A roadmap for robotic-assisted sigmoid resection in diverticular disease using a Senhance™ Surgical Robotic System: results and technical aspects

Since the turn of the century, robotic-assisted colorectal surgery has been synonymous with the da Vinci(R) robotic surgical system. We report in this study our first results in robotic-assisted sigmoid resection for diverticular disease using the Senhance (TM) Surgical Robotic System, while introducing a standardized roadmap for engaging the robotic arms. 12 patients underwent a sigmoid resection using the Senhance (TM) Surgical Robotic System. All four arms of the robotic system were engaged during all procedures according to a previously devised roadmap. A 4-trocar technique was used in all patients. Perioperative data, including those regarding technical difficulties, were collected and analyzed. Two procedures were converted into standard laparoscopy. There were no conversions to open surgery. The mean age of the patients was 62.5 years (47-79). One third of the patients were males. The mean BMI was 27 kg/m(2) (19-38). The mean operative time, the mean console time and the mean docking time were 219 min (204-305), 149 min (124-205) and 10 min (6-15), respectively. The mean length of stay was 9 days (6-15). There was one major complication (8.3%, Clavien-Dindo IIIb). There were no mortalities. No other complications were observed. No patients were readmitted after discharge. The Senhance (TM) Surgical Robotic System can be used safely in sigmoid resection for diverticular disease after adequate training and systematic planning of the different steps of the procedure. Further experience is needed to judge the benefit for patient and surgeon, as well as the cost and time effectiveness.