VM70 - Robotic Right Colectomy on the Novel Single-Port Da Vinci Platform

Purpose/Background: The single-port da Vinci surgical system is a novel platform that helps overcome technical
difficulties encountered during single site laparoscopic surgery. Studies have reported improved cosmetic satisfaction and faster recovery times with similar short-term outcomes as multi-port surgery. We performed a single port robotic (SPr) colectomy as part of a large multi-center investigative device (IDE) study.

Methods/Interventions: Single port robotic colectomy was performed at our institution under an IDE study with institutional review board approval as it is currently an off-label procedure. We obtained appropriate informed consent from the patient. The operating surgeons underwent training on the SP da Vinci surgical system prior to performing the procedure. Patient was an adult with a body mass index <=35 and presented with an indication for colectomy, thereby meeting inclusion criteria. She was an elderly female with a family history of colon cancer and colon polyps who had undergone multiple attempts at endoscopic resection of a dysplastic cecal polyp. Past abdominal surgical history included cholecystectomy.

Results/Outcomes: A 5cm long incision was made at the planned site of access. Docking time of the robot was 60 seconds. Total console time was 104 minutes and the total operating time was 161 minutes. The procedure was completed without any intra-operative complications or need to convert to an alternative approach. Specimen was extracted from the access site incision. Patient was advanced to a regular diet on post-operative day 1. Patient had return of bowel function with passage of flatus and bowel movement prior to discharge from the hospital on post-operative day 2. Final pathology was negative for malignancy and noted 16 reactive lymph nodes in the specimen. Patient recovered well with adequate healing of her incision and reported no issues at her post operative visits at 2 weeks and 6 weeks.

Conclusion/Discussion: Single port robotic colectomy was safely performed in this patient who met the study inclusion criteria. Based on our experience, this novel single port platform is non-inferior to the currently available multi-port da Vinci platform and offers a cosmetically acceptable outcome. However, this is a single institution experience with preliminary results. Results of the multi-center study is awaited before the procedure can be adopted widely after adequate training on this unique platform.