Evidence map›Paper›PMID 37917223›Full record

ArticleWorld journal of urology2023

Transitioning from Da Vinci Si to Xi: assessing surgical outcomes at a high-volume robotic center.

Carlo A Bravi, Angelo Mottaran, Luca Sarchi, Adele Piro, Marco Paciotti, Luigi Nocera, Federico Piramide, Eleonora Balestrazzi, Maria Peraire, Rui Farinha and 8 more

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In one paragraph

Article in World journal of urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 2 countries.

Carlo A Bravi *Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium. carloandrea.bravi@gmail.com.ORCID http://orcid.org/0000-0002-6412-9546
Angelo Mottaran *Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Luca SarchiDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Adele PiroDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Marco PaciottiDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Luigi NoceraDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Federico PiramideDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Eleonora BalestrazziDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Maria PeraireDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Rui FarinhaDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Gabriele SorceDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Claudia Collà-RuvoloDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples, Italy.
Silvia RebuffoDepartment of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy.
Pieter De BackerORSI Academy, Ghent, Belgium.
Frederiek D'HondtDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Ruben De GrooteDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Geert De NaeyerDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Alexandre MottrieDepartment of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.
Onze Lieve Vrouwziekenhuis Hospital · BEORSI Academy · BEOspedale Policlinico San Martino · ITUniversity of Modena and Reggio Emilia · ITUniversity of Naples Federico II · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn the emerging field of robotics, only few studies investigated the transition between different robotic platforms in terms of surgical outcomes. We aimed at assessing surgical outcomes of patients receiving robot-assisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN) at a high-volume robotic center during the transition from Si to Xi Da Vinci surgical systems.

methodsWe analyzed data of 1884 patients undergoing RARP (n = 1437, 76%) and RAPN (n = 447, 24%) at OLV hospital (Aalst, Belgium) between 2011 and 2021. For both procedures, we assessed operative time, estimated blood loss, length of stay, and positive surgical margins. For RARP, we investigated length of catheterization and PSA persistence after surgery, whereas warm ischemia time, clampless surgery, and acute kidney injury (AKI) were assessed for RAPN. Multivariable analyses (MVA) investigated the association between robotic platform (Si vs. Xi) and surgical outcomes after adjustment for patient- and tumor-related factors.

resultsA total of 975 (68%) and 462 (32%) patients underwent RARP performed with the Si vs. Xi surgical system, respectively. Baseline characteristics did not differ between the groups. On MVA, we did not find evidence of a difference between the groups with respect to operative time (estimate: 1.07) or estimated blood loss (estimate: 32.39; both p > 0.05). Median (interquartile range [IQR]) length of stay was 6 (3, 6) and 4 (3, 5) days in the Si vs. Xi group, respectively (p < 0.0001). On MVA, men treated with the Xi vs. Si robot had lower odds of PSM (Odds ratio [OR]: 0.58; p = 0.014). A total of 184 (41%) and 263 (59%) patients received RAPN with the Si and Xi robotic system, respectively. Baseline characteristics, including demographics, functional data, and tumor-related features did not differ between the groups. On MVA, operative time was longer in the Xi vs. Si group (estimate: 30.54; p = 0.006). Patients treated with the Xi vs. Si system had higher probability of undergoing a clampless procedure (OR: 2.56; p = 0.001), whereas the risk of AKI did not differ between the groups (OR: 1.25; p = 0.4). On MVA, patients operated with the Xi robot had shorter length of stay as compared to the Si group (estimate: - 0.86; p = 0.003), whereas we did not find evidence of an association between robotic system and PSM (OR: 1.55; p = 0.3).

conclusionWe found that the Xi robot allowed for improvements in peri-operative outcomes as compared to the Si platform, with lower rate of positive margins for RARP and higher rate of off-clamp procedures for RAPN. Hospital stay was also shorter for patients operated with the Xi vs. Si robot, especially after robot-assisted partial nephrectomy. Awaiting future investigations-in particular, cost analyses-these results have important implications for patients, surgeons, and healthcare policymakers.

Indexed as

Acute Kidney InjuryNeoplasmsRoboticsRobotic Surgical ProceduresHumansMaleTreatment OutcomeDa Vinci SiDa Vinci XiRobot-assisted partial nephrectomyRobot-assisted radical prostatectomyRobotic surgerySurgical outcomes

Identifiers

PMID37917223
OpenAlexW4388221688

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.