Implementation of the Versius robotic surgical system for colorectal cancer surgery: First clinical experience.

Abstract

The Versius surgical system, from CMR Surgical, is the first UK-based robotic platform to become commercially available. This is a prospective series in accordance with the IDEAL development framework for surgical innovation reporting the clinical implementation and initial experience using this robotic platform. Patients with colorectal cancer were included. Exclusion criteria included T4 tumours, ultra-low rectal cancer and severe comorbidity (American Society of Anesthesiologists grade ≥ 3). Institutional ethical approval was obtained, and patients were counselled preoperatively with informed consent. Patients underwent colorectal resection using the Versius surgical system. Procedures were anticipated as hybrid operations (laparoscopic/robotic) consistent with a proof of concept/technical feasibility study. Main outcome measures included operative time, complication rates and pathological results. Thirty-two patients (15 men) underwent colorectal cancer resections. The mean age was 68years (27-85years). Estimated blood loss was 150ml; range <100to <500ml. For right hemicolectomy, the average operative time was 221min (183-323min). The average console time was 111min (64-213min). For robotic anterior resection, the total operative time was on average 319min (222-408min) with an average console time of 204min (85-242min). Eight patients experienced Grade II morbidities (22%) with no serious morbidities and no mortalities. Mean return to bowel function was 2.9days (1-6days). The average length of stay was 5.3days with a median of 4days (2-20days). All resections were R0 with an average lymph node yield of 20 nodes (8-46 nodes). Our initial experience with Versius demonstrates its safe adoption and implementation for colorectal resections.