Abstract：
BACKGROUND: The da Vinci surgical systems (X and Xi) are fourth-generation systems marketed by Intuitive Inc. The X system is less expensive than the Xi system. This study compared the surgical outcomes of patients who underwent hysterectomy using the X and Xi systems.
METHODS: Data from 172 patients who underwent robot-assisted total hysterectomies by four surgeons between April 2019 and March 2023 were retrospectively analyzed in a single-center study. The patients were divided into two groups based on the surgical system used. Approval was granted by the Institutional Review Board of the Tottori University Hospital (22A134). All patients provided opt-out consent in accordance with the institutional guidelines.
RESULTS: Operative time (126.6 ± 29.5 for X, 138.2 ± 38.5 for Xi, p = .227) and console time (92.9 ± 27.0 for X, 105.5 ± 34.7 for Xi, p = .089) were insignificantly shorter in group X than in group Xi after propensity score matching for age, body mass index, nulliparity, previous history of abdominal or pelvic surgery, preoperative diagnosis, and surgical approach. No significant differences between X and Xi were observed in a subgroup analysis of patients who underwent robot-assisted total laparoscopic hysterectomy without lymphadenectomy (operative time: 199.0 ± 26.5 for X, 221.5 ± 45.1 for Xi, p = .227; console time: 162.1 ± 25.0 for X, 178.3 ± 0.314 for Xi, p = .314).
CONCLUSIONS: Perioperative outcomes for the X and Xi da Vinci surgical systems were equivalent. The cost-effective X system may allow the widespread use of robotic surgeries.
METHODS: Data from 172 patients who underwent robot-assisted total hysterectomies by four surgeons between April 2019 and March 2023 were retrospectively analyzed in a single-center study. The patients were divided into two groups based on the surgical system used. Approval was granted by the Institutional Review Board of the Tottori University Hospital (22A134). All patients provided opt-out consent in accordance with the institutional guidelines.
RESULTS: Operative time (126.6 ± 29.5 for X, 138.2 ± 38.5 for Xi, p = .227) and console time (92.9 ± 27.0 for X, 105.5 ± 34.7 for Xi, p = .089) were insignificantly shorter in group X than in group Xi after propensity score matching for age, body mass index, nulliparity, previous history of abdominal or pelvic surgery, preoperative diagnosis, and surgical approach. No significant differences between X and Xi were observed in a subgroup analysis of patients who underwent robot-assisted total laparoscopic hysterectomy without lymphadenectomy (operative time: 199.0 ± 26.5 for X, 221.5 ± 45.1 for Xi, p = .227; console time: 162.1 ± 25.0 for X, 178.3 ± 0.314 for Xi, p = .314).
CONCLUSIONS: Perioperative outcomes for the X and Xi da Vinci surgical systems were equivalent. The cost-effective X system may allow the widespread use of robotic surgeries.
摘要：
背景：达芬奇手术系统（X和Xi）是由IntuitiveInc.销售的第四代系统。X系统比Xi系统便宜。这项研究比较了使用X和Xi系统进行子宫切除术的患者的手术结果。
方法：在一项单中心研究中，回顾性分析了在2019年4月至2023年3月期间由四名外科医生接受机器人辅助全子宫切除术的172名患者的数据。根据所使用的手术系统将患者分为两组。鸟取大学医院机构审查委员会（22A134）批准。所有患者都按照机构指南提供了选择退出同意书。
结果：手术时间（X为126.6±29.5，Xi为138.2±38.5，p=.227）和控制台时间（X为92.9±27.0，Xi为105.5±34.7，p=.089）在年龄倾向评分匹配后，X组比Xi组短，身体质量指数,无效,既往腹部或骨盆手术史，术前诊断,和手术方法。在接受机器人辅助无淋巴结清扫的全腹腔镜子宫切除术的患者的亚组分析中，X和Xi之间没有显着差异（手术时间：X为199.0±26.5，Xi为221.5±45.1，p=.227；控制台时间：X为162.1±25.0，Xi为178.3±0.314，p=.314）。
结论：X和XidaVinci手术系统的围手术期结果相当。具有成本效益的X系统可以允许广泛使用机器人手术。
方法：在一项单中心研究中，回顾性分析了在2019年4月至2023年3月期间由四名外科医生接受机器人辅助全子宫切除术的172名患者的数据。根据所使用的手术系统将患者分为两组。鸟取大学医院机构审查委员会（22A134）批准。所有患者都按照机构指南提供了选择退出同意书。
结果：手术时间（X为126.6±29.5，Xi为138.2±38.5，p=.227）和控制台时间（X为92.9±27.0，Xi为105.5±34.7，p=.089）在年龄倾向评分匹配后，X组比Xi组短，身体质量指数,无效,既往腹部或骨盆手术史，术前诊断,和手术方法。在接受机器人辅助无淋巴结清扫的全腹腔镜子宫切除术的患者的亚组分析中，X和Xi之间没有显着差异（手术时间：X为199.0±26.5，Xi为221.5±45.1，p=.227；控制台时间：X为162.1±25.0，Xi为178.3±0.314，p=.314）。
结论：X和XidaVinci手术系统的围手术期结果相当。具有成本效益的X系统可以允许广泛使用机器人手术。
