In experienced hands, does the robotic platform impact operative efficiency? Comparison of the da Vinci Si versus Xi robot in colorectal surgery

Robotic surgical platforms have aimed to assist surgeons in meeting the challenges accompanying minimally invasive colon and rectal surgical procedures. Since early adoption over decade ago, there has been an evolution of the robotic platforms aimed at improved usability. We hypothesize, when compared to da Vinci Si, the Xi will allow for greater efficiency and result in shorter operative times. A case log review was completed for a single colorectal surgeon with 7 years’ robotic experience, totaling over 800 cases. Patients were identified using CPT code S2900 (robot) for the most recent 15 months (January 2018–March 2019) contemporaneously at two tertiary care teaching hospitals; one equipped with the Si platform and the other with the Xi. A retrospective chart review of patients undergoing sigmoid colon resection or low anterior rectal resection (LAR) was completed. Categorical values were assessed using Fisher’s exact test or Chi-square tests. Continuous data was compared using unpaired t test. 158 patients were identified as undergoing robotic major colonic surgical resection. A total of 93 patients underwent robotic sigmoid resection or LAR and were grouped based on the robotic platform used (Si, n = 52 vs. Xi, n = 41). The Xi group had significantly shorter surgical times for LAR and sigmoid resection, 162 vs 238 min (p = 0.0001). In the hands of an experienced surgeon, the da Vinci Xi system results in shorter operative times when performing sigmoid resection or LAR compared to older platforms. The da Vinci Xi may allow for improved efficiency as reflected by shorter operative times.