Hybrid Coronary Revascularization: Da Vinci Xi Vs Da Vinci Si. Is Future Better? Comparison Of Two Generations Of Davinci System
Gianluca Torregrossa, John D. Puskas.
Mount Sinai Hospital - NYC, NYC, NY, USA.
OBJECTIVE: The da Vinci system (da Vinci Surgical System; Intuitive Surgical Inc.) has rapidly developed in several years from the S system to the Si system and now the Xi System. We aimed to compare our experience using da Vinci robot Si system vs Xi system in order to offer a guide for surgeons who are willing to perform the transition using the two systems.
METHODS: We compare our early experience of robotic coronary revascularization using da Vinci robot Xi vs our previous cases using da Vinci robot Si system. Patients were classified into 2 groups (Xi, n=5 vs. Si, n=35) and perioperative outcomes were analyzed.
RESULTS: The new surgical robotic system has been upgraded in all respects. The da Vinci Xi robotic platform helps operating room personnel in its easy movement, allows easier patient side-docking with the help of its boom feature, in addition to easy and swift movements of the robotic arms. The telescope and camera were incorporated into one system, with a digital end-mounted camera. Overhead boom rotation allows multiquadrant access without axis limitation, the arms are now thinner and longer with grabbing movements for easy adjustments. The patient clearance feature can be used to avoid collision with the robotic arms or the patient's body. In patients with challenging body habitus, modifications can be made through reassigning the camera to a different port. In our experience our first 5 cases with da Vinci Xi system had similar outcomes compared to Si system ones but longer total operative time
CONCLUSIONS: Subjectively and objectively, there is a learning curve to progress from the Si to Xi da Vinci surgical platforms, but this does not negatively impact the outcome.
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