The Use of the New Integrated Table Motion for the Da Vinci Xi: A Case of Combined Right Colectomy And Sigmoid Resection

Introduction: The Integrated Table Motion (ITM) is the new operating table developed by Intuitive, that works together via Bluetooth with the Da Vinci Xi surgical cart, so that it allows patient’ re-position without undocking the robot and with instruments inside the abdomen. We present a case of combined right colectomy and sigma resection using the new platform and its specific operating bed. Materials and methods: An 80-years old woman with an adenocarcinoma of the right colon and a polyp of the sigma resulted an tubulo-villous adenoma containing adenocarcinoma was referred to our center. She was operated on with Da Vinci Xi® platform with left lower quadrant trocar’ disposition shift to the left for both operation. Results: The procedure was successfully completed in 300 min. The patient position changed three times during the intervention with instruments left inside the abdomen and without undocking the robot. Firstly the patient was arranged 15° tilted to the left for right colectomy. Then for the ileocolic anastomosis, the right inclination was reduced to 5°. For the sigma resection, the robot was undocked and the boom rotated of 180° and the patient was arranged a in 20° Trendelenburg position and 15° the tilted to the right. No external collision or other problems related to the operating bed was noted. There were no surgical complications or a need for conversion to laparoscopy or laparotomy. The patient have an uneventful recovery and she was discharged from hospital after 8 days. Conclusions: The Da Vinci Xi® with the specific table motion seems to give some advantages in multi-quadrant surgery. In fact we were able to perform right colectomy and sigma resection with the same trocar’ disposition rotating the boom of 180°. Moreover, with the use of specific table motion the patient can be moved without undocking the robotic platform. These advantages can also reduce the overall operating time and make the procedure more fluid.