hundred forty-four Xi Surgical System and 195 Si Surgical System procedures were identified. Mean age (p = 0.9), gender distribution (p = 0.8), BMI (p = 0.6), and ASA scores (p > 0.5) were similar in both cohorts. Operating room times were similar in both groups (219.4 ± 58.8 vs. 227.4 ± 60.5 min for Xi vs. Si, p = 0.22). Docking times were significantly longer with the Xi compared with the Si Surgical System (9 ± 4.8 vs. 5.8 ± 4 min, p < 0.0001). There was no difference in incidence of minor (13.9 vs. 10.3%, p = 0.3) and major complications (5.6 vs. 5.1%, p = 1 for Xi vs. Si). Costs were higher for the Xi Surgical System caused by higher capital investment and yearly maintenance.
Roux-en-Y gastric bypass surgery can be safely performed with the Xi Surgical System, while drawbacks include longer docking times and higher costs.
KeywordsRobotic surgery da Vinci Si Surgical System da Vinci Xi Surgical System Roux-en-Y gastric bypass
We thank Francoise Bernardi and Bénédicte Nicaise Saridas (University Hospital Geneva) for data collection.
Nadja Niclauss, Philippe Morel, and Monika E. Hagen were implicated in study conception and design. All authors realized acquisition of data. Nadja Niclauss and Monika E. Hagen performed analysis and interpretation of data. Nadja Niclauss and Monika E. Hagen wrote the manuscript draft. All authors revised the manuscript.
Compliance with ethical standards
Conflict of interest
Nadja Niclauss and Philippe Morel have no conflicts of interest to declare. Minoa K. Jung received fellowship grants non-related to the research from Ethicon Inc. and Intuitive Surgical Inc. Monika E. Hagen received personal fees and non-financial support from Intuitive Surgical Inc. and Ethicon Inc., outside this project.
All procedures performed in studies involving human participants were in accordance with the ethical standards with the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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