Perioperative outcomes comparing the DaVinci 5 with DaVinci Xi in patients undergoing robotic-assisted radical prostatectomy.

Abstract

Background: In the last two decades, several Da Vinci robotic platforms have been released. The new generation DaVinci-5 robot (DV5) promises hardware and software improvements with the potential for enhanced operative performance. The study aimed to compare the intraoperative performances and short-term perioperative outcomes between the DV5 and DaVinci-Xi robotic platforms in patients undergoing robotic-assisted radical prostatectomy (RARP).

Methods: We conducted a single-center retrospective cohort study from April to May 2024, during a unique 4-week period when both the Da Vinci 5 (DV5) and Da Vinci Xi (DV-Xi) platforms were available. A total of 103 patients who underwent robotic-assisted radical prostatectomy with the DV5 were retrospectively compared to 101 patients operated on with the DV-Xi during the same time frame. The primary endpoint was the comparison of intraoperative performance metrics between groups, including operative time, estimated blood loss, and intraoperative complications.

Results: The DV5 had shorter median console time (80 min, IQR [80-90] vs 90 min, IQR [80-90], median difference = 10 min, p < 0.001) and shorter median total operative time (96 min, IQR [90-103] vs 100 min, IQR [98-105], median difference = 4 min, p < 0.001). Neither group had any device malfunctions, intraoperative complications, or blood transfusions. We could not find the difference in hospital length-of-stay, postoperative complication rate, and surgical margin status. This study was done at a high-volume prostate cancer referral centre, which may limit the study findings' generalizability.

Conclusion: This is the first study comparing outcomes of the DV5 and DVXi robotic platforms in patients undergoing RARP. The use of the DV5 robot was associated with modest gains in some perioperative outcomes, but these values were not clinically significant in our routine. Due to the short-term follow-up, we are still evaluating the long-term impacts of this new platform on these patient's outcomes.