The Revo-i Robotic Surgical System in Advanced Pancreatic Surgery: A Second Non-Randomized Clinical Trial and Comparative Analysis to the Da Vinci™ System

Overview

Journal Yonsei Med J

Specialty General Medicine

Date 2024 Feb 19

PMID 38373834

Authors

Ji Su Kim

Munseok Choi

Hyeo Seong Hwang

Woo Jung Lee

Chang Moo Kang

Affiliations

Soon will be listed here.

Abstract

Purpose: Numerous robot-assisted pancreatic surgery are being performed worldwide. This study aimed to evaluate the feasibility and safety of the Revo-i robot system (Meerecompany, Seoul, Republic of Korea) for advanced pancreatic surgery, and also compare this new system with the existing da Vinci™ robot system (Intuitive Surgical, Sunnyvale, CA, USA) in the context of robot-assisted pancreaticoduodenectomy (RPD).

Materials And Methods: This study was a one-armed prospective clinical trial that assessed the Revo-i robot system for advanced pancreatic surgery. Ten patients aged 30 to 73 years were enrolled between December 2019 and August 2020. Postoperative outcomes were retrospectively compared with those of the da Vinci™ surgical system. From March 2017 to August 2020, a total of 47 patients who underwent RPD were analyzed retrospectively.

Results: In the prospective clinical trial, pancreaticoduodenectomy was performed in nine patients and one patient underwent central pancreatectomy. Among the 10 study participants, the incidence of major complications was 0% in hospital stay. There were eight postoperative pancreatic fistula (POPF) biochemical leaks (80%). In the retrospective analysis that compared the Revo-i and da Vinci™ robotic systems, 10 patients underwent Revo-i RPD and 37 patients underwent da Vinci™ RPD, with no significant differences in complication or POPF incidence rates between the two groups (=0.695, =0.317).

Conclusion: In this single-arm prospective study with short-term follow-up at a single institution, the Revo-i robotic surgical system was safe and effective for advanced pancreatic surgery. Revo-i RPD is comparable to the da Vinci™ RPD and is expected to have wide clinical application.

Citing Articles

Robotic abdominopelvic surgery: a systematic review of cross-platform outcomes.

Pal A, Gamage R J Robot Surg. 2024; 18(1):386.

PMID: 39470929 DOI: 10.1007/s11701-024-02144-w.

ArtiSential laparoscopic cholecystectomy versus singlefulcrum laparoscopic cholecystectomy: Which minimally invasive surgery is better?.

Jeong J, Hong S, Choi M, Rho S, Radkani P, Goh B Ann Hepatobiliary Pancreat Surg. 2024; 29(1):48-54.

PMID: 39314032 PMC: 11830895. DOI: 10.14701/ahbps.24-137.

References

Kang I, Hwang H, Lee W, Kang C . First experience of pancreaticoduodenectomy using Revo-i in a patient with insulinoma. Ann Hepatobiliary Pancreat Surg. 2020; 24(1):104-108. PMC: 7061047. DOI: 10.14701/ahbps.2020.24.1.104. View

Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M . The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017; 161(3):584-591. DOI: 10.1016/j.surg.2016.11.014. View

Caba Molina D, Lambreton F, Arrangoiz Majul R . Trends in Robotic Pancreaticoduodenectomy and Distal Pancreatectomy. J Laparoendosc Adv Surg Tech A. 2018; 29(2):147-151. DOI: 10.1089/lap.2018.0421. View

Ku G, Kang I, Lee W, Kang C . assisted robotic central pancreatectomy. Ann Hepatobiliary Pancreat Surg. 2020; 24(4):547-550. PMC: 7691199. DOI: 10.14701/ahbps.2020.24.4.547. View

Falk V, Diegeler A, Walther T, Banusch J, Brucerius J, Raumans J . Total endoscopic computer enhanced coronary artery bypass grafting. Eur J Cardiothorac Surg. 2000; 17(1):38-45. DOI: 10.1016/s1010-7940(99)00356-5. View

Abdel Raheem A, Troya I, Kim D, Kim S, Won P, Joon P . Robot-assisted Fallopian tube transection and anastomosis using the new REVO-I robotic surgical system: feasibility in a chronic porcine model. BJU Int. 2016; 118(4):604-9. DOI: 10.1111/bju.13517. View

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

Novara G, Ficarra V, Rosen R, Artibani W, Costello A, Eastham J . Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol. 2012; 62(3):431-52. DOI: 10.1016/j.eururo.2012.05.044. View

Lim J, Lee W, Park D, Yea H, Kim S, Kang C . Robotic cholecystectomy using Revo-i Model MSR-5000, the newly developed Korean robotic surgical system: a preclinical study. Surg Endosc. 2016; 31(8):3391-3397. DOI: 10.1007/s00464-016-5357-0. View

10.

Callery M, Pratt W, Kent T, Chaikof E, Vollmer Jr C . A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg. 2012; 216(1):1-14. DOI: 10.1016/j.jamcollsurg.2012.09.002. View

11.

Luca F, Cenciarelli S, Valvo M, Pozzi S, Lo Faso F, Ravizza D . Full robotic left colon and rectal cancer resection: technique and early outcome. Ann Surg Oncol. 2009; 16(5):1274-8. DOI: 10.1245/s10434-009-0366-z. View

12.

Nassour I, Choti M, Porembka M, Yopp A, Wang S, Polanco P . Robotic-assisted versus laparoscopic pancreaticoduodenectomy: oncological outcomes. Surg Endosc. 2017; 32(6):2907-2913. DOI: 10.1007/s00464-017-6002-2. View

13.

Mungroop T, Klompmaker S, Wellner U, Steyerberg E, Coratti A, DHondt M . Updated Alternative Fistula Risk Score (ua-FRS) to Include Minimally Invasive Pancreatoduodenectomy: Pan-European Validation. Ann Surg. 2019; 273(2):334-340. DOI: 10.1097/SLA.0000000000003234. View

14.

Montagnini A, Rosok B, Asbun H, Barkun J, Besselink M, Boggi U . Standardizing terminology for minimally invasive pancreatic resection. HPB (Oxford). 2017; 19(3):182-189. DOI: 10.1016/j.hpb.2017.01.006. View

15.

Maenpaa M, Nieminen K, Tomas E, Laurila M, Luukkaala T, Maenpaa J . Robotic-assisted vs traditional laparoscopic surgery for endometrial cancer: a randomized controlled trial. Am J Obstet Gynecol. 2016; 215(5):588.e1-588.e7. DOI: 10.1016/j.ajog.2016.06.005. View

16.

Wente M, Bassi C, Dervenis C, Fingerhut A, Gouma D, Izbicki J . Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007; 142(5):761-8. DOI: 10.1016/j.surg.2007.05.005. View

17.

Nagakawa Y, Nakamura Y, Honda G, Gotoh Y, Ohtsuka T, Ban D . Learning curve and surgical factors influencing the surgical outcomes during the initial experience with laparoscopic pancreaticoduodenectomy. J Hepatobiliary Pancreat Sci. 2018; 25(11):498-507. DOI: 10.1002/jhbp.586. View

18.

Baker E, Ross S, Seshadri R, Swan R, Iannitti D, Vrochides D . Robotic pancreaticoduodenectomy for pancreatic adenocarcinoma: role in 2014 and beyond. J Gastrointest Oncol. 2015; 6(4):396-405. PMC: 4502160. DOI: 10.3978/j.issn.2078-6891.2015.027. View

19.

Breitenstein S, Nocito A, Puhan M, Held U, Weber M, Clavien P . Robotic-assisted versus laparoscopic cholecystectomy: outcome and cost analyses of a case-matched control study. Ann Surg. 2008; 247(6):987-93. DOI: 10.1097/SLA.0b013e318172501f. View

20.

Cai J, Ramanathan R, Zenati M, Al Abbas A, Hogg M, Zeh H . Robotic Pancreaticoduodenectomy Is Associated with Decreased Clinically Relevant Pancreatic Fistulas: a Propensity-Matched Analysis. J Gastrointest Surg. 2019; 24(5):1111-1118. DOI: 10.1007/s11605-019-04274-1. View